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Wednesday, January 12, 2005
 
HEALTH ACCESS UPDATE
Wednesday, January 12th, 2005

SENATE LEGISLATIVE COMMITTEES ASSIGNED
* New Mix of Members on Health, Insurance, Budget, and Appropriations


BELOW are the lists of the new Senate legislative committees of direct interest to health consumer advocates.

A list of all the committees is available in the "press room" section of the Senate Majority Caucus website: http://democrats.senate.ca.gov/

A list of the Assembly committees of interest to health advocates was published last week, and is also available at the Health Access web site, at:
http://www.health-access.org/2005_01_01_Sac_archives.htm#110537299420201031

Senate Health Committee (11 members, 6 votes needed to pass bills)

  • Deborah Ortiz, Chair (D-6, Sacramento)
  • Elaine Alquist (D-13, San Jose)
  • Wes Chesbro (D-2, Napa/Eureka/Santa Rosa/Vallejo)
  • Liz Figueroa (D-10, Fremont)
  • Sheila Kuehl (D-23, Los Angeles)
  • Jackie Speier (D-8, San Francisco/San Mateo)
  • Ed Vincent (D-25, Inglewood)
  • George Runner, Vice Chair (R-17, Lancaster/Victorville)
  • Sam Aanestad (R-4, Chico/Nevada City/Redding/Colusa)
  • Dave Cox (R-1, Sacramento)
  • Abel Maldonado (R-15, San Jose/San Luis Obispo)

Senate Banking, Finance and Insurance Committee (10 members, 6 votes needed to pass bills)

  • Jackie Speier, Chair (D-8, San Francisco/San Mateo)
  • Liz Figueroa (D-10, Fremont)
  • Alan Lowenthal (D-27, Paramount/Long Beach)
  • Kevin Murray (D-26, Los Angeles/Culver City)
  • Jack Scott (D-21, Pasadena)
  • Vacancy (D)
  • Dave Cox, Vice Chair (R-1, Sacramento)
  • Jeff Denham (R-12, Modesto/Salinas/Merced)
  • Dennis Hollingsworth (R-36, Temecula/El Cajon)
  • Abel Maldonado (R-15, San Jose/San Luis Obispo)

Senate Budget and Fiscal Review Committee (17 members)

  • Wes Chesbro, Chair (D-2, Napa/Eureka/Santa Rosa/Vallejo)
  • Denise Moreno Ducheny, Chair of the Health Budget Subcommitee (D-40, Chula Vista/Coachella)
  • Joe Dunn (D-34, Garden Grove)
  • Christine Kehoe (D-39, San Diego)S
  • heila Kuehl (D-23, Los Angeles)
  • Alan Lowenthal (D-27, Paramount/Long Beach)
  • Mike Machado (D-5, Stockton/Vacaville)
  • Gloria Romero (D-24, Los Angeles/Baldwin Park/West Covina)
  • Jack Scott (D-21, Pasadena)
  • Joe Simitian (D-11, Santa Cruz/Palo Alto)
  • Tom Torlakson (D-7, Concord/Antioch)
  • Dennis Hollingsworth, Vice Chair (R-36, Temecula/El Cajon)
  • John Campbell (R-35, Costa Mesa)
  • Bob Dutton (R-31, Rancho Cucamonga)
  • Bob Margett (R-29, Diamond Bar)
  • Tom McClintock (R-19, Thousand Oaks)
  • George Runner (R-17, Lancaster/Victorville)

Senate Appropriations Committee (13 members)

  • Carole Migden, Chair (D-3, San Francisco/San Rafael)
  • Elaine Alquist (D-13, San Jose)
  • Debra Bowen (D-28, Redondo Beach)
  • Martha Escutia (D-30, Norwalk)
  • Kevin Murray (D-26, Los Angeles/Culver City)
  • Deborah Ortiz (D-6, Sacramento)
  • Jackie Speier, Chair (D-8, San Francisco/San Mateo)
  • Vacancy
  • Sam Aanestad, Vice Chair (R-4, Chico/Nevada City/Redding/Colusa)
  • Roy Ashburn (R-18, Bakersfield)
  • Jim Battin (R-37, Moreno Valley/Palm Desert)
  • Bob Dutton (R-31, Rancho Cucamonga)
  • Charles Poochigian (R-14, Fresno/Ripon)

Senate Government Modernization, Efficiency & Accountability Committee (10 members)

  • Liz Figueroa, Chair (D-10, Fremont)
  • Debra Bowen (D-28, Redondo Beach)
  • Denise Moreno Ducheny (D-40, Chula Vista/Coachella)
  • Dean Florez (D-16, Fresno/Bakersfield)
  • Sheila Kuehl (D-23, Los Angeles)
  • Kevin Murray (D-26, Los Angeles/Culver City)
  • Bob Dutton, Vice Chair (R-31, Rancho Cucamonga)
  • Roy Ashburn (R-18, Bakersfield)
  • John Campbell (R-35, Costa Mesa)
  • Tom McClintock (R-19, Thousand Oaks)

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posted by Anthony Wright | Permalink | 8:17 AM


 
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Monday, January 10, 2005
 
HEALTH ACCESS UPDATE
Monday, January 10th, 2005

GOVERNOR’S BUDGET WOULD RESTRICT ACCESS TO CARE

  • "Medi-Cal redesign" would impact the care of hundreds of thousands
  • Plan would add premiums, restrict dental benefits, and shift many into managed care

Governor Arnold Schwarzenegger announced his 2005-06 budget today, and along with it several changes to the Medi-Cal program that provides health coverage to 6.6 million California children, parents, seniors, and people with disabilities. The full budget is available online, both in hypertext and Adobe Acrobat format, at:
http://govbud.dof.ca.gov/

The Governor’s budget would increase the cost and restrict the care of hundreds of thousands of Californians, making policy changes not just for a bad budget year but into the future. After several years of cuts to services, the Governor did not seek to balance those cuts with additional revenues. By taking taxes and other budget solutions off the table, the Governor forced a budget that made cuts to health care and other vital services on which Californians rely. The California Health and Human Services Agency has a more specific write-up of the budget cuts and changes in health care, at:
http://www.chhs.ca.gov/CHHSBudget20052006/HHS%20Briefing%20Summary%202005-06.pdf

Most of the major health cuts are part of a proposed "Medi-Cal redesign," which would be phased in over several years, and which part of would require a federal waiver. When fully implemented in the "out years," such as 2008-09, the proposal is expected to yield an annual savings of $287.1 million dollars overall, and be equal to a $144.9 million general fund cut. A full description on the Medi-Cal redesign in available online at:
http://www.dhs.ca.gov/mcs/mcpd/MCReform/default.htm

The Medi-Cal redesign cuts to health care include:

  • Imposing premiums on 550,000 children, parents, seniors, and people with disabilities with Medi-Cal coverage, which would cause 110,000 Californians to fall off coverage ($22.1 million general fund cut in out years). The premiums would be imposed on those on Medi-Cal over the federal poverty level, including 460,000 children and parents. The premiums would be $4/month for each child under 21, and $10/month for adults, up to $27/month per family. Beneficiaries will be disenrolled if they do not pay premiums for two consecutive months.

  • Limiting dental benefits to three million adults with Medi-Cal coverage, and meaning that 125,000 will face out-of-pocket expenses for severe dental treatment ($25.3 million general fund cut in out years). Dental coverage would be limited to $1,000 in a twelve-month period.

  • Forcing hundreds of thousands of seniors, people with disabilities and families into managed care plans that may restrict access to needed care, including the ability to see their current doctors and specialists ($85.4 million general fund cut in out years). The proposal would geographically expand Medi-Cal managed care plans into 13 counties now without such plans, and force this shift for 262,000 children and parents in El Dorado, Placer, Imperial, Madera, Merced, Marin, Mendocino, San Benito, San Luis Obispo, Sonoma, Ventura, and possibly Kings and Lake counties. The proposals would also mandatorily enroll intop managed care 554,000 seniors and people with disabilities in 27 counties who are now in fee-for-service plans.

  • The redesign package also includes a “hospital financing” restructuring, where the details are not fully fleshed out, but will have significant impacts on the viability of public and other safety-net hospitals. The plan also includes a change to eligibility processing for children, relying more on a statewide vendor rather than counties, and would also increase monitoring of counties with regard to processing Medi-Cal eligibility and redeterminations.
Finally, advocates continue to be concerned about the specific content of the proposed federal waiver, the process in its negotiation, and any agreement that might serve to cap or "block grant" federal Medicaid funding, as had been proposed by the Bush Administration.

Good things in small packages: The few positive program increases in health care are all small--under $6 million--but of note to health advocates. They include new efforts around obesity prevention ($6 million general fund), the restoration of application assistance fees for Medi-Cal and Healthy Families enrollment ($5.9 million general fund), and an initiative to keep children enrolled in the "bridge" transition from Medi-Cal to Healthy Families ($2.1 million general fund). Also included is the implementation of a prescription drug discount card program announced last week that will attempt to secure voluntary discounts from pharmaceutical companies for some low-income uninsured ($4 million general fund).

Other concerns: In addition to the real impact of the cuts, health advocates are also concerned about the Governor's proposed "budget reforms," that would institute across-the-board cuts when spending would outpace revenues. Such a proposal could be devastating to health care programs, which are roughly a third of the budget, and which require more spending during times of economic recession--when revenues go down. This proposal, as well as other "spending cap" proposals that are being circulated for the ballot, raise issues about future cuts.

What is not in the budget at this point are many other proposals that have been rejected in the past several years by the Legislature, including direct cuts to eligibility, benefits, and provider rate reimbursements. Governor Schwarzenegger withdrew those proposals after protest and legislative opposition last year. The proposed Medi-Cal redesign cuts still have the impact of restricting and denying access to needed care for hundreds of thousands of Californians.

Next steps: Health advocates, legislative staff, and other analysts will be reviewing the budget in the next few days, weeks and months to flesh out the details and the impacts. What is clear is that the cuts to education, social services, and other programs will affect some of the same vulnerable people and populations as are impacted by the health cuts.The next step is the budget process, including a series of hearing in budget subcommittees in March, April and May. Health policy committees are also expected to review the Medi-Cal redesign proposals as well.

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posted by Anthony Wright | Permalink | 8:06 AM


 
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Friday, January 07, 2005
 
HEALTH ACCESS UPDATE
Friday, January 7th, 2005

ASSEMBLY COMMITTEES NAMED
  • Smaller memberships for committees, including for health, budget, and appropriations

As announced today by Speaker Fabian Nunez (D-46, Los Angeles) as well as Assembly Republican Leader Kevin McCarthy (R-32, Bakersfield), below are the lists of the new memberships of the Assembly committees of interest to consumer health advocates. They include the Assembly Health Committee, the Assembly Budget Committee, and the Assembly Appropriations Committee:


Health Committee: 13 members (need 7 votes to pass legislation out of committee)

Assemblymember Wilma Chan, Chair (D-16, Oakland)
Assemblymember Patty Berg (D-1, Santa Rosa)
Assemblymember Rebecca Cohn (D-24, San Jose)
Assemblymember Mervyn Dymally (D-52, Compton)
Assemblymember Dario Frommer (D-43, Glendale)
Assemblymember Mike Gordon (D-53, Torrance)
Assemblymember Dave Jones (D-9, Sacramento)
Assemblymember Cindy Montañez (D-39, Mission Hills)
Assemblymember Gloria Negrete McLeod (D-61, Montclair)

Assemblymember Greg Aghazarian, Vice Chair (R-26 Stockton)
Assemblymember Alan Nakanishi (R-10, Lodi)
Assemblymember Keith Richman (R-38, Granada Hills)
Assemblymember Audra Strickland (R-37, Westlake Village)


Budget Subcommittee #1 on Health and Human Services: 5 members

Assemblymember Hector De La Torre, Chair (D-50, South Gate)
Assemblymember Loni Hancock (D-14, El Cerrito)
Assemblymember Gene Mullin (D-19, San Mateo)

Assemblymember Dave Cogdill (R-25, Modesto)
Assemblymember Rick Keene (R-3, Chico)


Budget Committee: 25 members

Assemblymember John Laird, Chair (D-27, Santa Cruz)
Assemblymember Juan Arambula (D-31, Fresno)
Assemblymember Rudy Bermúdez (D-56, Norwalk)
Assemblymember Wilma Chan (D-15, Oakland)
Assemblymember Joe Coto (D-23, San Jose)
Assemblymember Hector De La Torre (D-50, South Gate)
Assemblymember Mervyn Dymally (D-52, Compton)
Assemblymember Noreen Evans (D-7, Santa Rosa)
Assemblymember Jackie Goldberg (D-45, Los Angeles)
Assemblymember Loni Hancock (D-14, El Cerrito)
Assemblymember Cindy Montanez (D-39, Mission Hills)
Assemblymember Gene Mullin (D-19, San Mateo)
Assemblymember Pedro Nava (D-35, Santa Barbara)
Assemblymember Nicole Parra (D-30, Bakersfield)
Assemblymember Fran Pavley (D-41, Woodland Hills)
Assemblymember Lois Wolk (D-8, Vacaville)

Assemblymember Rick Keene, Vice Chair (R-3, Chico)
Assemblymember John Benoit (R-64, Riverside)
Assemblymember Sam Blakeslee (R-33, San Luis Obispo)
Assemblymember Dave Cogdill (R-25, Modesto)
Assemblymember Chuck DeVore (R-70, Irvine)
Assemblymember Lynn Daucher (R-72, Brea)
Assemblymember Bob Huff (R-60, City of Industry)
Assemblymember George Plescia (R-75, San Diego)
Assemblymember Michael Villines (R-29, Fresno)


Appropriations Committee: 18 members

Assemblymember Judy Chu, Chair (D-49, Monterey Park)
Assemblymember Karen Bass (D-47, Los Angeles)
Assemblymember Patty Berg (D-1, Santa Rosa)
Assemblymember Ron Calderon (D-58, Montebello)
Assemblymember Mike Gordon (D-53, Torrance)
Assemblymember Johan Klehs (D-18, Hayward)
Assemblymember Betty Karnette (D-54, Long Beach)
Assemblymember Mark Leno (D-13, San Francisco)
Assemblymember Joe Nation (D-6, San Rafael)
Assemblymember Jenny Oropeza (D-55, Carson)
Assemblymember Mark Ridley-Thomas (D-48, Los Angeles)
Assemblymember Lori Saldaña (D-76, San Diego)
Assemblymember Leland Yee (D-12, San Francisco)

Assemblymember Sharon Runner, Vice Chair (R-36, Lancaster)
Assemblymember Bill Emmerson (R-63, Rancho Cucamonga)
Assemblymember Ray Haynes (R-66, Temecula)
Assemblymember Alan Nakanishi (R-10, Lodi)
Assemblymember Mimi Walters (R-73, Laguna Niguel)


STATE BUDGET TO BE UNVEILED MONDAY

* Medi-Cal redesign briefings scheduled

Governor Arnold Schwarzenegger will unveil his proposed budget for 2005-06 on Monday, which is expected to include a "Medi-Cal redesign," and other items, including other cuts to health and other vital services. Health Access will put out an quick analysis as soon as possible, as well as ongoing updates on responses to the budget. Some actions and events are already being scheduled, and will be on the Health and Budget Advocacy Calendar, at: http://www.health-access.org/calendarhome.html

After the budget is released, the Administration will hold briefings for "stakeholders" on the Medi-Cal redesign proposal in both Sacramento and in Los Angeles. The briefing will be conducted by Kimberly Belshé, Secretary of the California Health and Human Services Agency and Sandra Shewry, Director of the California Department of Health Services. The briefing will include a presentation on the Redesign proposal followed by a public "Question and Answer" session. The identical briefings will be:

  • SACRAMENTO: Thursday, January 13, 2005; at the Department of Health Services Auditorium, 1500 Capitol Avenue, Sacramento, California 95814. Time: 1:00pm - 3:00pm.
  • LOS ANGELES: Friday, January 21, 2005; at the Kenneth Hahn Hall of Administration, Los Angeles County Board of Supervisor's Board Room 500, West Temple Street, Los Angeles, CA 90012-2713. Time: 1:00pm - 3:00pm.

The Governor expects and will get a vigorous response to his budget proposals, as he cited in his State of the State speech: "And we all know what's going to happen. The special interests will run TV ads calling me cruel and heartless. They will organize protests out in front of the Capitol. They will try to say I don't understand the consequences of these decisions. Let me tell you something. I am well aware there are lives behind the numbers." Let the debate begin.

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posted by Anthony Wright | Permalink | 7:58 AM


 
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Wednesday, January 05, 2005
 
HEALTH ACCESS UPDATE
Wednesday, January 5th, 2004

PRESCRIPTION DRUG POLITICS HEAT UP;THE ONLY HEALTH ISSUE MENTIONED IN THE STATE OF THE STATE
  • Governor announces a drug discount card in the State of the State
  • Assembly Democrats announce new slate of bills
  • New HMO regulations proposed on prescription drug access
  • Upcoming events of note for advocates
The new year brings a new set of issues and politics around prescription drugs in Sacramento. On Monday, a group of Democratic Assembly legislators held a press conference announcing a package of bills around the cost and safety of prescription drugs. On Tuesday, the Department of Managed Health Care announced draft regulations of a bill to ensure access to medically necessary prescription drugs for HMO patients. On Wednesday, Governor Arnold Schwarzenegger announced a new prescription drug discount card, updating his proposal from last fall. On Thursday, he plans to release the details of his proposals.


STATE OF THE STATE: Governor Schwarzenegger gave his State of the State speech tonight, offering proposals for changes to the budget, education, government, and elections. He did not mention Medi-Cal redesign or health care budget cuts directly. But he did say he was about to release a "painful budget" that "does not solve our ongoing structural problem, because our deficit the following year will be even worse." He proposed to "reform" the "budget system," but did not details what that would mean except that he would submit "legislation that cuts expenditures across the board when they grow above revenues."

In last year's speech, the Governor never mentioned health care issues. This year, he only gave health care passing reference, even as hospitals and emergency rooms close, health costs go up, and more Californians become uninsured. His entire statement on health care in the speech focused on his prescription drug discount proposal:

"Another thing every state needs is affordable health care for its citizens. Millions of Californians lack coverage for the prescription drugs they need. Many of these people are the working poor who do not qualify for assistance. Therefore, I am announcing a prescription drug discount card with minimal costs to the state. We will make prescription drugs available to nearly 5 million low-income Californians, at prices competitive with those from Canada." The entire speech is available at the Governor's website, at:
http://www.governor.ca.gov/state/govsite/gov_htmldisplay.jsp?sCatTitle=%20&sFilePath=/govsite/spotlight/010505b_update.htm

GOVERNOR'S DRUG DISCOUNT CARD: The Governor will release his proposal tomorrow, which is reported to include a drug discount card, which would be available to Californians under 300% of the federal poverty level. Those who sign up for the card would get discounts off of the retail price of the certain drugs, that would be given voluntarily by the drug companies for three years. Finally, the proposal would also include a online clearinghouse and toll-free phone number for Californians to increase awareness about "free" proposals that would be offered by the drug companies.

More details will be released tomorrow, but some advocates are concerned that these proposals offer only a limited benefit that would go to a limited number of Californians. A greater concern is that these discounts are not required but voluntary, and what would ensure these savings into the future.

ASSEMBLY LEGISLATION INTRODUCED: Indicating this will be a hot political topic this year, Democratic Assemblymembers announced a package of bills earlier this week. A Monday press conference featured Assembly Majority Leader Dario Frommer (Glendale), Assembly Health Committee Chair Wilma Chan (Oakland), and many old and new Assemblymembers, in many cases right off of camapigns that featured the issue prominently. Wihle we also expect a full slate of bills introduced in the Senate as well, the Assembly bills included:
  • AB 71: Establish a California Drug Safety Watch to compile data about adverse reactions from consumers who use prescription drugs.
  • AB 72: Require drug makers to supply the state with all its data about the safety and effectiveness of drugs being marketed in California.
  • AB 73: Provide information to consumers about international pharmacies that meet state standards for safety and accessibility that sell prescription drugs for 40% to 75% less.
  • AB 74: Set up an information hotline providing consumers with information on available prescription drug discount programs and services.
  • AB 75: Establish a state program offering a drug discount card for low-income Californians.
  • AB 76: Consolidate drug purchasing for state programs to negotiate for lower drug prices.
  • AB 77: Set up a pilot program for the California Department of Corrections to purchase prescription drugs at federal discount prices
  • AB 78: Increase financial disclosure by pharmacy benefits managers who negotiate for their clients (CalPERS, employers, insurers, unions) for discounts from drug manufacturers to eliminate conflict of interest relationships.
  • A yet to be filed bill will also seek to reduce the state’s costs for marketing certain prescription drugs for certain life-threatening chronic conditions.
HMO REGULATIONS: Also this week, the Department of Managed Health Care (DMHC) Director Cindy Ehnes unveiled new regulations to ensure that HMO enrollees with prescription drug coverage actually have access to medically necessary prescription drugs. The regulations seek to implement SB842 (Speier) passed in 2002, which was passed when HMOs won court battles challenging the Department's power to regulate drug coverage. Consumer advocacy groups will comment on the regulations, and in particular seek stronger language protecting consumers from out-of-pocket costs that would impede access to medically necessary drugs. The draft regulations, and the opportunity to provide comment, are available at the website, at:
http://www.hmohelp.ca.gov

ADVOCACY EVENTS OF NOTE: The new year has gotten off to a busy week in Sacramento, and there are more events in just the next few days. They include:
  • A California HealthCare Foundation session on Thursday on a new tool to evaluate coverage expansions.
  • A California Working Families Policy Summit on Friday that will review various ideas and proposals on health and other vital issues for the new legislative year.
  • A Californians for Healthy Kids briefing on Friday to discuss the emerging policy framework on a proposal to cover all children, and to engage advocacy group in such a campaign
These events, and many others, are described in much more detail (and with links to more materials and to RSVP) on the Health and Budget Advocacy Calendar. Visit it regularly as it is constantly updated, at:
http://www.health-access.org/calendarhome.htm

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posted by Anthony Wright | Permalink | 8:16 AM


 
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Anthony Wright is the executive director,
with a background as a consumer advocate and community organizer on many issues, including health issues for the last ten years in California and New Jersey.


 
Hanh Kim Quach is the policy coordinator; previously serving as
a newspaper reporter covering the Capitol for the Orange County Register and other papers for eight years