SACRAMENTO — While much of the country is gearing up for the holidays, political forces in Sacramento are girding for battle.

Already, special interests are lined up with plans that could shape next year’s general election ballot. They are considering propositions to increase medical malpractice awards, hike tobacco taxes and give local governments the right to scale back public employee pensions, among other ideas.


Each of the proposals could spawn campaigns costing tens of millions of dollars. Decisions about whether to proceed will be made in the next couple of weeks as de facto deadlines loom.

Some propositions have already qualified for the November ballot. One would allow the state insurance commissioner to veto proposed increases in healthcare premiums, as he now can with auto policies. Another is a referendum on a new Central Valley casino project approved by Gov. Jerry Brown this year.


Votes are also scheduled on a multibillion-dollar water bond and a limit on state spending. But those measures were placed on the ballot by the Legislature and could change, because lawmakers are not bound by the same rules or deadlines as initiative sponsors.

The interest groups behind the proposed initiatives have submitted their plans and a $200 check to the state attorney general, who reviews and titles them. Then proponents have 180 days to gather more than 500,000 valid signatures in favor of placing the measure on the fall ballot.


Getting the petitions signed requires a large investment — typically $1 million or more to pay signature collectors. The petitions must be validated by the secretary of state by mid-June. That usually means starting the signature-gathering by mid-December and finishing in early spring.

“It usually takes about a year to get everything together, so now is absolutely the time to get going,” said Matt Rexroad, a Republican political consultant and veteran of several initiative campaigns.


A fight over medical malpractice awards would be one of next year’s biggest election battles. It would pit lawyers against doctors — two influential interests that spend hundreds of thousands of dollars on politics in Sacramento each year.

The proposal’s supporters, which include the Consumer Attorneys of California, want to raise the limit on what juries can award victims of medical malpractice from $250,000 to slightly more than $1 million. As part of the same measure, they also would require that hospitals perform random drug tests on physicians.


Jamie Court is president of the advocacy group Consumer Watchdog, which is backing the malpractice proposal. He said there is “absolutely 100% commitment to gather the signatures and go forward.”

A coalition of doctors, hospitals and insurers is preparing to mount an opposition campaign. The group has hired Democratic political consultant Gale Kaufman, a veteran of major initiative fights, to help them beat back the measure if it goes ahead.


Kaufman helped lead teachers and other labor groups in their defeat of ballot measures pushed by Gov. Arnold Schwarzenegger in 2005.

Proponents have retained Chris Lehane, former press secretary for Al Gore and half of the crisis communications team known as the “Masters of Disaster,” to advise their side.


Other potential ballot fights could also be costly.

An expansion of the insurance commissioner’s powers — sponsored by Court’s group — would no doubt be vigorously opposed by health insurance companies. The firms are among the largest donors in state politics and have spent millions warring against past initiatives.


Health groups are weighing a proposal that would hike cigarette taxes by $1 to raise money for cancer research. The same groups, including the American Heart Assn. and American Lung Assn., lost a similar effort in 2010 after a $50-million opposition campaign by tobacco companies.

The proposed repeal of state permission for a controversial tribal casino in the Central Valley could attract significant spending from competing tribes and other gambling interests on both sides of the issue. In 2008, a consortium of large tribes with casinos spent more than $80 million defeating referendums on their gambling deals.


A bipartisan coalition of mayors has drafted a proposed constitutional amendment that would give local governments more power to curb employee retirement benefits. The measure would allow cities and counties to negotiate reductions in future benefits for current employees, something Brown has said he believes is not allowed under existing state law.

The mayors’ effort received $200,000 in seed money from a group funded by Texas billionaire John Arnold, a former hedge fund manager. The proposal is strongly opposed by deep-pocketed employee unions.


The measure’s sponsor, San Jose’s Democratic Mayor Chuck Reed, has suggested he may wait on it until 2016. But if the effort goes forward, it could attract big money from across the country on both sides of the issue.

Aside from special elections, initiative battles in California used to come twice in even-numbered years, on both the primary and general-election ballots.


But a law signed by Brown in 2010 bars initiatives from primaries, on the grounds that fewer voters participate in such exercises than in November general elections — and new laws should be voted on by as many people as possible.

The change also gave Democrats an electoral advantage, because more of their party members typically turn out for general elections than for primaries.


In crafting the law, Sacramento reserved the right to place propositions on the June ballot.

anthony.york@latimes.com