Wednesday, April 30, 2003

HEALTH ACCESS UPDATE
Wednesday, April 30th, 2003


* MAJOR ACCESS EXPANSIONS PASS SENATE INSURANCE COMMITTEE:

The Senate Insurance Committee considered and passed two major proposals to dramatically expand health care to millions of California families, and to stabilize an ailing health system for everybody. As of this writing, both bills are expected to move to the Senate Health Committee, possibly as early as next week.

** SB921 (Kuehl), would establish a universal health care system in California similar to Medicare. Senator Sheila Kuehl (D-Los Angeles) had a range of expert testimony, including John Shearer of the California Physicians Alliance and Betty Perry of the Older Women's League. Dozens of both local and statewide organizations stated their strong support. Insurance Commissioner John Garamendi testified in favor of single-payer universal coverage, and urged both bills to pass to move the debate forward.

Opponents included the CA Association of Health Plans, which criticized the bill because it "promises too much," that the stated administrative savings "defies belief," and that the bill would replace "private competition in favor of a monopoly." The CA Healthcare Association, representing hospitals, stated that the "risks associated with abandoning" the current system are not worth it. The CA Chamber of Commerce, and other employer and business groups, complained about the envisioned taxes. (Supporters restated that revenues raised would serve to replace the current expense of health premiums, deductibles, and other expenses.) The CA Association of Physician Groups stated that "a government-run system in not acceptable." Some health underwriters from around the state turned out, wearing buttons against SB921.

The bill passed out of committee 5-3, with the Democrats voting in support, and the Republicans opposing. Senator Jack Scott (D-Pasadena) abstained, and in discussion expressed his concern about the current need to raise significant revenues to deal with the budget crisis, and how that needed to be prioritized first, before raising revenues for this plan.

** SB2 (Burton/Speier) would require employers to provide health care to workers and their families, or pay into a fund that would provide such coverage. Senate President John Burton presented the bill, followed by two working yet uninsured Californians, a janitor in Sacramento, and a retail worker in a supervisory position at The Gap in San Francisco. In addition to testimony by leaders of the California Labor Federation and the California Medical Association, about two dozen consumer, community and labor groups indicated their support.

Opponents included a full range of business groups, including the Chamber of Commerce, National Federation of Independent Businesses, CA Small Business Association, CA Restaurant Association, CA Farm Bureau Federation, and the Western Growers Association. They indicated their opposition to additional mandates on employers, as well as additional fees, citing the unaffordability of health insurance, and the impact on current jobs and job creation. Blue Cross, also in opposition, argued that some employers would switch to self-insured health plans under the federal ERISA law.

The bill passed out of committee 6-3 on a party line vote, with Democrats supporting, and Republicans opposing.

** Health Access California strongly supports both bills, which are expected to go next to the Senate Health Committee. Contact information for each of the member Senators is available at http://www.sen.ca.gov. The members are:

Sen. Deborah Ortiz (D-Sacramento), Chair
Sen. Samuel Aanestad (R-Grass Valley), Vice-Chair
Sen. Richard Alarcon (D-Sun Valley)
Sen. Roy Ashburn (R-Bakersfield)
Sen. Jim Battin (R-La Quinta)
Sen. Wesley Chesbro (D-Arcata)
Sen. Martha Escutia (D-Whittier)
Sen. Liz Figeroa (D-Sunol)
Sen. Dean Florez (D-Shafter)
Sen. Sheila Kuehl (D-Santa Monica)
Sen. Gloria Romero (D-Los Angeles)
Sen. John Vasconcellos (R-Santa Clara)
Sen. Edward Vincent (D-Inglewood)


* BUDGET ACCOUNTABILITY ACT UPDATE:

Health Access California and other organizations continue to seek additional supporters for the Budget Accountability Act, a proposed March 2004 initiative which would hold the Governor and Legislature more accountable to taxpayers in order to produce more responsible and timely State budgets.

CHAMBER FILES "STATUS QUO" OPPOSITION MEASURES: In the last week, the California Chamber of Commerce filed no fewer than five initiatives that would work to block reforms proposed in the Budget Accountability Act and keep California in budget gridlock. The purpose of these initiatives was explicitly stated in their text: “(d) Those who favor the status quo have a right to resist such efforts by placing competing measures on the ballot.” All five of the Chamber’s "status quo" initiatives contain “poison pill” provisions designed to kill the Budget Accountability Act. We expect that opponents of the Budget Accountability Act would collect signatures on behalf of one of these five proposals they have submitted.

BUDGET ACCOUNTABILITY ACT TO BE REFILED: In response, proponents of the Budget Accountability Act will withdraw the current initiative before circulation and will refile the initiative with new language to counter the “poison pill” provisions as soon as possible. The principles of the act will be maintained. We continue to seek organizational endorsements and other support to back this important effort.

The Budget Accountability Act, although not formally in circulation, has already received favorable editorial support of its major provisions from both the San Diego Union Tribune and the San Jose Mercury News. It is supported by the California Congress of Seniors, the League of Women Voters of California, Health Access California, California State Parent Teachers Association, and labor unions from across the state.

Provisions include denying pay to legislators when the budget is late, and prohibiting legislative action on other items until a budget is passed; setting the threshold to pass a budget at 55% of the legislature; providing information to voters about the budget and their legislators' votes; and maintaining a "rainy day" fund during good economic times to prevent major cuts in recessions. More information will be distributed as we move forward.

--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 7:33 PM


 

Tuesday, April 29, 2003

HEALTH ACCESS UPDATE
Tuesday, April 29th, 2003

* BUDGET: Assembly Republican Reveal Budget Plan
* ACCESS EXPANSION: Assembly Health Committee Passes Major Proposals
* LEGISLATION: Other Health Policy Bills Considered


REPUBLICAN BUDGET CUTS PLAN REVEALED

This afternoon, Assembly Minority Leader Dave Cox announced a budget plan sponsored by the Assembly Republican Caucus. While more specific than the Senate Republican proposal announced a few months ago, the Assembly Republican plan also seeks to:
* accept most of the Governor's proposed cuts,
* avoid raising revenues,
* shift a major part of the burden of the deficit into future years, and
* impose a spending freeze in the subsequent budget year.

The plan would restore some of the Governor's proposed cuts, but make many other additional reductions that have a similar, if not more damaging effect (see below). They are also pushing for other reforms, from a stricter state spending cap, to the removal of various mandates and regulations on employers. Ironically, even though the plan would refinance around $10 billion of the deficit, it would "limit future deficit financing." The press release, with some of the details, can be found at the Assembly Republican Caucus web site, at:
http://republican.assembly.ca.gov/news/archived/newsletter344.html

HEALTH IMPACTS: SOME GOOD, BUT LOTS OF BAD, AND EVEN MORE UGLY: In terms of health care, the proposal states that the "Assembly Republicans reject specific provisions of the Governor's Budget based on severe consequences on public services. Overall reductions need to be made while being mindful of the compassion for the truly needy." Specifically, the proposal emphasizes the restoration of three key health care cuts. It would:
* Reject the proposed cut to "1931b" cut that would have lowered eligibility for parents from 100% to 61% of the federal poverty level, which would deny coverage to around 300,000 low-income working parents in the first year, and hundreds of thousands more afterwards.
* Reject the proposed 15% Medi-Cal rate reductions to doctors, nursing homes, and other providers.
* Reject the proposed elimination of dental benefits to 2.8 million adults on Medi-Cal, but instead cap dental benefits at $1,000 per individual, and place other utilization controls.

THE BAD: At the same time, the Assembly Republican proposal would keep all of the rest of the proposed health cuts, including the institution of quarterly status reports, and the elimination of 17 medically necessary benefits, from disposable medical supplies to hospice care to wheelchairs to prostetic limbs.

It would also add a full range of additional cuts, some of which would deny basic health care to hundreds of thousands of Californians, mostly children. Health Access California will provide analysis of the impact of these cuts in the near future. Some of the new cuts proposed by Assembly Republicans would:

* Rescind continuous eligibility for children ($76M)
* Eliminate accelerated enrollment for children ($6M)
* Eliminate the Child Health and Disability Prevention Program (CHDP) Gateway ($57M)
* Eliminate state-only health programs ($183M)
* Require co-payments for Medi-Cal recipients ($31M)
* Exclude over-the-counter drugs from Medi-Cal coverage ($8M)
* Place new people with disabilities in Medi-Cal into managed care ($1M)
* Place new seniors in Medi-Cal into managed care ($69M)
* Reduce Medi-Cal county administration by 20% ($110M)
* Cut Expanded Access to Primary Care funding to community clinics ($10M)
* Impose a moratorium on new adult day health centers ($30M)
* Accept President Bush's Medicaid block-grant proposal that would provide some help now but force major cuts in Medi-Cal in future years. ($390M)

THE UGLY: There are other health care cuts as well, both explicit and implicit. In particular, the proposal calls for a spending freeze in 2004-05, and a strict spending cap afterwards. Given that health care costs rise greater than the rate of inflation, such a freeze would translate into an immediate and steep cut into health care. While such cuts are unspecified, the cuts would have to result in even more people losing coverage and care, having benefits scaled back for those still in public health programs, and reductions in reimbursements to health care providers that we all rely on.


MAJOR ACCESS EXPANSIONS PASS ASSEMBLY HEALTH COMMITTEE

The Assembly Health Committee, chaired by Assemblyman Dario Frommer, considered and passed three bills to significantly expand health coverage in California. While different committee members and organizations expressed concerns about specific provisions in each of the proposals, the sentiment was to move the bills forward to advance the discussion. With the expectation that SB2 (Burton) and SB921 (Kuehl) will move in the Senate through committee tomorrow, Chairman Frommer suggested that he wanted the Assembly to have vehicles of its own. He even suggested that these bills, if passed by the Assembly, may then be send to a Conference Committee with any of the bills that pass the Senate.

The "trilogy" of bills included:

* AB 1527 (Frommer) would require employers with 51 or more employees to provide health care to their workers, or pay into a fund that would provide such coverage. It includes an idea borrowed from Rhode Island that would use Healthy Families matching money to subsidize employer-sponsored health care. The bill was (generally) supported by Health Access California, California Medical Association, California Healthcare Association (hospitals), California Association of Health Underwriters, Kaiser, Blue Shield, Jericho, and others. It was opposed by the California Chamber of Commerce and the National Federation of Independent Businesses.

* AB 1528 (Cohn), sponsored by Blue Shield, Kaiser, and the California Healthcare Association, also includes an employer mandate, as well as a range of other provisions, including a subsidy for employers and individuals to buy health insurance, the definition of an "essential benefits package," and "community rating" market reforms. The California Chamber of Commerce and National Federation of Independent Businesses opposed. Health Access California did raise opposition to two provisions: the mandate on individuals to purchase health care without any guarantee that it would be affordable and available; and the current definition of the benefit package that is substantially narrower that what is currently defined.

* AB 30 (Richman) would not require participation by employers, but would use state and federal Healthy Families dollars to match employer and employee contributions to cover childless adults up to 250% of the federal poverty level. The bill was supported by the California Medical Association and California Healthcare Association and others. Health Access California raised opposition to a recent amendment that would allow these Healthy Families dollars to subsidize "high deductible catastrophic coverage," setting a dangerous precedent in terms of what level of benefits are acceptable for low-income people.


OTHER ASSEMBLY HEALTH COMMITTEE ACTIONS

Into the night, the Assembly Health Committee also acted on a full range of other important proposals. Bills of note included:

* AB1163 (Frommer), sponsored by the 100% Campaign, which would increase the retention of children in Medi-Cal and Healthy Families plans. The preliminary vote total was 19-5, with all Democrats and several Republicans supporting the proposal.

* AB910 (Diaz), supported by Health Access California and other consumer and labor organizations, would establish an Attorney General review process for downgrades or closures of hospitals, to ensure oversight over hospitals regarding market concentration. Opposed by California Healthcare Association, Kaiser, and Sutter Health, the bill passed on a party-line vote.

* AB1627, AB1628, AB1629 (Frommer), is a package of bills that would provide transparency and disclosure to hospital costs and billing practices. Opposed by hospitals yet supported by Health Access California and many consumer and labor organizations, the bills were passed on largely party-line votes.

* AB1401 (Wolk) was scheduled but not brought up for consideration, and is not expected to proceed this year. This bill, was sponsored by the California Healthcare Association and actively opposed by Health Access California, Western Center on Law and Poverty, Consumers Union and others. The bill would have established a definition of "charity care" that would have continued to allow anti-consumer billing practices to the uninsured hospital patients. A preferred bill with strong consumer protections for uninsured hospital patients, AB232 (Chan), passed the committee earlier in the year.

--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 10:54 PM


 

Friday, April 25, 2003

HEALTH ACCESS UPDATE
Friday, April 25, 2003


* ACCESS EXPANSION PROPOSALS AMENDED, SET FOR HEARINGS NEXT WEEK: For the first time in a decade, the California Legislature next week will be considering multiple proposals to comprehensively expand access to health care. The Assembly Health Committee will consider AB 1527 (Frommer), AB 1528 (Cohn), and AB 30 (Richman) in its session on the afternoon of Tuesday, April 29th. The Senate Insurance Committee will consider SB 2 (Burton) and SB 921 (Kuehl) at 3:00pm on Wednesday, April 30th.

Each of the mentioned Assembly bills have had substantive amendments in the last week. ATTACHED is a UPDATED chart of access expansions that summarizes and compares all the various proposals in their amended form, and indicates the position of Health Access California. Also ATTACHED are talking points for advocates of both SB 2 and SB 921, which go into the basic facts on the uninsured crisis, and how these bills build upon proven solutions.


* ASSEMBLY BUDGET DEAL CLARIFICATION: As reported yesterday, among the proposed cuts in the Assembly Democratic "April" plan is a $50 million cut to adult dental coverage, as opposed to full elimination of the benefit. This reduction would be acheived through a series of cost-savings measures, including: using stainless steel crowns as opposed to porcelain for posterior teeth; limiting access for "deep cleanings" to institutionalized individuals; requiring the need for X-rays for reimbursements of treatments of cavities; and other items. As of this writing, the reduction does *not* include a cost cap on the individual dental care, as previously reported.

The content of the list of cuts is still in flux. Advocates for the uninsured should continue to communicate their concerns about the possible inclusion of direct cuts to Medi-Cal patients, such as quarterly status reports and optional benefits. As of this writing, these are not in the package of cuts, but the situation is fluid.


* UPCOMING EVENTS OF INTEREST:

* Thu. May 1st-May 3rd: CONFERENCE: “Moving Beyond Health Disparities Into Wellness.” 22nd Statewide Black Health Conference. Renaissance Los Angeles Hotel, 9620 Airport Blvd., Los Angeles. For more information, contact: 619-295-5413.

* Wed. May 7th: SENIOR RALLY: “Save Our Safety Net” rally organized by multiple senior organizations, including AARP, California Commission on Aging, California Legislative Council for Older Americans, Congress of California Seniors, Gray Panthers, Older Women’s League, and others. 10am-3pm. West Steps of the State Capitol, Sacramento. Contact: Nina Weiler at nina.weiler@aarp.org.

* Wed. May 15th: LOBBY DAY: Women in Action Lobby Day: “Access to Health Care: Do We Have It When We Need It?” Welcome by Senator Deborah Ortiz; Keynote Speech by Rose Ann DeMoro, Executive Director, California Nurses Association. 8:00am-4:00pm. Sheraton Grand Sacramento Hotel, 1230 J Street, and the State Capitol, Sacramento. For more information, go to www.wiald.org, or contact Rosemary DaSilva, California NOW, (916)442-3414, pad@canow.org.

--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org

Labels: Updates

posted by Anthony Wright | Permalink | 8:15 PM


 

HEALTH ACCESS UPDATE
Thursday, April 24th, 2003

* ASSEMBLY CONSIDERS ADDITIONAL CUTS IN NEW PACKAGE

The Assembly Democratic Caucus, including Speaker Herb Wesson (D-Los Angeles), is considering a budget package that would include the sale of bonds to pay the state's yearly contribution to the pension funds of state employees, teachers, and others. In order to attract support from the Republican Caucus, Wesson has crafted a bigger "package of solutions," that includes the "pension obligation bond," as well as $2.5 billion in "cuts and deferrals," and $1.2 billion in "fund shifts, fees, tranfers, and loans."

This would include $493 million in cuts to health and human services, including:
* $194 million "savings" through new "performance standards" for county redeterminations of Medi-Cal patients. These new measures are intended to get counties to be more aggressive in finding and disenrolling ineligible people from Medi-Cal (with no similar performance standards for the necessary work of enrolling eligible people). The administration estimates that over 590,000 people would be denied Medi-Cal coverage under this effort.
* $50 million cut to dental coverage for the 2.8 million adults in Medi-Cal, who would now have a $1,000 cap to their dental expenses. The Governor's proposal was to eliminate Denti-Cal entirely.
* $20 million cut in eliminating outreach and media campaign funding for various health programs, such as on teen pregnancy.
* $124 million in smaller health and human services cuts, including the elimination of the Rural Health Demonstration Project ($3 million) and other service cuts.

Over the past couple of days, this list of reductions has also included the institution of quarterly status reports (QSRs) for adults on Medi-Cal; and additional (unspecified) "optional" benefits. While QSRs are not on the list at this writing, the issue is still very much in discussion. The burdensome requirement of QSRs is estimated by the Administration to deny around 200,000 Californians health coverage under Medi-Cal in the first year, and hundreds of thousands more in future years.

ACTION: Direct phone calls and faxes to Speaker Wesson and other legislators to oppose the inclusion of quarterly status reports--or other eligibility or reporting changes that would deny basic health coverage to California families--in any budget deal. Those who write or call should also emphasize their ongoing support for a balanced solution that includes increased revenues to prevent cuts to vital services. This is a urgent request, as the Assembly needs to act on the pension obligation bond issue in the next week, before May 5th, in order to get maximum savings. Speaker Wesson's phone number at the Capitol is 916-319-2047; the fax number is 916-319-2147.


* HELP JANITORS AND THEIR FAMILIES GET BASIC HEALTH COVERAGE

Across the nation, janitors find themselves working full days and nights, and yet struggling to stay above poverty. This spring, many California janitors will head to the bargaining table with employers to try to improve their wages and their health coverage for their families. In Sacramento, janitors do not have family health benefits, and are seeking support to win. With take-home pay at around $1,000 per month, insurance is out of reach for most, forcing many janitors to choose between medical care, food and housing for their families.

Organizations can support the janitors' fight for health coverage by signing the ATTACHED support form for the janitors, as part of the campaign by the Service Employees International Union (SEIU) Local 1877.

Those in Sacramento can show their support by coming to a PUBLIC FORUM, on this Saturday, APRIL 26th, from 1pm to 3pm, at the Church of the Immaculate Conception, 3263 1st Avenue. ATTACHED is a relevant flyer. The forum will include CA Secretary of Health & Human Services Grantland Johnson, Assemblyman Darrell Steinberg, and local elected and religious leaders. Similar events in other parts of the state have been important and inspirational, and are highly recommended.

Labels: Updates

posted by Anthony Wright | Permalink | 8:15 PM


 

Digging a bigger whole for reform...

 

Scoring at home...

 

We are hiring, to make a difference...

 

Field Poll: strong opposition to the health cuts.....

 

An Unhealthy Trend

 

Dressing up the Individual (Market)

 

A great debate on the great divide...

 

Jones to be chair of Health Committee...

 

Bass on the budget...

 

Pretty soon, the insureable will be a pretty exclu...