Tuesday, December 28, 2004

HEALTH ACCESS UPDATE
Tuesday, December 28th, 2004


NEW YEAR TO BRING NEW DEBATE ON HEALTH CARE

• Continuing advocacy needed over health impact of budget cuts, Medi-Cal redesign, CPR
• Multiple proposals on health coverage expansion expected next year
• Renewed efforts on single-payer, employer responsibility, and children's health programs
• New interest on individual mandates for health coverage

The new year brings new political debates over health care programs and policies, that bring both promise and peril to California health care consumers, the insured and the uninsured.

BUDGET CUTS COMING: Governor Arnold Schwarzenegger is expected to give his State of the State address on Wednesday, January 5th, and then release his budget on Monday, January 10th. There have been unconfirmed rumours that the budget might be released earlier. With a continuing deficit projected to be over $8 billion, the proposed budget will be painful, and Administration officials in the Health and Human Services department have warned of serious cuts.

The Governor was to announce his plans for "Medi-Cal redesign" and his proposals under the "California Performace Review (CPR)" as part of the budget. However, recent statements have suggested that the Governor will not directly incorporate these proposals into his budget announcement for January 10th, but that they will be released soon afterwards. Finance Director Tom Campbell and others indicated that the Governor may announce some details of the proposals, but that their financial impact would not be incorporated into the proposed January budget. Health advocates have been very concerned about the Medi-Cal redesign's attempt to place additional costs on Medi-Cal patients, and shift seniors and people with disabilities into managed care. The continuing delay has been around another area of significant concern, on hospital financing. Consumer advocates also had specific concerns about many of the policy and restructuring proposals in the CPR. While the budget cuts, Medi-Cal redesign, and CPR are all related in that they are the Administration's attempts to seek to save mone--often by restricting access to care, these proposals seem to be proceeding along parallel tracks at this time.

HEALTH COVERAGE EXPANSION: For advocates who support expanding health coverage to the uninsured, there might be an opportunity to move the debate forward, building on the conversation from SB2/Proposition 72 and other efforts in the past few years.

For 2005-06, the policy conversation in Sacramento seems to resemble that of two years ago, with multiple proposals by different legislators and various interest groups. We may very well have five or six major proposals to expand health coverage in the legislature, and one or two may go to the ballot.

However, as opposed to general concepts of two years ago, the policy discussion will be more specific and sophisticated. As advocates and other interested parties have been through this discussion once, we all know what questions to ask, and a better sense of what our basic principles are. The continuing health care crisis, with more people uninsured and high-profile hospital closures up and down the state, as well as the closeness of the Prop 72 vote, will add urgency to this debate. On a cautionary note, the overall political environment means there will be more conservative proposals, advanced by the President, the Governor, and other sources. Consumer health advocates will be forced to spend more time raising concerns, about mandatory catastrophic or high deductible coverage.

But at this point, we know:

• Supporters of SB 2 and Proposition 72, after seeing the closeness of the vote, are exploring re-introducing a similar measure to set a level playing field for employer responsibility to the health of their workers, that sets a basic standard for on-the-job health benefits. This could be either as legislation or a future ballot measure.
  
• Senator Sheila Kuehl will re-submit her ambitious proposal for universal, single-payer health coverage for all Californians, which got considerable enthusiasm from many grassroots organizations in the last two years as SB921. The new version will include more details on not only health care quality, but the financing mechanism for the system.
  
• A major effort seeks to expand coverage for all children, led by the 100% Campaign and PICO California, building on the county initiatives that have a proven track record and have already-developed constituencies.
  
• There still is the pending Healthy Families parent waiver, which needs a relatively small amount of funding in order to extend coverage to up to 300,000 parents. Some groups are actively looking to re-propose this, as well as expand the income threshold for children in the Healthy Families program.
  
• Speaker Fabian Nunez has decided to make health care a major priority of his caucus, both in the budget, and in policy. He is likely to be active on the issue of hospital closures in Los Angeles and statewide, and in looking for ways to maintain and strengthen the safety net, as well as ways to expand coverage.
  
• Other policymakers and elected leaders are convening meetings to generate ideas and come up with proposals, including Insurance Commissioner John Garamendi, Senator Jackie Speier, and Assemblyman Dario Frommer. Others who will be active in the debate are the chairs of the health policy committees, Senator Deborah Ortiz and Assemblywoman Wilma Chan.


• Several proposals may introduce the notion of mandating individuals to get coverage. The California Medical Association has floated one proposal; Assemblymen Keith Richman and Joe Nation have talked about the concept and plan to introduce legislation in town halls; and Governor Schwarzenegger has mentioned publicly, two or three times now, the notion that if people have to buy car insurance, they should also be require to carry health insurance.
  

INTEREST IN INDIVIDUAL MANDATES: Having been conspicuously silent to date on his ideas for health reform as hospitals close and the situation gets worse, Governor Schwarzenegger is said to be looking at possible solutions, including supporting tax credits, a Healthy Families expansion, and/or some form of individual mandate. Members of his Administration are looking at a policy proposal by the New American Foundation, a Washington, D.C., think tank, around "universal responsibility." The executive summary of this proposal is at their website, at:
http://www.newamerica.net/Download_Docs/pdfs/Pub_File_1442_1.pdf

The vast majority of uninsured are not offered health coverage on the job, and find individually-purchased health insurance either unavailable or affordable. An individual mandate thus seems to solve the wrong problem. The individual mandate does not address the barriers of affordability and accessibility in the individual insurance market, and any proposal would need to include significant regulatory oversight and new consumer protections, and substantial subsidies in order to work. Health Access California and other consumer groups would be opposed to any proposal that would serve to criminalize the act of getting care, which would seem to be the only way to enforce such an individual mandate. In contrast, health advocates have not opposed requiring individual participation in social insurance system, like Medicare. For a two-page brief on Health Access California's concerns with individual mandates, go to our website at:
http://www.health-access.org/docs/IndividualMandateConcerns.doc

WHAT WORKS IN HEALTH: The debate on health reform is alive and well. Health consumer groups will once again have the opportunity to support multiple proposals to expand coverage, with the advocacy for each proposal hopefully complementing and supporting the efforts behind other worthy proposals. At the same time, there will be a new challenge in opposing other proposals that would be ineffective in expanding coverage or violate key principles. Fundamentally, the health policy approaches that work are those that pool people together to share risk, either in a community or at the worksite, rather than those proposals that encourage people to risk it alone in the marketplace. Of 35 million Californians, over 18 million get coverage through an employer; over 10 million get coverage through a public insurance program. Alternatively, less than 2 million get coverage in the individual insurance market. We want to expand on the solutions that work, not the ones that don't.

For more background, link to this Los Angeles Times story last week that began to describe this upcoming debate in California:
http://www.latimes.com/news/local/la-me-health15dec15,1,4355249.story

Labels: Updates

posted by Anthony Wright | Permalink | 9:51 AM


 

Tuesday, December 14, 2004

HEALTH ACCESS UPDATE
Tuesday, December 14th, 2004

NEW CAMPAIGN TO INSURE EVERY CALIFORNIA CHILD

• New Numbers on Child Health Insurance: More than 1.1 Million Uninsured Children in 2003
• Public Insurance Programs Pick Up the Slack From Declining Employer-Based Coverage
• New Campaign to Push 100% Children's Coverage in New Legislative Session

Today at the State Capitol, a new advocacy campaign was launched to insure every child in California. "Californians for Healthy Kids" will build on the success of Medi-Cal and Healthy Families, as well as the 27 county initiatives that now cover hundreds of thousands of children, or have plans to start covering children. The new statewide effort is being led by PICO California and the 100% Campaign, a collaboration of Children Now, Children's Defense Fund and The Children's Partnership.

NEW NUMBERS: New data, released today by the UCLA Center of Health Policy Research, shows that the number of uninsured children in California decreased by nearly 500,000 over the last two years due to the effectiveness of public insurance programs. In 2001, 1.5 million children were uninsured at some point in a given year. While children's coverage through a parent's employment-based insurance dropped 4.3 percent, public insurance programs picked up the slack. In 2003, the number of uninsured children dropped to 1.1 million. A full brief is available at:
http://www.healthpolicy.ucla.edu/pubs/publication.asp?pubID=107

BROAD COALITION: Speakers at the press conference also included representatives from the California Teachers Association, the California State PTA, California Small Business Association, the Los Angeles Area Chamber of Commerce, and the L.A. Care Health Plan on behalf of the Children's Health Initiative of Greater Los Angeles and other county child health efforts. Other organizations, including Health Access California and United Way, were present in support. The groups unveiled a list of over 75 organizations in support.

SIGN-ON: Organizations are actively encouraged to sign on to the overall principles of the campaign, at:
http://www.100percentcampaign.org/priorities/healthy-kids-signup.htm

PRINCIPLES: The principles that organizations are being asked to support include:

• Create a strong private/public initiative in which all children living in California from birth to age 21 will have access to affordable health insurance coverage.
• Build upon what works in California's publicly-funded state insurance programs and reform what does not, including modernizing and simplifying how children get enrolled and stay enrolled in coverage.
• Create a statewide insurance system that leverages the lessons and successes of local children's health initiatives.
• Promote voluntary opportunities to strengthen employer participation in covering dependents.
• Develop sustainable financing that supports the system over the long term, including maximizing federal funding.
• Promote opportunities for children to access services under their health insurance coverage.
• Ensure a strong safety net as a vital component of access to care.
• Do no harm as these reforms are put in place.

MATERIALS: More materials, including fact sheets, questions and answers, press releases, and other information, are available at the 100% Campaign website, at: http://www.100percentcampaign.org/priorities/healthy-kids-main.htm

Labels: Updates

posted by Anthony Wright | Permalink | 1:11 PM


 

Monday, December 13, 2004

HEALTH ACCESS UPDATE
Monday, December 13th, 2004

OFFICIAL NOVEMBER VOTES TALLIED; ANALYSIS ON HEALTH ISSUES CONTINUES

• Final numbers on Proposition 72 vote
• Momentum continues: CA debate heats up;
• Other states attempting similar reformsList of funding for Prop 72 opposition

Overall Votes Reported: In the certification of official results, Secretary of State Kevin Shelley reported that 12,598,683 Californians cast ballots in the November election, representing 76.04% turnout among registered voters. Almost a third of the votes casts--32.61%, or 4,105,179--were absentee. The Secretary of State web site has official tallies at:
http://vote2004.ss.ca.gov/

Prop 72 Result Official: Out of the 12.6 million votes cast, the margin against Proposition 72 was a mere 200,023 votes, with 5,681,863 Californians voting for the measure (49.1%), and 5,881,886 voting against (50.9%). Over a million voters--1,021,934, to be exact--did not take a position on Proposition 72, in addition to the millions of both registered and unregistered nonvoters. Proposition 72 did the best of those measures that had opposition with significant funding, and the result was the closest of all the ballot measures.

Message Forum on Friday: Health advocates are invited to a forum on health reform messaging, and other lessons learned from the Proposition 72 campaign. The forum, to be held this Friday, December 17th, from 10am to 1pm in Sacramento, will feature consultants from the Proposition 72 campaign going over polling, focus group, and election results. Space is limited and registration required. Please RSVP to Louise Jones at Health Access Foundation, at 916-497-0923, or ljones@health-access.org.

Momentum continues: The closeness on the vote on Proposition 72 is already generating momentum for future efforts at health reform. Advocates expect multiple legislative proposals to be introduced next year on the subject of expanding access to health coverage, from a universal, single-payer proposal, to a new proposal to expand coverage to all children. More information on these efforts will be sent out in the coming days and weeks.

Other states: Legislators and advocates in other states from Illinois to Maryland are continuing with their effort on health reform, including proposals to require employers to provide a basic level of health benefits, similar to SB2 and Proposition 72. The closeness of the vote in California suggests they have a real shot to win in their states. If you are interested, visit the website describing these efforts for the following areas:

• Massachussetts: http://www.hcfama.org/index.cfm?fuseaction=Page.viewPage&pageId=422
• Washington: http://www.wacitizenaction.org/hc/hcwafams.htm
• New York City: http://www.nychealthcaresecurity.org/

Prop 72's Opposition: The opposition raised over $18.3 million dollars. (Correction: a previous Health Access Update incorrectly estimated the figure at $16 billion.) But while the opposition was deep-pocketed, it wasn't widespread: over 82% of the opposition's money came from just the thirty contributors that gave over $100,000. Only restaurants and retailers mobilized their money against Proposition, donating nearly 85% of the opposition's funding. Fast-food chains made up over 30% of the contributions, not including their umbrella organization, the California Restaurant Association. Retailers made up over 18%. Much thanks to Rafael Ruthchild of the Strategy Group for pulling these figures together, and for the good research and information throughout the campaign.

BELOW is a list of the top thirty-three contributors against Proposition 72, those that gave $100,000 or more. The list is striking for the range of recognizable brand names on it:

CALIFORNIA RESTAURANT ASSOCIATION $5,042,000
MCDONALDS AND FRANCHISEES $1,535,128
YUM! BRANDS AND FRANCHISEES [KFC, Pizza Hut, Taco Bell] $970,320
CARL'S JR. AND FRANCHISEES $760,250
WAL*MART STORES, INC. $648,449
ROUND TABLE PIZZA AND FRANCHISEES $569,550
OUTBACK STEAKHOUSE AND FRANCHISEES $528,000
ROBINSON-MAY $400,000
SEARS ROEBUCK AND CO. $400,000
MACY*S WEST, INC. $400,000

TARGET CORPORATION $350,000
CALIFORNIA BUSINESS PROPERTIES ASSOCIATION $325,000
WENDY'S AND FRANCHISEES $323,000
JACK IN THE BOX AND FRANCHISEES $313,610
BEST BUY PURCHASING LLC $300,000
EL POLLO LOCO AND FRANCHISEES $234,500
JACK IN THE BOX AND FRANCHISEES $313,610
CALIFORNIA CHAMBER OF COMMERCE BUSINESS PAC $255,000
J.C. PENNEY $200,000
DARDEN RESTAURANT INC. [Olive Garden, Red Lobster] $200,000

MICHAEL'S STORES $190,000
DEL TACO $159,500
BURGER KING CORP. $156,899
LOWE'S $150,000IN-N-OUT BURGERS $145,000
GOVERNOR SCHWARZENEGGER'S CALIFORNIA RECOVERY TEAM $123,608
APPLEBEE'S AND FRANCHISEES $114,000
CALIFORNIA PIZZA KITCHEN, INC. $100,000
AUTOZONE $100,000
OFFICE DEPOT $100,000
WALGREENS $100,000
NORDSTROM $100,000
CEC ENTERTAINMENT, INC. [Chuck E. Cheese] $100,000

Labels: Updates

posted by Anthony Wright | Permalink | 8:24 AM


 

Saturday, December 11, 2004

HEALTH ACCESS UPDATE
Saturday, December 11th, 2004

NEW LEGISLATURE, NEW HEALTH LEADERS; NEW CALENDAR

• Chan and Ortiz Heading Health Policy Committees
• De La Torre and Ducheny To Lead Health Budget Subcommittees
• New Two-Year Legislative Calendar Through 2006
  

Earlier this week, a new class of Assemblymembers and Senators were sworn into the California legislature. While the partisan makeup of both legislative chambers were the same, some of the faces were new, as term-limited legislators moved on.

The new session also introduces a new legislative calendar for consideration of bills and budgets, from now until the election in November 2006, which will feature a critical campaign for governor, as well as many statewide posts and legislative seats.

The legislative leadership, led by Assembly Speaker Fabian Nunez (Los Angeles), and newly-minted Senate President Pro Tem Don Perata (Oakland), announced the chairs of the committees for the upcoming session. The announcements include a blend of familiar and new names for health advocates to work with. In their speeches and statements, both leaders placed health care as a top priority for their caucuses and legislative chambers.

Senators Ortiz and Speier will continue to chair the Senate Health and Senate Insurance Committees, respectively. Consumer health advocates are pleased to see Assemblywoman Wilma Chan rise to be chair of the Assembly Health Committee, which handles both health and health insurance issues.

The budget subcommittees on health will have new leadership: Senator Denise Ducheny and the newly-elected Assemblyman Hector De La Torre. Neither have exrperience on the committee they now chair, although Senator Ducheny was previously chair of the Assembly Budget Committee when she was in that house. Senator Wes Chesbro, who chaired the subcommittee for the last several years, will continue to be the overall chair of the Senate Budget Committee, while Assemblyman John Laird is newly named to be his Assembly counterpart. Laird served on the health subcommittee for the last year and was thoughtful and knowledgeable on these issues.

BELOW is a list of the new chairs of the legislative committees of interest to health advocates, as well as a new calendar of legislative and budget hearings and deadlines, courtesy of Health Access legislative advocate Beth Capell. The calendar is available LINKED in another format as a handout at the Health Access website, at:
http://www.health-access.org/docs/HealthAccessBudgetLegCalendarJan2005.doc

* Committee Chairs In the Senate:

Health Committee: Deborah Ortiz (Sacramento)
Banking, Finance, & Insurance Committee: Jackie Speier (San Mateo/San Francisco)
Budget Committee: Wes Chesbro (Santa Rosa)
Budget Subcommittee #3 on Health and Human Services: Denise Ducheny (San Diego)Appropriations Committee: Carole Migden (San Francisco)

Human Services Committee: Joe Simitian (Palo Alto)
Government Modernization, Efficiency, and Accountability: Liz Figueroa (Fremont)
Judiciary Committee: Joe Dunn (Garden Grove)
Revenue & Taxation Committee: Mike Machado (Linden/Stockton)
Rules Committee: Don Perata (Oakland)

* Committee Chairs In the Assembly:

Health Committee: Wilma Chan (Oakland)
Budget Committee: John Laird
Budget Subcommittee #1 on Health and Human Services: Hector De La Torre
Appropriations Committee: Judy Chu

Aging and Long Term Care Committee: Patty Berg
Human Services Committee: Noreen Evans
Insurance Committee: Juan VargasJudiciary Committee: Dave Jones
Labor and Employment Committee: Paul Koretz
Revenue and Taxation Committee: Johan Klehs
Rules Committee: Cindy Montanez

2005-06 Calendar

Dec. 6, 2004: Legislature convenes, adjournsJ
an. 1, 2005: Laws enacted in 2003 take effect
Jan. 3, 2005: Legislature reconvenesJ
an. 10, 2005: State Budget Announced
Jan. 21. 2005: Last day to submit bill drafts to Legislative Counsel
Feb. 18, 2005: Last day to introduce legislation
Early March 2005: Budget subcommittees begin meeting
Mid- March 2005: Policy committees begin meeting
Mar. 17-Mar. 29, 2005: Legislative Recess
April 29, 2005: Policy committee deadline, first house
May 10 (?): May Revise of Budget
May 27 (?): Budget conference committee convenes
May 27, 2005: Appropriations committee deadline, first house.
June 2, 2005: Deadline to pass first house
June 6-July 8, 2005: Policy committees, second house
July 1, 2005: Deadline to enact Budget
July 8, 2005: Policy committee deadline
July 15-Aug 15, 2005: Summer recess
Aug 2005: Initiatives for 2006 Primary circulate
Aug. 15, 2005: Legislature reconvenes
Aug. 26, 2005: Appropriations Committee deadline
Aug. 29-Sept 9, 2005: Floor Session
Sept. 9, 2005: Legislature adjourns until Jan 06 (this could be delayed until 9/15)
Oct. 9, 2005: Governor’s deadline to sign/veto (if legislature adjourns 9/9)
Nov. 8, 2005: Possible special election?
Dec. 2005: Deadline for candidates to file, deadline to file initiative signatures for June primary

Jan. 1, 2006: Legislation enacted in 2005 becomes effective
Jan. 4, 2006: Legislature reconvenes
Jan. 10, 2006: State Budget Announced
Jan. 20, 2006: Last day to submit bill drafts to Legislative Counsel
Jan. 31, 2006: Last day for bills introduced in 2005 to pass house of origin
Feb. 18, 2006: Last day to introduce legislation
Mid-March 2006: Budget subcommittees begin meeting
Late March 2006: Policy committees begin meeting
April 21, 2006: Policy committee deadline, first house
Late April, 2006: Deadline for Nov. ballot initiative signatures
May 10 (?): May Revise of Budget
May 19, 2006: Appropriations committee deadline, first house.
May 27 (?): Budget conference committee convenes
May 28, 2006: Deadline to pass first house
June 1, 2006: Policy committee, second house
June 2, 2006: Primary election
July 8, 2006: Policy committee deadline
July 1, 2006: Deadline to Enact Budget
July 3-Aug 3, 2006: Summer recess
Aug 3, 2006: Legislature reconvenes
Aug 12, 2006: Appropriations Committee deadline
Aug 12-Aug 31, 2006: Floor Session
Aug 31, 2006: Legislature adjourns until Dec 06
Sept 30, 2006: Governor’s deadline to sign/veto
Nov. 6, 2006: General election: Governor, other statewide offices, Legislature
January 1, 2007: Legislation enacted in 2006 takes effect

* 2006 dates not officially announced; there are best estimates unless set by Constitution.

Labels: Updates

posted by Anthony Wright | Permalink | 11:08 AM


 

Wednesday, December 01, 2004

HEALTH ACCESS UPDATE
Wednesday, December 1, 2004

PROP 72 VOTE TALLY CONTINUES TO BE CLOSE

• "No" Vote Continues To Prevail
• Votes Still Being Counted In Remarkably Close Election

As has been reported last night and this morning, the Secretary of State posted an update last night on election returns that showed Prop. 72 winning by 50.5% with a vote margin of 102,271 votes. Unfortunately, this seems to have been a clerical or reporting error, although the campaign is checking.

New reporting this morning has a "no" vote on Prop. 72 prevailing again. In addition, some ballots remain to be counted in many counties. Final final results will not be known for some days yet. However, it seems unlikely although not impossible that the end result will be a victory for Prop. 72.

This continues to show the closeness of the vote, that despite $16 billion of scare tactics by the opposition, that over 5.5 million Californians voted for health care reform. With this momentum, we will win an expansion of health coverage, if not immediately, in the near future.

We are carefully monitoring the situation and will provide updates as we get them.

Labels: Updates

posted by Anthony Wright | Permalink | 9:27 AM


 

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...