Tuesday, July 29, 2003

HEALTH ACCESS UPDATE:
Tuesday, July 29, 2003


BUDGET PASSES ASSEMBLY; NOW HEADS TO GOVERNOR
* Cuts Now, Next Year, Into the Future


After the "longest legislative day in the history" that extended from yesterday morning through the night into this evening, the state Assembly passed a budget, AB1765, by a vote of 56-22. The health trailer bill, AB1762, passed by a vote of 54-22. The Assembly adjourned afterward until mid-August. The budget will head to the Governor, who is expected to sign it in the next week.

On the main budget, the unofficial tally has most Democrats supporting the bill, along with Republican Assemblymembers Aghazarian, Benoit, Cogdill, Cox, Daucher, Dutton, Harman, Shirley Horton, Houston, Leslie, and Maze. All other Republicans present voted no. Democratic Assemblymembers Dutra and Canciamilla voted no. Assemblymembers Firebaugh and Maddox were absent/excused for the session.

On the health trailer bill, most Democrats supported the bill, with the exception of Assemblywomen Cohn and Chan that voted against it, and Assemblymembers Dutra and Goldberg that abstained. Most Republicans voted no, with the exception of 11 who supported it, including Aghazarian, Benoit, Cogdill, Cox, Daucher, Dutton, Garcia, Harman, Shirley Horton, Leslie, and Maze.

This was virtually identical to the budget passed by the Senate on Sunday night, July 27th, by a vote of 27-10. The budget had the support of most Democrats, as well as Republican Senators Ashburn, Brulte, Johnson, Knight, and McPherson. All other Republican Senators voted no. Democratic Senators Alarcon and Soto abstained and Senator Vasconcellos was absent.

With the discussion taking place behind closed doors, the public debate in both houses was minimal. In both houses, the Democratic leadership successfully requested that at least a third of the Republican caucuses (5 of 15 Senators; 11 of 34 Assemblymembers) vote in support, since the budget met the main Republican demand that it not include increased taxes.

ATTACHED is our revised and updates Health Budget Cuts Scorecard, which indicates the health cuts made in this Senate Budget Deal, as well as those in previous rounds.

COMMENT ON HEALTH CUTS: Seniors, children, and all hospital patients will have their health care negatively affected by this budget, now, next year, and into the future.
* Already half of all doctors won't provide care to the 6.5 million Californians with Medi-Cal coverage, and this budget cuts rates by 5% so even more doctors will refuse to care for these children, seniors, and people with disabilities.
* Next year, this budget proposal would make significant cuts to nursing homes, hospitals, and Healthy Families plans. The Senate has approved a spending freeze on these caregivers without a single hearing on the impacts. While we do not know the specifics, care will be compromised to seniors, children, and all hospital patients.
* By not raising revenues, the Legislature just postponed the worst of cuts for next year's budget crisis, where we are projected to have an approximately $8 billion deficit. We have squandered an opportunity to ask everyone, including high-income earners, to share in the solution. While legislative leaders correctly stood against many cuts that would directly deny needed care to California families, they neglected to use this opportunity to find a long term solution to the budget crisis--and remove the continued threat of additional health cuts.

--
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 | 6:15 PM


 

Friday, July 25, 2003

HEALTH ACCESS ALERT:
Friday, July 25th, 2003

SENATE BUDGET DEAL SLATED FOR CONSIDERATION ON SUNDAY;
INCLUDES HEALTH CUTS NOW AND IN THE FUTURE

As of this writing, the Senate is expecting to consider and vote on a budget proposal during a Sunday night session starting at 6:00pm, although that is subject to change. If that takes place, the Assembly is expected to start its consideration of the budget package on Monday.

HEALTH CUTS: While there is no written documentation that has been made public as of this writing, Health Access understands that the proposed Senate budget deal would cut just over $100 million dollars in Medi-Cal health insurance program, and would freeze some health care spending in next year's budget. We will report further details when we get final documented verification.
* PROVIDER RATE CUT: The main cut is a 5% across-the-board rate reduction to providers in Medi-Cal (and some other programs like California Childrens Services and state-only Family PACT). Starting January 2004 and lasting for three years, this would mostly affect doctors, as long-term care providers and clinical labs are excluded. This adds up to a cut of $87 million general fund dollars. Over half of California's doctors already decide not to serve the 6.5 million children, seniors, and people with disabilities on Medi-Cal; this will mean that it will be even harder for these patients to access a doctor or specialist.
* OTHER REDUCTIONS: Contrary to prior reports, NO Medi-Cal benefits will be eliminated. There are some cost-containment measures, including on hearing aids and on rental equipment, that each provide about a half-million dollars of savings. Other reductions are assumed, including a $6.2 million savings from better collection of child support for medical expenses, and a $6.1 million savings from the mental health portion of the EPSDT program.
* FREEZES NEXT YEAR: For the next budget year, in 2004-05, the budget would assume a freeze in Medi-Cal rates to long-term care institutions, Medi-Cal rates for hospital inpatient services, and the rates of Healthy Families vision, dental, and health plans. Given that health costs are expected to go up in double-digit figures, this translates into a significant cut and will have a real impact on access and quality of care to seniors, children, and all who use safety-net hospitals.

THE BOTTOM LINE IMPACT: The cuts made are serious: with the cut to medical providers, the 6.5 million children, seniors, and people with disabilities on Medi-Cal will have a harder time finding a doctor or specialist to serve them. These impacts will be worse next year, when additional cuts to nursing homes, hospitals, and the Healthy Families program come into effect.

FUTURE IMPACTS: By not raising revenues, the Legislature is simply postponing the worst of cuts for next year's budget crisis, which already in projected to have a $8 billion deficit. By passing this budget, we have squandered an opportunity to ask everyone, including high-income earners, to share in the solution. While legislative leaders have appropriately stood against cuts that would directly deny needed care to California families, they are neglecting to use this opportunity to find a long term solution to the budget crisis--and remove the continued threat of additional health cuts in the imminent future.

--
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 | 5:35 PM


 

Monday, July 14, 2003

HEALTH ACCESS UPDATE
Monday, July 14, 2003


SENATE TO VOTE ON SENATE REPUBLICAN BUDGET
PROPOSAL WOULD DENY HEALTH COVERAGE TO HUNDREDS OF THOUSANDS OF CHILDREN;
DENY PRESCRIPTION DRUGS TO LOW-INCOME SENIORS AND PEOPLE WITH DISABILITIES

The Senate is scheduled to vote tomorrow, Tuesday, July 15th, on a budget proposal by the Senate Republican Caucus. In order to avoid increasing revenues, this plan would cut an additional $2.7 billion from the plan (AB1769) proposed by Senate Democrats in late June.

SIGNIFICANT HEALTH CUTS: The Senate Republican plan would make it much harder for California seniors, children, and families to get the care they need. Cuts of note:

* CHILD HEALTH COVERAGE: Rescind continuous eligibility for children ($76M; $175M in 05-06). This would endanger continuity of care for the 3 million children in Medi-Cal, and the loss of coverage for eventually up to 471,500 children, who would drop off health insurance when the circumstances of their parents change.

* BENEFITS: Eliminate or reduce various medically necessary Medi-Cal benefits ($693M), in some cases beyond what has been proposed by anybody previously.
* PRESCRIPTION DRUGS: Half of the savings of this proposal would be to reduce prescription drug coverage to the 3 million adults, seniors, and people with disabilities with Medi-Cal coverage by 25%. It is unstated how such a savings would be generated, but such a large reduction would need to involve denying patients medically necessary prescription drugs, including anti-psychotics, insulin, pain medications, treatment for HIV and AIDS, many cancer medications, anti-biotics and other life-saving and life-maintaining prescriptions. Such a reduction would also cause additional hospitalizations, which would probably cost more than any booked savings.
* ELIMINATION OF BENEFITS: This proposal would also eliminate many benefits for the roughly 3 million adults on Medi-Cal, including acupuncture, family nurse, independent rehab facilities, heroin detox centers, occupational therapy, psychology, speech & audiology, and hearing aids.
* REDUCTION OF BENEFITS: This proposal would also cut in half (50%) the following benefits: dental, chiropractic, podiatry, opticians & optical labs, physical therapy, orthotics, adults day health care, and medical supplies such as diabetic test strips, catheters, and asthma supplies. Optometry would be cut by 75%. Outpatient clinics, and durable medical equipment like wheelchairs, crutches and oxygen tanks would be cuts by 25%. Again, it is unstated how these changes would be affected, but it would have to include denying medically necessary benefits to some populations.

* COMMUNITY CLINICS: Reduce many health programs, including the Expanded Access to Primary Care Program, the Indian Health Program, the Seasonal, Agricultural, and Migratory Worker Program, and other crucial funding sources for community clinics on which many areas depend.

* MANAGED CARE SHIFT: Force newly-applying Medi-Cal seniors & people with disabiltiies into managed care, which may end up costing more money yet restricting care for these populations.

--
Anthony E. Wright
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 | 7:04 PM


 

Tuesday, July 08, 2003

HEALTH ACCESS UPDATE
Tuesday, July 8, 2003


REPUBLICAN BUDGET PLAN CONSIDERED; BUDGET DIVISIONS GROW SHARPER

On Sunday, June 6th, after about four hours of debate, the full Assembly voted down the budget presented by the Assembly Republican Caucus, on a party line vote of 27-45. Assembly Budget Committee Vice-Chair John Campbell remarked that it was the first time in recent memory that a minority party was allowed to bring "a complete and total budget bill" to the floor. He argued that it was only a 4.2% decrease in spending from last year's budget, and that it protected priorities of "education, public safety, and transportation," and put "people ahead of bureaucrats."

ATTACHED is a UPDATED BUDGET CUTS SCORECARD that includes the status of the selected proposed cuts in both the Governor's May Revise and the Assembly Republican Plan. This includes updated details and clarifications on the Assembly Republican Plan.

The debate was sharp, with Assemblymembers Chu, Jackson, Cohn, Frommer, Goldberg, Oropeza, and others specifically deploring the steep health cuts that the Assembly Republican plan would entail. Many talked about cuts in other areas, from human services to education, from funds for foster care burials to the delay in having children enter kindergarten. Others complained that many of the cuts were unallocated, and thus not specific enough to show the real impact, either in savings to the budget or in the change in services.

Half of the Assemblymembers ended up speaking during the debate, twenty from each party. Of the Assembly Republicans, the following spoke, in favor of the Republican plan and the cuts contained within: Campbell, Mountjoy, Leslie, La Suer, Strickland, Bates, Bogh, Haynes, Runner, Plescia, Aghazarian, McCarthy, Maze, Wyland, Samuelian, La Malfa, Houston, Keene, Pacheco, and Minority Leader Cox.

Of interest and in a break with party lines, five Republicans abstained on voting for the Republican plan, including Bonnie Garcia (R-Cathedral City), Shirley Horton (R-Chula Vista), Keith Richman (R-Northridge), Lynn Daucher (R-Brea), and Abel Maldonado (R-Santa Maria). Others Republican members that voted for the plan but did not speak during the debate include: Maddox, Nakanishi, Cogdill, Dutton, Harman, Benoit, and Spitzer.

All Democratic members voted against the plan, except for Canciamilla who abstained, and Firebaugh and Ridley-Thomas who were not present for personal reasons.

--

BUDGET ACCOUNTABILITY ACT HITS THE STREET

On Thursday, July 3rd, a coalition of organizations declared "Independence from Budget Tyranny," and announced support for the Budget Accountability Act, to hold legislators accountable for timely and responsible budgets. Decrying that legislators were not working through the holiday to pass what is already a late budget, the groups discussed their push to put the Budget Accountability Act on the March 2004 ballot. For more information about the initiative, go to www.budgetaccountabilitynow.org.

GET PETITIONS: Petitions are on the street, and Californians for Budget Accountability is looking for help in collecting the more than 600,000 signatures needed. If you or your organization can help gather signatures between now and mid-August, contact the Cristina Uribe at the campaign at 916-443-7817, including if you want to receive petitions for circulation.

JOIN OTHER SIGNATURE-GATHERERS: You and/or your organization can also link up with other volunteer signature-gathering operations, with Health Access California and other entities. For example, SACRAMENTO ADVOCATES are enthusiastically invited to meet with other volunteers EVERY SATURDAY MORNING until August 16th, 2003, at 9:00AM at the Sacramento Central Labor Council, 2840 El Centro Road, Sacramento, CA. Those who come will get a quick training and be sent with others to key "hot spots" in the region to gather signatures. For more information, contact Ali Cooper, at 916-541-4810., or ali@sacramentolabor.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 | 12:01 AM


 

Tuesday, July 01, 2003

HEALTH ACCESS ALERT
Tuesday, July 1, 2003


IT'S ORGANIZING TIME FOR HEALTH EXPANSION BILLS

Today, with minimal fanfare, SB 2 (Burton) was considered and passed out of the Assembly Health Committee. While the effort is to require employers to provide health care to their workers and their families, the bill currently only includes intent language, and is moving along the legislative process with the expectation that it will reach a conference committee with three Assembly bills that are currently moving through the Senate. It is likely that such a conference committee would meet and finalize details of a proposal during the July-August recess. Support was stated by the CA Labor Federation, CA Medical Association, Health Access, Genentech, CA Association of Public Hospitals, Congress of CA Seniors, Blue Shield, CA Healthcare Association, and the Alliance for Catholic Health Care. Opposition came from the Chamber of Commerce, National Federation of Independent Businesses, and other lobbyists representing small businesses, restaurants, and others.

Yesterday, Senator Sheila Kuehl announced that she "made a strategic decision that I believe will improve the possibility of getting a 2/3 vote in favor of SB 921 on the Assembly floor." SB 921, which would establish a universal, single-payer health care system in California, will "not be heard in Assembly Health Committee... during the current legislative" year. With legislative attention focused on the budget crisis and the need "to further craft the details of the reform," she asks that "the time between now and January must be used to build support for SB 921." In addition to holding hearings later in the fall, the Senator stated that "the interim presents an excellent opportunity for constituents to reach legislators who are in their districts for the break."

This is an important time for additional organizing during this time when the details get worked out for these two important bills. More information will be forthcoming on advocacy actions and recommendations on behalf of both bills.

--
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 | 6:24 PM


 

HEALTH ACCESS ALERT
Tuesday, July 1, 20031


NEW REPUBLICAN BUDGET RELEASED WITH NEW CUTS TO HEALTH

Another new fiscal year, another year without a budget in place...

Yesterday, the Assembly Republican Caucus has released a new version of their budget plan. This was in response to a challenge by Assembly Democrats on Friday, which put a version of their previous plan on the floor for a vote, which did not get any votes. The Assembly Republicans disavowed that version, saying it did not reflect changes from May Revise and economic factors, and thus worked over the weekend to release this new document. The plan may come up for a vote later this week. Assembly Minority Leader Dave Cox's statement is at:
http://republican.assembly.ca.gov/news/archived/NewsLetter356.html

The major thrust of the proposal is once again to cut, borrow, and make many budget adjustments short of raising revenues. The plan rejects the proposals to increase the sales, tobacco, and upper-income taxes, and also includes a range of other new restrictions, including a balanced budget amendment, the limiting of future deficit financing, local government mandate reform, a spending cap, "fee reform," "inmate health care reform," and local government protection. The plan lists additional cuts in many areas, with significant new cuts in health.

SIGNIFICANT HEALTH CUTS: The proposal would make it harder for families to be eligible for coverage, to enroll to get coverage, to stay on coverage, and to actually get medically necessary services and care. Cuts of note would:

* HEALTHY FAMILIES: Rescind Healthy Families coverage for over 50,000 children by dropping the eligibility from 250% to 200% of the federal poverty level ($56M).

* AGED AND DISABLED: Impose costs onto low-income seniors and people with disabilities ($50M), by reducing the eligibility for free Medi-Cal coverage from 133% of the federal poverty level to the $708/month individual SSI/SSP level. About 55,000 "aged and disabled" would bear the costs or drop off coverage as a result.

* QSRs: Institute quarterly status reports ($43M) on adults with Medi-Cal coverage, burdening them with additional paperwork requirements for the express purpose of having over 100,000 people fall off health insurance. The legislature earlier in the year approved reporting requirements every six months.

* CHILD COVERAGE: Rescind continuous eligibility for children ($76M; $175M in 04-05). This would endanger continuity of care for the 3 million children in Medi-Cal, and the loss of coverage for up to 471,500 children.

* BENEFITS: Eliminate various medically necessary Medi-Cal benefits ($40M). While this would not include dental or durable medical equipment, this proposal would eliminate 11 benefits for the roughly 3 million adults on Medi-Cal, including medical supplies, psychiatric, chiropractic, acupuncture, and podiatric services, occupational therapy, optician and optical lab services, optometry, hearing aids, speech and audiology services, and physical therapy.

* STATE-ONLY: Eliminate all "state-only" health programs ($290M), that don't get the federal matching funds that Medi-Cal services do. Among other cuts, this would:
* CHDP: Eliminate the Child Health and Disability Program ($50M), which provides immunizations and other preventative care to around one million California children.
* EAPC: Eliminate the Expanded Access to Primary Care Program ($23.5M), the Rural Health Services Development Program ($8M), the Indian Health Program ($6M), and other crucial funding sources for community clinics on which many areas depend.
* FAMILY PACT: Eliminate the Family Planning, Access, Care, and Treatment program ($63M), which actually does get up to a 9-to-1 federal match.

* MANAGED CARE: Force newly-applying Medi-Cal seniors & people with disabilities into managed care ($70M), which may end up costing more money yet restricting care for these populations.

* COUNTY ADMIN: Cut county administration for Medi-Cal by 20% ($112M). This would make it harder for families to enroll and get the health coverage they need, especially since county administration was cut severely last year as well.

The plan would also:
* Cut off funding for trauma centers on which we all rely ($15M)
* Institute co-payments for Medi-Cal services ($31M)
* Eliminate accelerated enrollment and the Healthy Families "bridge" ($6M)
* Eliminate "2nd year transitional" Medi-Cal for 2,000 adults entering workforce ($2M)
* Exclude over-the-counter drugs from Medi-Cal coverage ($8M)
* Enact California Dental Association proposals (instead of GB) ($73M)
* Impose an annual $1,000 limit on dental benefits for those on Medi-Cal ($6M)
* Reinstate Transitional Inpatient Care ($19M)
* Expand limits for Regional Center services ($97M)
* Impose a moratorium on new adult day health centers ($21M)
* Eliminate the pre-enrollment portion of the CHDP Gateway ($23M)
* Enact Medical Support Enforcement proposal (ACS) ($110M)
* Enact AIDS drug co-pay proposal ($6M)
* Eliminate Rural Health Care Equity Program ($11M)
* Reduce adolescent family life program ($12M)
* Establish new Regional Center Purchase of Service standards ($50M)
* Eliminate integrated services for homeless ($55M)

SPENDING CAP: In addition to this of cuts, the proposal would put in place a "spending cap" to "allow modest spending growth after 2003-04 to mirror increases in population and inflation." It is unclear how this would differ from the current spending cap that California already has, which is based on population and inflation. Health care advocates should be especially worried about new spending caps, which could handcuff the state from meeting basic health needs into the future. As consumers face health care premiums go up 15% and more, the notion of a cap at 4% clearly would force health care cuts in eligibility, benefits, and services. Health care advocates should oppose anything that restricts the ability to meet needs created by economic recession, rising health care costs, bioterrorism and other public health emergencies, and not only a growing but an aging population that will require additional health care.


--
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 | 6:22 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...