Thursday, April 28, 2005

HEALTH ACCESS UPDATE
* Special Edition *
Thursday, April 28th, 2005

HEALTH REFORM DISCUSSION IS ALIVE AND WELL: DISCUSSIONS AROUND THE STATE

• Universal Single-Payer Bill Passes Senate Health
• Children's Coverage Passes Key Committees
• "Individual Mandate" Proposal Fails in Assembly Health Committee With Broad Opposition
• San Francisco County Considers Expansion of Employer-Based Coverage, Similar to Prop 72

On the eve of another national "Cover the Uninsured Week," health care reform seems far from the national political discussion. However, the debate on expanding health coverage is alive and well in California, with mulitple bills, large and small, stirring debate and discussion in the legislature. Other initiatives are moving forward in counties around the state, from an employer-based expansion in San Francisco to new child health insurance expansions in many counties. Below are descriptions of these state and local discussions.

Cover the Uninsured Week will take place on May 1-8. A description of the week and its activities is available at:
http://covertheuninsuredweek.org/

Most of the CTUW events in California are based in and around San Diego, but there are other activities around the state as well. For a list of these and other events of interest to health advocates in a busy month of May, visit the online Health and Budget Advocacy Calendar, at:
http://www.health-access.org/calendarhome.htm


UNIVERSAL HEALTH CARE PASSES SENATE HEALTH COMMITTEE

SB840 (Kuehl), the California Health Insurance Reliability Act (CHIRA) passed out of Senate Health Committee 7-4 on Wednesday, with all the Democrats on the committee voting for the bill, and all the Republicans voting against it. The bill passed the Senate Banking, Finance, and Insurance Committee earlier this month. The bill will need to go through the Senate Appropriations Committee, and then through the full Senate before June 3, 2005.

SB840 creates a universal, single-payer health care system for all Californians. The financing for such a system is expected to included in a second bill to be introduced by Senator Sheila Kuehl (D). SB 840 will remain the policy bill with all of the benefits, governance structure, transitional procedures, delivery of care details, consumer advocacy and protections and structures for efficiencies and savings and sustainability spelled out.

Funding for CHIRA will be developed in the Senate Revenue and Taxation Committee, chaired by Senator Mike Machado, with a first hearing planned for June 2005. The committee will analyze different funding plans, including those considered by the Lewin Group in their two cost/benefit studies. A fiscal bill based on feedback from these hearings will be introduced in January 2006.

In Senate Health Committee, Senator Kuehl introduced the bill, and while she referenced the studies indicating the economic efficiencies of a single-payer system, she wanted to focus on the health benefits, given the focus of the committee. She referenced the Institute of Medicine study that declared that the U.S. suffered from an "epidemic of substandard care." She introduced Paul Heineken, MD, Associate Chief of Staff for Ambulatory Care at the SFVAMC, clinical professor of medicine at UCSF, and a member of the CA Physicians' Alliance. He stated that his "experiences working as a VA physician has made it clear to me that there are several fundamental principles of single payer that are essential to the delivery of the best quality care possible." He added that as a single-payer system, "in published studies of medical care quality, VA care exceeds that of the private sector in 70% of indices, and is equal in all the others. Most importantly, the VA lacks the perverse incentives built into the current payment system. Unbridled fee-for-service causes overuse of procedures, while abusive HMOs lead to too few."

To further point out the problems with the current health system, another witness told of her personal story of being insured, but facing a medical emergency with her baby, faced $90,000 in bills, leading her to file Chapter 13 bankruptcy, and undergo "emotional trauma on top of medical tragedy." Organizational supporters that lined up in support included Health Access California, Health Care for All, Congress of California Seniors, AARP, American Medical Student Association, National Association of Social Workers, Jericho, Friends Committee on Legislation, Planned Parenthood, SEIU, Latino Issues Forum, National Organization of Women, and many others.

The opposition was led by the Chamber of Commerce, which "rejected the premise that it is best to have government-run health care." The representative disparaged the ability of "elected officials" and a "huge bureaucracy" to run a health care system, and he feared that they would be "pressured to shift the cost away from individuals and onto those that don't vote, such as businesses." He also said that of his time around the Capitol, "I can't think of an instance of scaling back benefits, particularly in this area," citing that this would be a problem with controlling costs. (Kuehl rebutted later, citing worker's comp changes made recently.) A lobbyist for life and health insurance companies said they "disagree on the premise that the government can do a better job than the private sector." Other opposition came from insurers, optometrists, chiropracters, and other providers.

Senator Wes Chesbro (D) asked the Chamber what he thought of the current health system, and the Chamber lobbyist stated "we are willing to concede, given that there are 6.7 million uninsured, that the market is not operating at an optimal level, or close to opitmal," but he thought a single-payer system would provide "a different set of problems." Senator Chesbro followed up that if employers that provide coverage are paying for those that don't, and to remedy this, that they can choose between requiring employers to provide coverage, or having the government do it.

Senator George Runner (R) pointed out that some of the uninsured are eligible for public insurance programs but are not enrolled, or are offered employer-based coverage but don't take it up. From his point of view, in finding a solution for the remaining, smaller number of uninsured, "it doesn't make a lot of sense to change the whole system" for all of those that have coverage. Senator Deborah Ortiz (D), the chair of the Senate Health Committee and a co-author of the bill, said that while the legislature has been "struggling to provide access to these programs" that Runner mentioned, we need the SB840 to show the goal, to say "this is where we push."


CHILDREN'S COVERAGE ADVANCES THROUGH POLICY COMMITTEES

The flagship "Healthy Kids" legislation, AB 772 (Chan/Frommer) and SB 437 (Escutia/Alquist), to cover all children in California, successfully made it out of the key policy committees in April, including Assembly Health, Senate Health, and Senate Banking, Finance and Insurance. Each of those committees heard testimony from child advocates, religious leaders and people of faith, business representatives, and health advocates in support of the effort. These measures, which do not have financing in the bills at this time, are set for Appropriations Committees, before going for respective floor votes.

A press conference earlier this month gave a sense of the messages used to support this effort. The description below is taken from the Californians for Healthy Kids campaign website, at:
http://www.100percentcampaign.org/take-action-main.htm

AB 772 author Assemblymember Chan and SB 437 co-author Senator Alquist briefed the press on April 13th. Representatives from the staffs of SB 437 author Senator Escutia and AB 772 co-author Assemblymember Frommer were also present. Assemblymember Chan called for support for AB 772/SB 437 as a "common-sense approach to cover all children." Asm. Chan outlined the bills' provisions to build upon the current Healthy Families and Medi-cal programs, streamline the application process, and expand coverage to uninsured children. Senator Alquist, principal co-author of SB 437, continued the call to action by noting that "providing all children with health insurance is the least we can do in a civilized society." Sen. Alquist highlighted the unique opportunity to build upon successful local Children's Health Initiative programs.

Cheyanne Cook, from the Los Angeles Chamber of Commerce, reinforced this point by saying that the L.A. Chamber has worked closely with the L.A. Children's Health Initiative because "covering children leads to a stronger economy and a more productive workforce." Scott Hauge of Small Business California concurred that "business knows that this is the right thing to do for kids and that it makes good business sense."

Alicia Lozano, joined by fellow PICO representative Lucretia Hopkins, stated that "as people of faith, we need to look after the most vulnerable members of our society, the children." Nancy Marquez, a 19 year-old college student, spoke powerfully about her own personal experience living without insurance in California. She described the worry of knowing she couldn't afford to get sick, and the pain of going without needed care. Living under the grace of God, she said, is not sufficient insurance for 800,000 California children. Ted Lempert, President of Children Now and representative of the 100% Campaign, closed the conference by offering that "insuring all children is a common goal in California which can be achieved legislatively this year."


INDIVIDUAL MANDATE FAILS IN ASSEMBLY HEALTH COMMITTEE

A proposal to impose a "individual mandate" on uninsured Californians, AB1670 (Nation/Richman), failed in Assembly Health Committee. It got only two votes in support, five votes in opposition, and the rest of the committee not voting. Opposed by consumer and constituency groups, health plans, and many others, this bill would have required Californians to prove they have basic health insurance when filing income taxes each year. If they did not have coverage, they would be charged for a health plan with limited benefits and a $5,000 deductible.
Assemblymen Joe Nation (D) and Keith Richman (R) presented this proposal as a team, after citing a range of statistics showing how the current system is broken, and how the status quo is not an option. They correctly stated that most of the uninsured children are eligible for public insurance programs, which could be streamlined to get more of them enrolled. They went on to cite that half of the non-elderly uninsured adults are in the 18-34 years old category, and called them "young invincibles" that don't want coverage.

Their main witness was Dana Goldman, Rand Corp. director of health economics, who gave an overview of the problems in the health care system. Repeating what many health experts state, he cited that the "best practice in health insurance" was when people came together to "share risk," either through Medi-Cal or Medicare, or through employers, which attract a broad enough range of workers that the risk is spread around. He also cited the many problems in the individual market, where Californians could be denied for pre-existing conditions, or simply find the coverage unaffordable.

He acknowledged that his next statements were more contested, when he suggested that health coverage didn't have a major impact on health status or outcomes, and so many of the benefits provided by coverage were not essential. In his view, health insurance is simply a means for financial security, "just like other insurance products," and so a high-deductible plan could protect people from bankrtupcy with less cost. The California Chamber of Commerce and the California Restaurant Association supported the bill in concept. (Letters in support came from the California Healthcare Institute and the Insure the Uninsured Project.)

Opponents against the proposal included Health Access, the California Labor Federation, the Foundation for Taxpayer and Consumer Rights, the California Association of Health Underwriters, Kaiser Permanente, Blue Shield, Health Net, Latino Coalition for a Healthy California, California Nurses Association, California Immigrant Welfare Collaborative, Greenlining Institute, and many other consumer, labor, constituency, and health provider organizations.

Health Access California indicated that the problem was not that the uninsured didn't want care, and that contrary to the earlier statements, younger people take up coverage when offered as much as any other age group, but they are more likely to work at lower wage jobs that don't provide health coverage. Also, high-deductible plans are of dubious value: studies show that people with high deductibles fail to get the necessary and appropriate care, including not taking medicines or go to the doctor for chronic conditions. Health Access also cited a recent Harvard study that showed a huge increase in bankruptcies due to medical bills, and most of those financial problems were insured, often people with such high deductible plans.

The California Labor Federation raised concerns that such a individual mandate would allow and encourage employers to drop on-the-job health benefits, especially for low-wage workers. Individual workers would then find it hard to fend for themselves in the individual marketplace. The Foundation for Taxpayer and Consumer Rights said it didn't make sense to mandate a product that is "unaffordable and unavailable," and cited the money wasted in the profit and administration of the insurance companies. Health plan representatives were also in opposition, citing that the purchasing pools envisioned in the bill were unworkable, and would create more expensive health products, rather than the cheaper plans the authors envisioned. Blue Shield, which cited their support of previous reforms that "spread the burden" on government, employers, and individuals, opposed this measure for "simply shifting the burden onto individuals."

Numerous legislators on the panel commended the authors for thinking about the health care issue, but almost all raised concerns with the punitive nature of the mandate, how its was structured, and how it would impact lower-income families, as well as traditional employer-based coverage. In the end, only Republican Assemblymember Greg Aghazarian, Vice-Chair of the Committee, voted with Assemblyman Richman in support of the measure. All other Assemblymembers, both Democrats and Republicans, either didn't vote or voted no.

In closing, Assemblymember Nation said, "My fear, frankly, is that we will continue to say no, no, no to a number of bills, many with promise, and not do anything positive for the health care system." To date, the fear has not been realized: the legislature is still actively considering many other proposals, all of which expand health coverage. Many of the proposals have consumer advocacy support because they use the proven methods of bringing people together to share risk and responsibility, either through public insurance programs, or through the worksite, through employer-based coverage. The legislature did pass SB2 in the last legislative session, and there seems to be momentum to act on health reform this session.


SAN FRANCISCO CONSIDERS EXPANDING EMPLOYER-BASED HEALTH CARE

The continuing momentum for health reform seems partially fueled by the close vote for Proposition 72 last November, which would have provided employees of large companies health coverage, but that narrowly lost by less than 1% of the vote. In many counties around the state, including San Francisco, Proposition 72 got strong support.

On April 20, the San Francisco Board of Supervisors held a special hearing on a proposal by Supervisor Tom Ammiano to require employers (with more than 20 workers or more than $1 million in annual gross receipts) to provide health coverage to their full-time workers or pay a mitigation fee to cover the cost of city health services. Ammiano’s proposal, which has not yet been drafted as legislation, envisions a system similar to Proposition 72, with a Knox-Keene standard for minimum coverage and employers being required to cover at least 80% of the cost of the premium.

Unlike Prop 72, however, Ammiano is not proposing to require dependent coverage, since San Francisco already has near-universal coverage of children through its San Francisco Health Plan. Representatives from the SF Department of Public Health, SF Health Plan and Office of the Legislative Analyst presented data showing that: the city spends $24 million a year providing health care to uninsured workers through its public hospital and clinics; some 12% of San Francisco employers with more than 20 workers did not provide health coverage to their workers; some 56,000 employees would be helped by a policy requiring firms with 20 or more workers to provide health coverage; and, such a policy would save San Francisco taxpayers $11 million a year.

San Francisco is currently facing a deficit of at least $113 million and is contemplating deep cuts to health and human services, including the closure of full or partial closure of several public health clinics. During the hearing, Supervisor Daly said he wanted to be sure the $11 million saved would be used to reduce the need for cuts to public health.

Dozens of local activists and supporters spoke in support of the proposal, including the San Francisco Labor Council, SEIU, Health Care for All, Health Access, SF Organizing Project (the local PICO affiliate), Chinese Progressive Association, Planned Parenthood Golden Gate and Planning for Elders.

The SF Human Services Network, which represents private non-profits that contract with the city, also voiced support for the concept, although they also expressed concerns and want to make sure the final legislation does not hurt their members. A representative from the Council of District Merchants was the only speaker in opposition.

Supervisor Elsbernd suggested that the proposal be heard in the Small Business Commission. However, the Supervisor, whose district is home to City College, SF State and UCSF, also indicated an interest in making coverage available to part-time workers who were also students, by including the number of credits being taken along with the number of hours worked. In closing, Supervisor Ammiano said that he considered the proposal a “reasonable, incremental step toward universal coverage.” Ammiano said he intended to move forward regardless of the opposition he expects to encounter from business.

Thanks to Jessica Rothhaar of Health Access for this report from San Francisco.

Labels: Updates

posted by Anthony Wright | Permalink | 9:00 AM


 

Wednesday, April 27, 2005

HEALTH ACCESS UPDATE
Wednesday, April 27th, 2005

QUICK BILL UPDATE FROM SENATE HEALTH COMMITTEE


HEALTH COVERAGE: Tonight, the Senate Health Committee passed SB840 (Kuehl), the California Health Insurance Reliability Act (CHIRA), to create a universal, single-payer health care system. The vote was on a party-line vote, with Democrats voting for the bill. The measure had passed the Senate Banking, Finance and Insurance Committees earlier in the month.

(In the next few days, Health Access will put out a more detailed report on the discussion on this measure, as well as the discussions on other measures around health coverage, such as the children's coverage proposal, an expansion of employer-based coverage in San Francisco, and the failed "individual mandate" proposal.)

The Senate Health Committee also heard another measure to expand coverage: SB38 (Alquist) passed, to raise the threshold for the Healthy Families program from 250% to 300% of the federal poverty level.

PRESCRIPTION DRUGS: In other news, SB19 (Ortiz) failed in Senate Health Committee. The bill, sponsored by Governor Arnold Schwarzenegger and supported by the prescription drug industry and others, including some advocates, would have set up a "voluntary" prescription drug discount card program in California. Many consumer advocates and others were opposed to the measure, unless it was amended to include some requirement or leverage on the drug industry to participate and provide discounts. The final vote was 5-5, and the bill needed 6 votes to pass. Votes in support included Senator Ortiz and the Republican members of the committee; the other Democratic members of the committee voted against the measure, except for Senator Vincent, who simply did not vote. The measure was placed on reconsideration.

Labels: Updates

posted by Anthony Wright | Permalink | 2:09 PM


 

Tuesday, April 26, 2005

HEALTH ACCESS UPDATE
Tuesday, April 26th, 2005

COMMITTEES ACT ON VARIOUS HEALTH MEASURES

• Prescription Drug Bills Pass Assembly B&P, Senate Judiciary Committees
• Assembly Health Committee Supports Children's Coverage, Consumer Protection, Disclosure Bills
• Bills for an Individual Mandate, Mandatory Medi-Cal Managed Care Rejected

Many consumer protection bills and other legislation of interest to health advocates advanced through the legislative process, as part of a busy day at the state legislature.

On health care coverage, the Assembly Health Committee voted to expand health coverage to all children in California, while rejecting another effort to mandate that the uninsured purchase high-deductible health plans on the individual market. With that troublesome proposal now defeated, there can be a renewed discussion on expanding health coverage, which is the subject of many measures in the legislature. For example, the Senate Health Committee will hear the California Health Insurance Reliability Act, SB 840(Kuehl), tomorrow, Wednesday, April 27th.

Consumer protections were passed in the Assembly Health Committee on the individual insurance market, so-called discount health plans, hospital charges, hospital quality, and Medicare prescription drug plans. Numerous bills to address the cost and safety of prescription drugs were passed out of Assembly Business and Professions Committee. The Senate Judiciary Committee also passed two other bills on the subject.

Here are some specific reports on specific issues. With the 14 members of the Assembly Health Committee, bills needed 8 "aye" votes to be passed out. Many of the votes were party-line votes, with the 10 Democrats voted to support and the 4 Republicans either voting "no" or not voting. However, there were several deviances from this pattern, some of which are described below. Most of the bills passed are moving on to the Appropriations Committee, the final hurdle before reaching a full floor vote in the Assembly or Senate, respectively.

For more information on health care consumer advocacy legislation, both these bills and others of interest, as well as to see copies of these bills, and the positions of Health Access California, the statewide health care consumer advocacy coalition, visit the "Legislative Corner" of Health Access' website at:
http://www.health-access.org/2005_bills.htm

* CHILDREN'S COVERAGE: AB772 (Chan) passed, with a the support of a broad coalition and a large crowd representing the religious community, as part of Catholic Lobby Day. The bill is part of a larger effort to cover all California children, by expanding and streamlining public insurance programs. While propelled by solid Democratic support, sponsorship and prioritization, the effort has been picking up some bipartisan support as well: the bill did get the vote of Republican Vice-Chair Aghazarian today. Earlier in the month, Republican Senator Maldonado voted for the Senate version of the bill, SB437 (Escutia).

* INDIVIDUAL MANDATE: AB1670 (Nation/Richman) failed, with only two votes in support, five votes in opposition, and the rest of the committee not voting. Opposed by consumer and constituency groups, health plans, and many others, this bill would have imposed a mandate on individuals to buy individual health insurance. In the broader health care package by the two Assemblymen, three bills on other subjects (AB1671, AB1672, AB1674) passed, while another (AB1673) on hospital seismic retrofitting failed.

* PRESCRIPTION DRUGS: AB73 (Frommer), AB74 (Gordon), AB75 (Frommer), AB76 (Frommer), AB78 (Pavley) all passed Assembly Business and Professions Committee. AB163 (Scott) and SB401 (Ortiz) also passed Senate Judiciary. All these bills addressed issues with the cost of prescription drugs. AB73 would provide consumer information to faciliate reimportation of cheaper drugs from other countries. AB 74 would establish a hotline to advise consumers on drug discount programs in California. AB 75 would provide a drug discount card, providing negotiated discounts to millions of Californians, using the leverage of Medi-Cal's purchasing power. AB 76 would coordinate drug purchasing among state agencies for better prices. AB 78 would set standards for pharmacy benefit managers. AB163 required disclosure of drug company's marketing costs. AB401 prohibits advertising in the materials provided with a prescription drug.

* "DISCOUNT" HEALTH PLANS: In a mixed result for consumer advocates, both AB562 (Levine) and AB1091 (Parra) passed, to regulate the so-called "discount health plans," many of which have been characterized as frauds by consumer groups and health providers. AB562, supported by consumer groups, passed with 10 Democratic votes. While AB1091 was supported by the industry and opposed by consumer, low-income advocacy, and physician groups, that bill passed with 8 votes, including the four Republicans on the committee, Aghazarian, Nakanishi, Richman, and Strickland, and Democrats Frommer, De La Torre, Dymally, and Negrete McLeod. AB757 (Chan) to prevent the re-selling of provide networks, also passed.

* INDIVIDUAL INSURANCE CONSUMER PROTECTIONS: AB1199 (Frommer) passed on consent, to provide the equivalent of a consumer credit report for individual insurance health status. AB1111 (Frommer), to provide other consumer protections for those denied coverage because of "pre-existing conditions," was held without hearing, at the request of the author and sponsor, Health Access California. Both bills are expected to advance in the future, although on different timetables.

* HOSPITAL REPORTING: Both AB1045 (Frommer) and AB1046 (Frommer) passed on party line votes, with strong support from consumer groups, to provide greater public disclosure about hospital charges and quality, respectively.

* MEDICARE DRUG PLANS CONSUMER PROTECTIONS: AB1359 (Chan) passed, sponsored by Health Access California, to provide consumer protections in Medicare prescription drug plans.

* MEDI-CAL MANAGED CARE: AB1481 (Richman) failed, garnering only three votes from the 14 member committee. It would have mandated managed care for the "aged, blind and disabled" in Medi-Cal, similar to the Schwarzenegger Administration's proposal.

* PUBLIC INSURANCE PROGRAM STREAMLINING: AB699 (Chan) passed, to eliminate costly semiannual reports that disrupt coverage of Medi-Cal enrollees at cost to the person, the provider and the State. AB1533 (Bass) passed on consent, to facilitate enrollment in private insurance for children graduating from Healthy Families due to higher age or income.

Labels: Updates

posted by Anthony Wright | Permalink | 9:56 AM


 

Monday, April 25, 2005

HEALTH ACCESS ALERT
Monday, April 25th, 2005

ASSEMBLY HEALTH COMMITTEE TO CONSIDER KEY CONSUMER BILLS TUESDAY

• Consumer Groups to Support Children's Coverage, Hospital Disclosure, Individual Insurance Reforms
• Consumers Groups to Oppose Individual Mandates and So-Called "Discount Health Plans"
• Other Key Issues on Medi-Cal/Healthy Families Changes, Medicare Prescription Drug Plans

The Assembly Health Committee, chaired by Assemblywoman Wilma Chan (D-Oakland), will consider a wide range of bills of great interest to health care consumers this Tuesday, at 1:30pm in the State Capitol in Sacramento.

Big issues will be discussed on Tuesday, as the roster includes bills that are both actively supported and opposed by consumer groups, with wildly differing notions of how to expand coverage to the uninsured, improve the Medi-Cal and Healthy Families programs, regulate insurers who buy coverage as individuals, and how to deal with so-called "discount health plans." The full roster of bills to be considered, as well as the names and contact information of legislators on the committee, is listed in the Assembly Daily File, which can be viewed at the Assembly website, at:
http://www.assembly.ca.gov/

Below is a list of some of those bills, along with the position of Health Access California, the statewide health care consumer advocacy coalition. Health Access' website has links to many of the bills it is tracking this year, along with copies of the support and oppose letters described the organization's position, at:
http://www.health-access.org/2005_bills.htm

COVERAGE FOR ALL CHILDREN
The ongoing effort to cover all children in California is gaining momentum, most recently with a massive Californians for Healthy Kids town hall earlier this month of over 4,000 people rallying for legislative action, and the movement of a companion bill through key Senate committees. About 90% of California children are covered, and this effort is to complete the job by covering the over one million uninsured children still left in our state.

* AB772 (Chan): Strong Support. The California Healthy Kids Program would attempt to cover all California children, by streamlining and building on existing programs like Medi-Cal, Healthy Families, and the various initiatives at the county level. You can get more information at the 100% Campaign website, at: http://www.100percentcampaign.org/priorities/healthy-kids-main.htm

INDIVIDUAL MANDATE PACKAGE
Assemblymembers Joe Nation (D) and Keith Richman (R) have a package of bills that would impose an “individual mandate” to buy health coverage. As opposed to the many other bills like Healthy Kids that would expand coverage, this concept “blames the victim” by imposing the cost burden on those that don’t have health coverage, by requiring them to pay for substandard coverage.

* AB1670 (Nation/Richman): Oppose. It requires every Californian to purchase health insurance regardless of ability to pay. It would set a $5,000 per person deductible as minimum benefit, and allow a reduced benefit package. The bill subsidizes employers of low-income families, not the employees.
* AB1671 (Nation/Richman): Oppose Unless Amended. Intended as an effort to streamline public insurance programs, the bill would allows privacy violations by allowing DHS to search tax records and other sensitive individual information.

"DISCOUNT" HEALTH PLANS/PROVIDER NETWORKS
So-called "discount health plans" are today unregulated entities, with the most abusive offering phony discounts on phony fee schedules for phony networks of providers, who are often unaware that they have agreed to offer discounts. These abusive plans mislead consumers and even some employers into believing that a discount health plan is an alternative to health insurance, one that is cheaper and more readily available. For example, these plans advertise in multiple languages that “no medical exam required”, “no pre-existing conditions”, “no waiting period”, all terms associated with actual coverage, not merely illusory discounts. They also prey on disadvantaged populations: consumer groups obtained translations of the flyers from Spanish and Chinese and found that these were even more misleading than the English versions. Health Access California and other groups would prefer to ban such plans; regulations should at least provide clear consumer protections against fraud and abuse.

* AB562 (Levine): Support if Amended. This bill would regulate discount plans through the Department of Managed Health Care and provide key consumer protections.
* AB1091 (Parra): Oppose Unless Amended. While the bill provides for various disclosures, it does nothing to assure a genuine discount. It provides few consumer protections for refunds or complaints.
* AB757 (Chan): Support. The bill would prohibit the selling of health provider networks without the provider's consent. If a provider is not aware that they have agreed to participate in a network, consumers can get caught in disputes over payment rates and other contract terms and conditions.

INDIVIDUAL INSURANCE CONSUMER PROTECTIONS
The individual insurance market is the last refuge for those who are not eligible for employer-sponsored coverage or a public insurance programs. Yet for most of the uninsured, buying health insurance as an individual is either unaffordable, or unavailable. Health Access California is working to provide some assistance to those who are denied individual insurance because of “pre-existing conditions.” Always on the lookout for STORIES, Health Access organizers would appreciate any assistance in finding people who have been denied coverage because of "pre-existing conditions." Please contact any of our offices if you can help!

* AB1111 (Frommer): Sponsor/Support. The bill would allow consumers to switch among individual insurance products within specific categories of individual insurance, which is now difficult for many consumers.
* AB1199 (Frommer): Sponsor/Support. This bill would ensure that people denied because of "pre-existing conditions" could find out exactly why they were denied, and possibly correct any mistakes. It would provide the equivalent of a consumer credit report for individual insurance health status.

HOSPITAL REPORTING
Consumer advocates are continuing their efforts to use better data reporting and public disclosure to improve quality and address the rising cost of health care.
* AB1045 (Frommer): Support. A follow-up to previous legislation, this bill would require hospitals to disclose their 25 most-used charges on their price lists, or "chargemasters."
* AB1046 (Frommer): Support. This bill would create a web-based hospital quality report card for consumers and purchasers of health care.

MEDICARE DRUG PLANS CONSUMER PROTECTIONS
While the recently-passed Medicare Modernization Act creates a Part D prescription drug benefit, there are many questions about its implementation in the next year. There are great concerns with the actual level of the benefit, how low-income seniors will fare, and how the transition will be accomplished. While many of these issues are at the federal level, senior and consumer advocates are working to ensure oversight here in California.

* AB1359 (Chan): Sponsor/Support. The bill would require the new Medicare Rx plans to abide by existing law realting to similar health plans, including the consumer protections in the Knox/Keene Act.

MEDI-CAL/HEALTHY FAMILIES CHANGES
Advocates for low-income Californians are continuing their ongoing efforts to streamline and improve public insurance programs so that more people who are eligible the program can get on and stay on Medi-Cal and Healthy Families. At the same time, advocates oppose efforts that would restrict access to care for those on these important programs.

* AB699 (Chan): Support. The bill would eliminate costly semiannual reports that disrupt coverage of Medi-Cal enrollees at cost to the person, the provider and the State.
* AB1533 (Bass): Support. The legislation would facilitate enrollment in private insurance for children graduating from Healthy Families due to higher age or income.
* AB1481 (Richman): Oppose. The bill would force seniors and people with disabilities on Medi-Cal into managed care plans, possibly deprinving them of their current doctors and providers.

Labels: Updates

posted by Anthony Wright | Permalink | 8:22 AM


 

Tuesday, April 19, 2005

HEALTH ACCESS UPDATE
Tuesday, April 19th, 2005

BIG BUDGET BATTLE BREWS ON BALLOT

• "Live Within Our Means Act" Would Give Unilateral Power to Governor, Force Health Cuts
• Sign-On Statement to Support Solutions Beyond Cuts and Caps

As legislative budget subcommittees dutifully review the proposed cuts by Governor Arnold Schwarzengger here in Sacramento, a bigger battle brews at the ballot box, over not just next year's budget but also budgets into the future.

GOVERNOR'S BUDGET INITIATIVE: As part of his ongoing push for a special election this November, Governor Schwarzenegger has endorsed the "Live Within Our Means Act," for which signatures are now being collected. The initiative would impose a new cap on state spending, and give the governor unilateral powers to cut spending in the event revenues fall below expectations. (Among other things, it also would eliminate the state’s obligation to restore $4 billion in school spending under Proposition 98.)

Even though the Governor withdrew one of his ballot measures on pension reform, he has repeatedly said he is going forward with a special election with his budget proposal. The text of the initiative is at the Attorney General's website, at:
http://ag.ca.gov/initiatives/pdf/sa2005rf0067_amdt_1_ns.pdf

This proposal heading for the ballot has far-reaching consequences for health care and other vital services. The California Budget Project has published a full analysis of the proposal, entitled “Limiting the Future?: What Would the 'Live Within Our Means Act' Mean for California?” The analysis is available at their website, at:
http://www.cbp.org/2005/0504bb_lwom.pdf

POWER GRAB: The proposal would give the Governor broad new powers to make cuts to health care and other vital services without any oversight, public review, or legislative approval. In the past several years, health care advocates have been successful in preventing many cuts that would have denied access to health coverage and care to hundreds of thousands of Californians. While some cuts were made, the worst were rejected as too severe, in some cases by legislators of both parties. This Health Access Budget Cuts Scorecard lists the cuts that have been proposed by two Governors in the past few years, both those made and those rejected.
http://www.health-access.org/docs/HealthCuts04ScorecardAug3FINAL.doc

With the new powers under this proposal, a Governor could have made many of these cuts unilaterally. Last year, Governor Schwarzenegger proposed to cap enrollment in Healthy Families and many other public health insurance programs that serve children, AIDS patients, and people with disabilities; and to cut provider rates for health care providers that care for patients on Medi-Cal. In both cases, he withdrew them after the legislature rejected them, but if this initiative had been law, he could have made those cuts directly.

FORCED CUTS: In many instances, the cap would force cuts in existing programs--even when the funds are available. Since the cap would limit spending based on revenue growth in the three previous years, it would force cuts in health and other vital services even when the budget is balanced, the economy is improving, and more revenues are coming in.

The new cap would be in addition to the existing state appropriations limit already in place, would also be placed not just on the general fund, but on money raised by specific taxes and fees, even those that are voter approved, such as Proposition 99 funds for health programs, or Proposition 10 funds for early childhood programs. This would prevent the state from using available, voter-approved funds for these important services.

This new spending cap would make it harder for the state to make the needed improvements in our health care system, including expanding coverage to the six million uninsured. And finally, the governor's budget initiative would actually place more spending on "autopilot," by making it harder for the legislature to suspend Proposition 42 to fund certain transporation projects, or Proposition 1A, to provide some funding to local governments. That will even further increase the pressure to make cuts in other, unprotected areas, such as health and human services. Health care services are particularly vulnerable, since the need for them often increases during economic downturns, when the state is looking to make budget cuts.

The Los Angeles Times editorialized against the Governor's budget initiative yesterday, in an article appropriately entitled, "A Really Bad Idea." It is available at their website at:
http://www.latimes.com/news/opinion/editorials/la-ed-ballot18apr18,0,7711770.story?coll=la-news-comment-editorials

SIGN-ON STATEMENT: For the last several years, health advocates have not only worked to prevent health care cuts, but also joined with other coalitions in support of a balanced solution to the budget crisis, to consider choices beyond cuts and caps. Since the budget deficit was partially created due to the range of tax cuts made in the past decade, a balanced solution would not just make cuts, but also raise revenues, such as restoring the upper-tax brackets on high-income earners, as Governors Reagan and Wilson did.

Health advocates are continuing that effort with other "budget allies," to urge for a responsible budget solution that is balanced, and doesn't hinder the ability to meet future needs. The statement of principles below is an attempt to get organizations from different issue areas to support a broad vision and statement around the budget. The statement includes opposition to the type of spending cap that Governor Schwarzenegger is proposing.

ALERT: Have your organization endorse this broad statement on budget principles and goals, so we may have it by the May revision of the budget, on May 13th, 2005. Please fill out and return the form below. A one page fax-back form is available at the Health Access website, at:
http://www.health-access.org/docs/BudgetAlliesStatement2005Final.doc

FIGHTING FOR CALIFORNIA'S FUTURE

We believe California’s budget should invest in California’s future:

• We believe in a California that provides high-quality public services for all Californians, protects consumers, the environment, and our quality of life, builds the infrastructure we need to prosper, and that fosters opportunity, economic growth, and strong and vibrant communities.
• We believe that a responsible California budget would keep its commitment to meet the basic needs of our children, our seniors, our families, and our future. We believe there are budget choices beyond cuts.
• We believe in a balanced budget that invests in the future, rather than one that mortgages our future with more borrowing to fill a structural budget gap.

We support a balanced solution to the budget crisis:

• We support a balanced solution to the budget crisis, rather than a budget that seeks to solve the problem only through cuts and borrowing.
• We support raising revenues needed to prevent cuts, including closing tax loopholes, eliminating some of the tax cuts of the last decade, and updating our tax system to reflect our changing economy.

We oppose automatic mechanisms to cut vital and needed services:

• We oppose policies, in the legislature and on the ballot, which would hinder the ability of the State to meet the current and future needs of all Californians.
• We oppose proposals that would grant the Governor new powers to make unilateral cuts; formulas that would impose automatic across-the-board cuts; stricter spending caps; and other policy changes that seek to "starve the public sector" and which would damage healthcare, education, and other vital services that all Californians depend on.

A one page fax-back form of this statement is available at:
http://www.health-access.org/docs/BudgetAlliesStatement2005Final.doc

___ Our organization signs on to the above statement.
___ Please keep our organization informed about ballot campaign efforts against proposals to institute new gubernatorial powers to unilaterally make cuts, stricter spending caps, and/or formulas for automatic across-the-board cuts.

ORGANIZATION: __________________________________________

AUTHORIZING SIGNATURE: _________________________________

CONTACT: ________________________________________________

ADDRESS: _________________________________________________

PHONE NUMBER: __________________________________________

E-MAIL: ___________________________________________________

Please return to: Budget Allies, c/o Louise Jones, Health Access, ljones@health-access.org,
or Fax-back at 916-497-0921

Labels: Updates

posted by Anthony Wright | Permalink | 1:06 PM


 

Tuesday, April 12, 2005

HEALTH ACCESS UPDATE
Tuesday, April 12th, 2005

ASSEMBLY HEALTH COMMITTEE PASSES KEY CONSUMER BILLS


The Assembly Health Committee, chaired by Assemblywoman Wilma Chan (D-Oakland), passes numerous bills supported by health care and consumer advocates earlier today. These bills need continued support from health advocates as they continue on to other committees later this month.

The bills included nine bills presented in a special order on the subject of the cost and safety of prescription drugs. With over 100 seniors and consumer advocates packing the hearing room at the start of the hearing, the committee voted to support AB 8 (Chu), AB 71 (Chan), AB 72 (Frommer), AB 73 (Frommer), AB 74 (Gordon), AB 75 (Frommer), AB 76 (Frommer), AB 78 (Pavley), and AB 95 (Koretz). After testimony from a range of key organizations, the vote tallies were almost uniformly party-line votes, with Democrats supporting these consumer-friendly bills, and Republicans voting against them or not voting.

The same was true for two measures that passed sponsored by Health Access California: AB 774 (Chan) to prevent hospital overcharging and other unfair billing practices, and AB 977 (Nava) to provide public oversight of rising out-of-pocket costs of health plans. Also passing with some Republican support was AB 624 (Montanez), to streamline enrollment of children from the Child Health and Disability Prevention Program into the Medi-Cal and Healthy Families program.

For a selected list of bills that are of interest to health care consumer advocates, as well as links to the actual bills and a letter analyzing the bill, visit the Health Access website at:
http://www.health-access.org/2005_bills.htm

Labels: Updates

posted by Anthony Wright | Permalink | 1:55 PM


 

Sunday, April 10, 2005

HEALTH ACCESS UPDATE
Sunday, April 10th, 2005

BIG WEEK: KEY HEALTH CONSUMER BILLS UP FOR VOTES

• Tuesday's Assembly Committee to Vote on Prescription Drug Bills, Consumer Protections Against Hospital Overcharging, Oversight of High-Deductible Plans;
• Children's Coverage to be Heard Wednesday in Senate Health Committee; Town Hall in Evening;
• Also: Briefings on Hospital Financing; Multicultural Health; and Medicare Part D Implementation
  

On Tuesday, April 12th, the Assembly Health Committee, chaired by Assemblywoman Wilma Chan, is slated to hear testimony and consider bills on many issues of great interest to health care consumers. Health Access California, the state's health care consumer advocacy coalition, and a range of consumer, senior, children's, labor, religious, and community groups will be supporting bills to make prescription drugs affordable, provide protections against hospital overcharging, and place oversight over rising out-of-pocket costs.

HOSPITAL OVERCHARGING: The Assembly Health Committee will vote on AB774 (Chan), sponsored by Health Access California, which would limit charges to the uninsured and underinsured to what public insurance programs pay for the same service, and provide other consumer protections against unfair billing practices. When vetoing a similar version of this bill last year, the Governor challenged the hospital industry to abide by their voluntary guidelines against overcharging, or else. California is the epicenter of this issue, which has gotten national press attention and been the subject of high-profile lawsuits around the nation and of Congressional hearings. For a fact sheet on the issues, visit the Health Access website at: http://www.health-access.org/ab774_facts.htm

PRESCRIPTION DRUGS: During a special order currently slated for 2pm, the Assembly Health Committee will also hear nine bills to reduce the cost and increase the safety of prescription drugs. For fact sheet on the bills supported by the "OuRx" Coalition, and the issue of prescription drugs, go to the Health Access website: http://www.health-access.org/ourx.htm

Of particular note is AB75 (Frommer), which would provide meaningful discounts for prescription drugs to millions of Californians. Unlike the drug industry's counter proposal (SB19) that is supported by the Governor, AB75 (and the similar Cal Rx Plus ballot measure that Health Access is sponsoring) would use the purchasing power of the state to leverage better prices, and make those discounts available to a wider range of Californians, including seniors, the uninsured, and the underinsured. A comparison chart of these measures in available at the website above.

HIGH DEDUCTIBLES: Another bill, AB977 (Nava), also sponsored by Health Access California, would bring some oversight to protect the increasing number of Californians who have high-deductible health plans. It would require the Department of Managed Health Care to take public comment on the issue of out-of-pocket costs, just as they do now on specific benefits and other issues. This issue has been raised when a recent Harvard study indicated that a majority of bankruptcies due to medical problems and medical bills were of insured people dealing with high costs.

COVERAGE FOR ALL CHILDREN

On Wednesday, the Senate Health Committee will consider SB437 (Escutia), to expand health coverage for all California children, by building on the work of the Medi-Cal and Healthy Families program and many county-based initiatives, as well as streamlining these program so it is easy for children to be enrolled and stay on coverage.

The hearing will be followed in the evening by a major TOWN HALL to focus on the issue of covering all children, from 6:30pm - 8:30pm, at the Sacramento Convention Center, Exhibition Hall A, 12th and J St. That event, which is expecting nearly 3,000 people, is sponsored by PICO California and the 100% Campaign.

OTHER EVENTS OF NOTE FOR HEALTH ADVOCATES

MONDAY: L.A. Briefing on Hospital Financing: Southern California advocates that want the background on the controversial federal Medicaid waiver on hospital financing are invited to a Health Access briefing: "Hospital Financing: An Informational and Strategy Convening for Health Advocates" will be on Monday April 11th, from 1:00pm till 3:00 pm at the auditorium at SEIU 660 (500 S. Virgil St., Los Angeles.) The briefing will go over the specifics, explain what the proposed changes might be, provide the latest update on the negotiations, and what the impacts are. Speakers include Rachel Kagan of the California Association of Public Hospitals and Health Systems, Jonathan Freedman, County of Los Angeles, Yolanda Vera of LA Health Action, and Kathy Ochoa of SEIU 660. Please RSVP to Idabelle Fosse at idabelle@health-access.org or 213-748-5287.

TUESDAY/WEDNESDAY: CPEHN's Multicultural Legislative Agenda Convening: Join the California Pan-Ethnic Health Network (CPEHN) as they explore the impact of upcoming legislation and the state budget on the health of California’s communities of color with a presentation of our firstever Multicultural Health Legislative Agenda. Their Agenda addresses hospital overcharging, universal health coverage for children, school food nutrition standards, refugee social services, the prohibition on the use of children as interpreters in medical settings, and state budget cuts to Medi-Cal. On Tuesday in Los Angeles: Time: 11:00am - 2:00pm Location: Asian Pacific American Legal Center, 1145 Wilshire Boulevard, 2nd Floor, Validated parking available (Automatic Parking Lot, 1317 Wilshire Blvd.) On Wednesday in San Diego: Time: 11:00am - 2:00pm Location: Tubman Chavez Multicultural Center, 415 Euclid Avenue, San Diego, CA. Similar events will be in Fresno and Oakland next week. For questions please contact (510) 832-1160 or info@cpehn.org

FRIDAY: Sacramento Briefing and Discussion on the New Medicare Part D & Dually Eligible Medicare/Medi-Cal Beneficiaries: Nearly one million of California’s most vulnerable Medi-Cal beneficiaries will lose their Medi-Cal prescription drug coverage on January 1, 2006. The briefing will discuss that: Vulnerable seniors & individuals with disabilities will be at risk of treatment interruptions and loss of continuity of care; The new coverage will provide fewer prescription drug benefits than Medi-Cal; Effective and appropriate outreach will be needed to avoid confusion and fear in this most vulnerable population; The state will need to effectively use opportunities to reach low-income Medicare beneficiaries who may be eligible for, but not yet enrolled in Medi-Cal or Medicare Savings Programs; Beneficiaries will need assistance obtaining low-income subsidies to avoid unnecessarily paying for the costs of their medications. Friday, April 15, 2005 11:00 am – 2:00 pm Westminister Presbyterian Church 1300 N Street, Sacramento, California. Sponsored by numerous senior, consumer, and advocacy organizations. Please RSVP to Arlene Peterson with the Western Center on Law and Poverty, 916 442-0753 ext 11, or by E-Mail – Apeterson@wclp.org Please RSVP--Space is limited Box lunches will be available.

Labels: Updates

posted by Anthony Wright | Permalink | 8:20 AM


 

Wednesday, April 06, 2005

HEALTH ACCESS UPDATE
Wednesday, April 6th, 2005

KUEHL BILL PASSES SENATE INSURANCE COMMITTEE;
HEALTH ACCESS BRIEFINGS ON HEALTH COVERAGE & HOSPITAL FINANCING

The new debate over health coverage kicked off today with a Senate committee vote on SB840 (Kuehl), to establish a single-payer universal health insurance system. (See item below) Other bills have been introduced and will be discussed as the year progresses, including proposals that health consumer advocates strongly support, such as an effort to expand coverage to all children, and oppose, such as a proposal for an "individual mandate" of coverage.

SAC BRIEFING ON HEALTH COVERAGE EXPANSION: In order to assist advocates and legislative staff in evaluating these proposals, Health Access is sponsoring a briefing THURSDAY, APRIL 7th, at 1:30pm to 3:30pm, at Room 2040 of the State Capitol, in Sacramento. Entitled "THE NEW HEALTH COVERAGE EXPANSION DANCE: TWO STEPS FORWARD, ONE STEP BACK: A Health Consumer View of Current Legislative Proposals to Cover Uninsured Californians," the convening features Dr. Bree Johnston from California Physicians' Alliance on SB 840(Kuehl); Deena Lahn and Kristin Golden Testa of the 100% Campaign on AB772 (Chan)/SB437 (Escutia) and the effort to cover all children; and Beth Capell and Anthony Wright from Health Access on problems with the "individual mandate" in AB1670 (Nation/Richman).

L.A. BRIEFING ON HOSPITAL FINANCING: While advocates work to expand coverage, they continue their efforts to support the safety-net providers that care for the uninsured, like public hospitals. Southern California advocates that want the background on the controversial federal Medicaid waiver on hospital financing are invited to another Health Access briefing: "HOSPITAL FINANCING: An Informational and Strategy Convening for Health Advocates" will be on Monday April 11th, from 1:00pm till 3:00 pm at the auditorium at SEIU 660 (500 S. Virgil St., Los Angeles.) The briefing will go over the specifics, explain what the proposed changes might be, provide the latest update on the negotiations, and what the impacts are. Speakers include Rachel Kagan of the California Association of Public Hospitals and Health Systems, Jonathan Freedman, County of Los Angeles, Yolanda Vera of LA Health Action, and Kathy Ochoa of SEIU 660. The conversation will also talk about strategy, about how advocates can help ensure that California gets its fair share of hospital funds, and that all Californians, including the uninsured, insured, communities of color, seniors, people with disabilities, and other populations get the hospital care they need. Please RSVP to Idabelle Fosse at idabelle@health-access.org or 213-748-5287.

For other events of interest to health advocates, go to the online Health and Budget Advocacy Calendar:http://www.health-access.org/calendarhome.htm

UNIVERSAL HEALTH CARE BILL, SB840, PASSES FIRST COMMITTEE

The California Health Insurance Reliability Act, SB840(Kuehl), which would institute a statewide, universal health insurance system, was passed out of Senate Banking, Finance, and Insurance Committee, chaired by Senator Jackie Speier (D-San Francisco).

The vote in the committee was 7-4 today, on a straight party-line vote, with Democrats supporting and Republicans opposing. The bill is next slated to ne heard in the Senate Health Committee on Wednesday April 20th, at 1:30pm. Organizational letters for support are due to the committee Thursday, April 14th by noon.

THE SUPPORT: Senator Sheila Kuehl (D-Los Angeles) introduced her bill with both an overview of the health care crisis, and of her bill as a solution to the problem. She pitched the bill as a way to more efficiently use the health care dollars now spent to cover all Californians without many of the financing and access issues that now threaten care for everybody.

To outline the problem, she had a representative of CalPERS, the third-largest purchaser of health care in the country, to give an overview of the problem of rising health care costs, and how addressing these costs is such a challenge for even the most powerful actors in the health care marketplace. A California citizen gave stirring testimony about how she was forced into bankruptcy after a medical emergency, even though she had coverage.

To support the solution, Dr. Richard Quint of California Physicians Alliance described the merits of CHIRA. He was followed by dozens of organizations that stated their support, including: Health Access California, Gray Panthers, SEIU, California Teachers Association, United Nurses Association of California, Resources for Independent Living, Consumers Union, Congress of California Seniors, California School Employees Association, Older Women’s League, Congress of Racial Equality, California Commission on the Status of Women, Friends Committee on Legislation, Vote Health, Health Care for All, National Association of Social Workers, Mental Health Association, Neighbor to Neighbor, Unitarian Universalist Legislative Ministry, and Progressive Democrats of America.

THE OPPOSITION: The opposition was led by the Chamber of Commerce, which stated their “opposition to a universal, single-payer health care system,” stating that they believe it would lead to “higher costs for consumers” and “greater bureaucracy, including several new state agencies and many new state employees.” The Chamber “fundamentally disagrees that a government-run system can be more efficient and cost less,” and that such a system would be “ripe for cost-overruns” that would lead to tax increases.

Senator Kevin Murray (D-Los Angeles) called the Chamber’s position “disingenuous,” citing that they opposed SB2 because they didn’t want the burden of health coverage on business, yet they also opposed this solution where the cost would be shared throughout society. He asked to be added as a co-author, stating that “I don’t expect this to be more efficient, or provide better care, but more people will get care. We need to figure out a way to cover all the people.”

Senator Speier similarly challenged the Chamber, which admitted under questioning that they have not been supportive of any policies to address rising costs or access to coverage, although they were currently doing an “internal analysis” of what they would support. When Senator Dave Cox (R-Sacramento) raised the issues of low Medicare and Medicaid rates as cost driver, Senator Speier also challenged the Chamber about why they didn’t support increased revenues in order to fund increased provider reimbursements. She was frustrated because the Chamber opposes any health coverage proposal, “and when we do something, you spend $20 million dollars to undo it.”

The National Federation of Independent Businesses also opposed, which cited the vote against a single-payer plan in Oregon, and support of Health Savings Accounts and Association Health Plans. Other opponents included life and health insurers, America’s Health Insurance Plans, HealthNet, the Association of Health Underwriters, California Association of Health Plans, California Medical Association, and the California HealthCare Institute, which made the argument that such a plan would stifle innovation.

OTHER DISCUSSION: Senator Jack Scott (D-Pasadena) agreed that “while people may not like government to run their health care, the 7 million uninsured would like somebody to run their health care.” Responding to opponents claim about waiting times and other issues in Canada, Great Britain, and other countries that have universal health care, the Senator simply pointed out that “they provide all their citizens health care, at a lower cost.” He also referred to their better rates of infant mortality, longevity, and other public health indicators. “If you a wealthy American, we have the best system in the world. If you are poor, we don’t.”

Senators Cox and Jeff Denham (R-Modesto) cited their opposition to the measure, thinking it would create a “more broken system.” Senator Mike Machado (D-Stockton), chair of the Revenue and Taxation Committee, cited his support and said he looked forward to working with Senator Kuehl on the financing piece of the measure. Senator Speier closed the debate by indicating that Medicare is a system that may have problems, but “we don’t have millions of senior citizens without health coverage,” and many seniors are pleased with this “government-run” system.

Labels: Updates

posted by Anthony Wright | Permalink | 12:53 PM


 

Tuesday, April 05, 2005

HEALTH ACCESS UPDATE
Tuesday, April 5th, 2005

APRIL ACTIVITY IN LEGISLATURE ON HEALTH ISSUES

• Senate Budget Subcommittee Votes Against Medi-Cal Premiums
• Consumer Bills Up Next Tuesday on Drugs, Hospital Overcharging, Etc.
• New Bill to Provide Oversight on Deductibles, Out-of-Pocket Costs
• Sacramento Briefing Thursday on Health Coverage Bills
  

SENATE BUDGET SUBCOMMITTEE VOTES AGAINST MEDI-CAL PREMIUMS

Yesterday, a Senate budget subcommittee voted to reject key parts of Governor Arnold Schwarzenegger's "Medi-Cal redesign" package, including a controversial proposal to impose premiums on over a half-million Californians in near poverty that get Medi-Cal coverage.

The Senate Budget and Fiscal Review Subcommittee #3 on Health and Human Services, chaired by Senator Denise Ducheny (D-San Diego), considered several health budget issues yesterday. After a few months of informational hearings, the three-member subcommittee did start making some preliminary decisions, with the votes of Senator Ducheny and Tom Torlakson (D-Antioch) carrying the majority, often over the vote of George Runner (R-Antelope Valley). Of particular interest to health advocates, the issues raised included:

* PREMIUMS: The subcommittee voted to reject the Administration's proposal to impose permiums on nearly 550,000 Californians on Medi-Cal, including 90,000 seniors and people with disabilities, and 460,000 families with children, all between 100% and 155% of the federal poverty level. The proposal would have set these premiums at $4/month for children, $10/month for adults, with a $27/month maximum for a family.

Among the issues discussed was the projection that 95,000 Californians would drop off coverage as a result, and the cost shifts to county and safety-net providers as a result. Many questions were raised about the details of the proposal, including the significant administrative costs of imposing these premiums. After testimony by a full range of consumer, provider, and county represetatives, Chair Ducheny called to "just get this one over with" and the subcommittee voted to reject the proposal, which would actually provide $6.2 million savings in the budget year, recouping the administrative costs.

* MAXIMUS CONTRACTING: The subcommittee also voted to reject the proposal to change the existing "single point of entry" process for joint Medi-Cal and Healthy Families applications, contracting out a specific piece of processing of applications to the Healthy Families vendor, currently Maximus. There was considerable confusion about the proposal, and debate about whether the proposal was workable, or whether it actually streamlined the process for the state or the applicants. With Senator Ducheny commenting that "well, this is messy," the committee rejected it, for a budget year savings of $5.7 million to recoup the implementation costs.

* CAP ON ADULT DENTAL: The subcommittee did not take action on the Governor's proposal to place an annual $1,000 cap on Medi-Cal dental coverage for nearly 3 million seniors, parents, and adults with disabilities. It would be anticipated that 94,900 Californians would be impacted by the cap, and would have to pay out-of-pocket for medically necessary treatments. There also would be a cost shift to other parts of the state budget, as regional centers would have to pick up the full cost of the dental care for developmental disabilities, without the benefit of a federal match from Medi-Cal. The subcommittee discussed many options, including excluding certain services from the cap, raising the cap level, and rejecting it altogether. The subcommittee decided to hold the issue open and revisit the issue.

Health advocates should note that these decisions on premiums and application contracting are important, but nothing is final: the Assembly also has its budget process, the Governor can change his proposals in the May Revision of the budget, and items can be reinserted as the budget moves through the legislature in June.

CONSUMER BILLS TO BE HEARD NEXT TUESDAY

The Assembly Health Committee, chaired by Assemblywoman Wilma Chan (D-Oakland), is set to hear many key bills of interest to health consumer advocates, on issues including prescription drugs, hospital overcharging, and out-of-pocket costs.

A range of prescription drug bills will be heard during a "special order." A range of senior and consumer organizations are supporting many of these bills. A list of this "OuRx" package is at: http://www.health-access.org/ourx_bill_rights.htm

Another bill to be heard seeks to prevent hospital overcharging and other unfair billing practices. A fact sheet, sample letter and bill description is available at: http://www.health-access.org/ab774_facts.htm

These and other bills are set to be heard next Tuesday, April 12th, at 1:30pm in Assembly Health Committee at the State Capitol. Health advocates that wish to support these bills NEED TO SEND LETTERS ASAP to the Assembly Health Committee. In order to be listed in the bill analyses, organizational letter need to be received by tomorrow, Wednesday, April 6th.

OVERSIGHT OF HIGH-DEDUCTIBLE PLANS AND OUT-OF-POCKET COSTS

Also up for a vote next Tuesday in Assembly Health Committee is a measure to provide oversight over high deductible plans and other rising out-of-pocket costs. AB 977, as introduced by Assembly Member Pedro Nava and sponsored by Health Access California, would create a public process for review and approval of co-pays, deductibles and other out of pocket costs and would provide guidelines against which these must be reviewed by the Dept. of Managed Health Care and the Dept. of Insurance. AB 977 would create a mechanism for limiting out of pocket costs, which have increased dramatically in recent years.

In recent years, the share of health care costs paid by consumers, even those with health insurance on the job, has climbed as employers have shifted a greater share of health insurance costs to employees and their families. For family coverage, California employees now pay an average of $2580, 27% of the cost of the health insurance premium. Similarly co-payments, deductibles and other out of pocket costs have increased. Many employees have no cap on the out of pocket maximum to be paid for health benefits. Half of employees now face co-payments for prescription drugs, as well as hospital care. Deductibles of $1000, $1500 or even $5000 per person exist. Out of pocket costs may be capped at several thousand dollars – or not at all.

Under existing law, the Dept. of Managed Health Care and the Dept. of Insurance approve changes in out of pocket costs without any public input or public review. Consumers have no voice in designing health benefits. There is literally no way for consumer groups to affect what benefits are being provided – what the deductibles are, what the co-payments are, or what the out of pocket maximum is. These decisions are made in secret by the Department of Managed Health Care and the Department of Insurance.

AB 977 (Nava) would create a public process for reviewing changes in out of pocket costs for health insurance. It would set standards for review of out of pocket costs by DMHC and DOI that include affordability, accessibility of care, and impact on clinical outcomes. Health advocates wanting to support this measure should send letters ASAP to Assemblymember Nava and Health Committee Chair Chan.

BRIEFING THURSDAY ON HEALTH COVERAGE MEASURES

Health Access invites health advocates and legislative staff to a briefing entitled: "THE NEW HEALTH COVERAGE EXPANSION DANCE: TWO STEPS FORWARD, ONE STEP BACK: A Health Consumer View of Current Legislative Proposals to Cover Uninsured Californians."

The briefing is this Thursday, April 7th, 1:30pm-3:00pm at the State Capitol, Room 2040 in Sacramento. Please RSVP to Louise Jones, Health Access, 916-497-0923; ljones@health-access.org. An agenda and list of speakers will be sent out shortly to those who RSVP.

This quick briefing, led by experts from key consumer and community organizations, will provide briefings and answer questions on the substance of the legislative proposals to expand coverage, as well as those bills they oppose on this topic. This month, both Senate and Assembly committees will be actively considering several health reform proposals, from building on the Healthy Families program to provide coverage to all California children, to an ambitious proposal for single-payer, universal health coverage. Health Access California and other health consumer advocates actively support the multiple proposals to expand coverage. At the same time, they are alarmed by “individual mandate” and other proposals to shift the cost and burden of health care onto consumers.

Health advocates will provide their organization’s principles and issues as we enter this new discussion about health reform. Handouts will also include a more extensive list of pending legislation, good and bad, on coverage.

Labels: Updates

posted by Anthony Wright | Permalink | 3:10 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...