California voters, after a $132 million scorched-earth advertising campaign, rejected a labor-backed statewide cap on dialysis providers’ profits.

The country’s largest dialysis companies pumped $111.46 million into defeating Proposition 8, including $66.9 million from DaVita Inc. and $40 million from Fresenius Medical Care North America. The two companies operate 72 percent of the state’s 588 dialysis clinics, the nonpartisan California Legislative Analyst’s Office said.

Service Employees International Union-United Healthcare Workers West infused $20.37 million to support Prop 8, which it contends targeted inadequate patient care, staffing, and safety at the clinics. The initiative would’ve capped charges to 15 percent above costs.

The union promises it will return in two years and expand the effort. “This is only the beginning; we are in this for the long haul. We intend to re-file this initiative for the 2020 ballot in California, and we are preparing to bring it to other states in the 2020 election cycle,” dialysis patient care technician Emanuel Gonzales, whose father is also a dialysis patient, said in an SEIU-UHW statement Nov. 6.

The Ohio Supreme Court in August blocked SEIU from a signature-gathering drive to place a dialysis charge cap on the ballot.

Peter Grauer, chairman of Bloomberg Law’s parent company, is a member of DaVita’s board of directors.

Voters in two San Francisco Bay Area cities also trashed local caps on health-care charges in what turned out to be a good night for health care companies and a bad night for labor. The proposals would have limited how much doctors and hospitals can charge for patient care.

Massachusetts Rejects Nurse Staffing

Massachusetts voted overwhelmingly against requiring hospitals to hire many more nurses, after a year of high-pitched battling between a nurse’s union and hospitals.

Voters rejected the measure 70 percent to 30 percent on election night. The heavily-lobbied issue would have required hospitals to hire enough nurses so that each nurse would care for between one and five very ill patients, instead of the eight very ill patients each nurse cares for on average today.

The Massachusetts Nurses Association was dealt a blow in October, when a state policy board released a report that estimated the ballot measure would make hospitals hire an additional 2,286 to 3,101 full-time registered nurses, drive up the hourly rate for nurses, and cost $900 million each year if it were implemented.

The union had lobbied on the issue for more than a decade and will continue the effort, Donna Kelly-Williams, president of the Massachusetts Nurses Association, said Tuesday night in a speech conceding defeat.

“Tomorrow is a new day, and we’ll awaken, ready to continue the fight for our patients,” Kelly-Williams said.