Tuesday, January 31, 2006

HEALTH ACCESS ALERT
Tuesday, January 31st, 2006


STATE OF THE UNION HIGHLIGHTS HIGH DEDUCTIBLE PLANS

• President Bush Plans Push for High Deductible Plans and Health Savings Accounts
• AB977 (Nava) Passes CA Assembly, to Review High Deductibles and Other Out-of-Pocket Costs
• ALERT: Budget Reconciliation Vote This Week on $3 Billion Cut to California; Rep. Bono Targeted
  

Health care is taking the spotlight in the federal discussion this week. President George W. Bush highlighted a handful of health care proposals in tonight's State of the Union speech, such as promoting high-deductible plans and health savings accounts. (See the full SOTU coverage and analysis below.)


MEDICAID CUTS PENDING

Also later this week, the U.S. House of Representatives is expected to have an exceedingly close vote on a "budget reconciliation" bill, that would make $16 billion in cuts to the federal Medicaid program, as well as major cuts to other services such as student loans and child support collection. The bill would impose additional costs on those with Medicaid coverage, and impose new administrative burdens to get such coverage.

CLOSE VOTE: In a previous House vote, this measure was approved by a very narrow margin, 212-206, largely on party lines, with Republicans supporting the measure, and Democrats opposing it. Because of pressure from advocacy organizations pointing out the economic and community impacts of these cuts, a few more Republicans have announced their opposition to the measure, suggesting an even closer vote in the next day or so.

ALERT: ALL CONGRESS MEMBERS SHOULD BE CALLED ASAP on this issue, to urge them TO OPPOSE BUDGET RECONCILIATION. Representatives from Health Access California and other health, senior, low-income, and community organizations have met in the past few days with both the DC and Palm Springs offices of Representative Mary Bono (R-45, Hemet), who is identified as a potential swing vote. THOSE IN REP. BONO'S DISTRICT SHOULD CALL HER OFFICE AT (202) 225-5330, OR FAX TO (202) 225-2961.

CALIFORNIA IMPACT: A recent Legislative Analyst's Office indicated that "the fiscal impact of this legislation on California would be $3.1 billion--$1.7 billion in reduced federal funds and $1.4 billion in increased state costs-during federal fiscal years 2006 through 2010." For the full LAO report, visit http://www.lao.ca.gov/PubDetails.aspx?id=1366

The Congressional Budget Office (http://www.cbo.gov/) has a national cost perspective. The California Budget Project also has an analysis of the California financial and policy impact, at:
http://www.cbp.org/2006/0601_federalbudget.pdf

Given this information, a coalition of groups, including the California Partnership, Health Access California, Western Center for Law and Poverty, and the California Association of Food Banks, have written to Governor Arnold Schwarzenegger to urge him to publicly oppose this measure, and urge the entire California Congressional delegation to do the same. Unfortunately, despite his pledges to be the "Collectinator" and protect federal money for California, and the fact that the votes of only a few California Congressmen could make the difference, Governor Schwarzenegger has not made this a priority.


STATE OF THE UNION, ON HEALTH CARE

In his State of the Union, President George W. Bush did highlight some health care policy proposals. While early signals were given that health care would be the centerpiece of the President's domestic agenda, the issue did merit a few paragraphs, fully transcribed below:

"Keeping America competitive requires affordable health care. Our government has a responsibility to help provide health care for the poor and the elderly, and we are meeting that responsibility. For all Americans, we must confront the rising cost of care, strengthen the doctor-patient relationship and help people afford the insurance coverage they need.

"We will make wider use of electronic records and other health information technology, to help control costs and reduce dangerous medical errors. We will strengthen health savings accounts by making sure individuals and small business employees can buy insurance with the same advantages that people working for big businesses now get. We will do more to make this coverage portable, so workers can switch jobs without having to worry about losing their health insurance. And because lawsuits are driving many good doctors out of practice, leaving women in nearly 1,500 American counties without a single OB-GYN, I ask the Congress to pass medical liability reform this year."

ANALYSIS ON HEALTH SAVINGS ACCOUNTS: The focus of the president's proposals are the expansion of health savings accounts, which consumer advocates say simply encourage high-deductible plans from employers and insurers, shift costs from insurers to individual consumers, starve public health programs for resources, and further undermine traditional insurance pools, making health care less affordable overall. More details about President Bush's health care proposals are at the White House website, at:
http://www.whitehouse.gov/news/releases/2006/01/20060131-7.html

Consumer advocates are concerned that high-deductible insurance policies will make health care costs even more unaffordable, as even people with their insurance will have to pay significant out-of-pocket costs, or lead them to forgo needed care.

Health Savings Accounts would not serve most of the millions of uninsured and underinsured Californians. They actually are another new tax shelters for the wealthy, disguised with the word "health." Since wealthy people can afford insurance policies with high deductibles, and since HSA tax breaks are most beneficial for people in high tax brackets (since most uninsured and underinsured people live paycheck to paycheck and won't be able to set aside money in an HSA), the President's proposal will provide the most help for those who need it the least.

In fact, HSAs are more likely to raise costs than to reduce them. The rationale for this policy is that consumers use too much health care and are over-insured, and they need financial penalties to discourage them from getting care. The group Families USA points out about HSAs that:

• The overwhelming majority of America’s health care costs are spent for people with major illnesses and disabilities and during the last stage of life. High-deductible insurance policies will have no impact on those costs.
• High-deductible insurance policies, however, deter people from spending the first-dollar costs needed for primary and preventive care. It is this care that is most important for protecting the American public’s health and avoiding the spread of detectable illnesses.
• As the wealthy who are healthy leave traditional insurance and purchase high-deductible coverage with HSAs, those left with traditional insurance coverage—less wealthy Americans and those who expect to need health care, including those with chronic health problems—will be forced to pay skyrocketing premiums because traditional insurance pools will have higher and higher per capita costs.
• HSAs will drain critical federal resources needed to strengthen the health care safety net, such as Medicaid and the State Children’s Health Insurance Program (SCHIP).
  

NEW GARAMENDI REPORT: In anticipation of the President's push, Insurance Commissioner John Garamendi released a study on the insurance impact of Health Savings Accounts, calling them "bad medicine" and that they "pose a clear danger" for an ailing health care system. The report is available at:
http://www.insurance.ca.gov/0400-news/0100-press-releases/0070-2006/upload/Jan_06_Dangerous_Prescriptions.pdf

The report indicates that Health Savings Accounts:

• Force the patient to play doctor and will likely reduce utilization of needed health care;
• Require currently nonexistent tools to help consumers understand health care quality;
• Discourage the use of preventive and disease management techniques;
• Increase the financial risk to families;
• Jeopardize continuity of care;
• Fail to address the true cost drivers in health care;
• Will not offer the needed help to the uninsured;
• Put California’s hospitals at risk, especially safety net hospitals;
• Are designed as tax breaks for the wealthy;
• Create a new boom market for investment banks instead of helping with health care; and
• Support employer efforts to transfer health care costs to employees.
  

STATE LEGISLATION ON HIGH DEDUCTIBLE PLANS (AB977)

In a related but contrasting story, yesterday the California Assembly voted to pass AB977 (Nava), sponsored by Health Access California, to have the Department of Managed Health Care conduct a public review of high deductibles and out-of-pocket costs, and to disapprove plans with "unusually high" deductibles and co-pays that serve to limit access to needed care. In this way, the bill can prevent the problem of underinsurance, as even those with insurance face medical debt and even bankruptcy because of high out-of-pocket costs.

The bill was stalled last year on the Assembly floor due to heavy lobbying by the insurance industry, which is heavily marketing new high-deductible and high-cost plans, which allow the insurers to shift more of the cost of health care onto patients. Assemblyman Pedro Nava (D-Santa Barbara) was able to pass the bill this year on a 42-36 votes, with most Democrats voting for it. Voting against the measure were all Republican Assemblymembers, as well as Democratic Assemblymembers Matthews, Nation, Parra, and Wolk. Assemblymembers Canciamilla and Chavez did not vote.

ALERT: AB977(Nava) now goes to the Senate Banking, Finance, and Insurance Committee, which includes Democratic Senators Speier, Florez, Lowenthal, Machado, Murray, and Scott, as well as Republican Senators Cox, Denham, and Hollingworth. Organizational letters of support should be sent to any or all of these committee members, as well as referred to the bill's author, Assemblyman Pedro Nava, as well as Health Access California.

Labels: Updates

posted by Anthony Wright | Permalink | 9:13 AM


 

Monday, January 23, 2006

HEALTH ACCESS UPDATE
Monday, January 23rd, 2006


THE MEDICARE PART D CRISIS CONTINUES

• Over 20 States, Including California, Now Providing Some Form of Emergency Coverage
• Governor Signs AB132 (Nunez) to Provide 30-Day Emergency Coverage, up to $150 Million
• Tens of Thousands of Prescriptions Filled Under State Coverage as Private Plans Fail
• Ongoing Problems Will Require Ongoing Solutions
  

On Friday, January 20th, Governor Arnold Schwarzenegger signed into law AB132 (Nunez), an emergency measures which gives the state of California authority to provide prescription drug coverage to "dual-eligibles"--seniors and people with disabilities who are on both Medicare and Medicaid--as a "payer of last resort" for an emergency period of thirty days.

MANY STATES ACTING: Over twenty states, large and small, blue and red, have put in place such plans given the widespread problems with the implementation of the new Medicare prescription drug benefits, which is largely administered though a myriad of private insurance plans.

NEAR-UNANIMOUS VOTE: The emergency legislation required a two-thirds vote, but received widespread, bipartisan support after being introduced just on Tuesday. The only "No" votes were from Republican Assemblymembers DeVore and Haynes, and Republican Senators Hollingsworth and McClintock.

BUSY WEEK FOR GOVERNOR: The press release regarding the bill signing is available on his website, along with press statements and materials going back to the Thursday, January 12th declaration of the emergency and the beginning of the state's effort, and a Thursday, January 19th meeting between the Governor and U.S. Health and Human Services Secretary Michael Leavitt in Sacramento on this topic.
http://www.governor.ca.gov/state/govsite/gov_homepage.jsp

CRISIS BACKGROUND: Up until January 1st, the state of California's Medi-Cal program provided prescription drug coverage to these 1.1 million low-income seniors and people with disabilities. Starting on January 1st, private prescription drug plans under Medicare were to start providing this coverage, with Medicare providing a low-income subsidy. With error rates reported at 20%, leaving potentially hundreds of thousands of Californians at risk of being denied prescriptions, or being charged fare more than they can afford, the state is now continuing to provide back-up coverage through the old Medi-Cal system, even though it was supposed to stop providing such coverage on December 31st. In its first full week, this emergency coverage filled over 77,000 prescriptions, that likely would have gone unfilled otherwise.

TIMELINE: The legislation actually authorizes the state to provide emergency coverage for 15 days, and gives the Governor authority to extend the emergency for another 15 days, with notice to the Legislature, through February 10th. In a meeting of health advocates last week, CA Secretary of Health and Human Services Kim Belshe explained that this was designed to keep pressure on the federal government to fix the problems, but that did "not in any way close the door" for future extensions or other future assistance if needed.

COST: The bills authorizes expenditures up to $150 million, which the Schwarzenegger Adminstration has been clear that they expect to be reimbursed by the federal government. The Centers for Medicare and Medicaid Services, however, have only offered to assist states in going after the prescription drug plans for the necessary reimbursements. While it is true that many of the problems were caused by these (mostly for-profit) prescription drug plans, the federal government has the main authority to run the program and policy these plans, and should be responsible for collections, rather than leave that burden to the states, who were filling in due to these federal failures.

ONGOING COSTS: The Medicare prescription drug benefit was supposed to save the state of California money, around $120 million a year, by taking some of the cost of providing medications to this vulnerable population of seniors and people with disabilities. Instead, the state is paying more so that these "dual eligible" Medicare & Medicaid recipients can get less comprehensive, more costly coverage. The costs are threefold:

• Without federal reimbursement, the initial $150 million cost of this emergency coverage is likely going to grow, since problems are expected into the future. Some states are putting into place long-term "wrap-around" coverage so that their seniors and people with disabilities don't get denied drugs or have to forgo medication because of cost burdens.
• A "clawback" provision in the Medicare drug benefit requires that states pay the federal government the money it would have used for drug coverage for this population that got coverage through state Medicaid programs. While it was supposed to provide 10% savings for states, the flawed formula actually is budgeted to cost California over $70 million in a year, even without the costs of emergency coverage.
• Finally, since the state is no longer the major purchaser of drugs for these 1.1 million vulnerable patients with above-average medical needs, it is losing its purchasing power in negotiating with the drug companies for better prices for the remaining Medi-Cal population, which has been successful in past years of yielding hundreds of millions of dollars in rebates.
  

ONGOING PROBLEMS MEAN ONGOING SOLUTIONS: Unfortunately, the federal government is not using its potentially massive purchasing power to get a better deal with the drug companies. In fact, this new Medicare law explicitly prohibits the federal government from negotiating with the drug industry, which is why the program is designed to delegate the administration of this benefit to this bewildering network of private plans, creating the complexity and confusion that now exists.

Senior, disability, health, low-income and consumer advocates will be working to put in place the needed policies at both the state and federal levels to fox this flawed program. Many of the problems in this program are structural, and will not go away in 30 days. The emergency legislation is a necessary, life-saving step in ensuring that California seniors get the prescription drugs they need, but it's just the beginning.

ACTIONS: Some initial steps that health advocates are taking include:
At the state level:

• Thank the Governor and state legislators for their emergency action.
• Remind them that even if the initial problems are solved, these vulnerable seniors and people with disabilities are still facing more costly, less comprehensive coverage, and the state should continue to provide real relief.
  

At the federal level

• Urge our Congressional delegation to support full reimbursement for California.
• Advocate for fixes to the Medicare benefit, from H.R. 3861(Stark) to delay implementation of other upcoming deadlines in the program, to a full reconsideration of the measure so that the program can be simplified by simply letting the federal government negotiate with the drug companies.

Labels: Updates

posted by Anthony Wright | Permalink | 9:10 AM


 

Thursday, January 12, 2006

HEALTH ACCESS UPDATE
Thursday, January 12th, 2006


CALIFORNIA EXTENDS 15-DAY EMERGENCY DRUG COVERAGE
TO VULNERABLE SENIORS AND PEOPLE WITH DISABILITIES IN MEDICARE

• Over One Million "Dual-Eligibles" Facing Problems Under Medicare Part D Implementation
• CA Joins Over 10 States, Providing Prescription Drug Coverage Costing $70 Million
• First Step in Fixing a "Challenged and Troubling Implmentation" and Flawed Benefit
  

Starting later today, California will extend emergency drug coverage to the over one million low-income seniors and people with disabilities, many of whom have faced problems is getting needed medications as they transitioned to the new Medicare Part D prescription drug benefit.

Governor Arnold Schwarzenegger's action under emergency authoriy allow California to joins over 10 states in offering emergency prescription drug coverage during Medicare Part D implementation. The press release is available at the Governor's website under "Press Room" and "Press Releases," at:
http://www.governor.ca.gov/state/govsite/gov_homepage.jsp

BACKGROUND: Senior, health, consumer, and low-income advocates had urged that the state step in to fill in for these federal failures. The impacted patients are the over one million "dual-eligible" Californians, low-income seniors and people with disabilities that qualify for both Medicare and Medi-Cal, who are the most vulnerable of California's residents.

Up until December 31, 2005, these patients got full prescription drug coverage from the state Medi-Cal program. On January 1, 2006, all of them were supposed to be switched to a new low-income Medicare benefit from the federal government. (Even if the benefit worked perfected, these new private Medicare plans would provide more costly, less comprehensive coverage)

WHAT IT DOES/DOESN'T DO: This coverage *will* help those patients that have fell through the cracks of this beginning implementation, who have found that they have no coverage, that there are errors in the system about what coverage and cost-sharing they may have, and in many cases that they can't get any drugs whatsoever. Many patients have gone to the pharmacy and found that they cannot get their prescribed drugs, or that they are being charged retail prices, placing many into hardship. Secretary Kim Belshe indicated that the federal Centers for Medicare and Medicaid Services (CMS) reports a 20% error rate, meaning that perhaps over 200,000 low-income Medicare recipients are at risk of not getting the drugs they need.

This emergency coverage *won't* deal with the ongoing issues of all of the over one million patients now facing higher co-payments, or that many will find that the drugs they need are not covered under the new, private prescription drug plans. The need to fix this Medicare benefit over the long-term will be an ongoing issue in the new year, but it wasn't the subject of this necessary, emergency provision.

CA JOINS OTHER STATES: In the last several days, news reports have indicated that over ten states, including New Hampshire, North Dakota, South Dakota, Connecticut, Vermont, Maine, Hawaii, New Jersey, Idaho, Illinois and Massachusetts, are offering state-funded temporary drug coverage. These actions have yielded national coverage, revealing the most acute problems about the implementation of the Medicare Part D prescription drug benefit. It is clear that with these federal failures, with life-and-death issues on the line, the states needed to step in.

HOW IT WORKS: In the press conference today, Secretary of Health and Human Services Kim Belshe described that the state will turn back on Medi-Cal coverage for these patients, and the state will be the payer of last resort. A 5-day emergency coverage program will start today under his emergency authority. With agreement through legislative leadership, legislation is expected to be introduced on Tuesday, January 17th to extend this program for a total of 15 days. The expectation is that the federal government will have remedied many of these transition issues in the next few weeks.

Secretary Belshe and Medi-Cal Director Stan Rosenstein indicated that pharmacists would be able to get reimbursed for providing prescribed drugs if they show that they were unable to get needed information from Medicare, that they inquired to Medicare but were incorrectly denied, or if the Medicare patient's deductible or co-payment was higher than the $5 maximum for these low-income patients.

Those who have been denied in the last 12 days should go back to the pharmacist, who can retry their name in the Medicare system, and if not, can get the needed drugs under Medi-Cal. At the press conference, several pharmacists were on hand to talk about the problems they have experienced in the last two weeks.

THE COST: Medi-Cal Director Rosenstein estimated the cost of this 15-day prorgam to be around $70 million, money that was not included in the proposed budget that was released a few days ago. Secretary Belshe was clear that "this does not mitigate the federal government's responsibility" for these costs, and that the state intends "to seek full reimbursement." In this vein, Sen. Frank Lautenberg (D-NJ) introduced legislation in Congress to get the federal government to reimburse states for these problems. However, up until this point, the federal government was clear that it was not intending to even provide Medicaid matching funds for drugs covered under the Medicare benefit.

THE FALLOUT: In response to a reporter's question, Secretary Belshe indicated that this was a "challenged and troubling implementation" of the Medicare drug benefit, and that California and other states had advised caution to the federal government, which went unheeded. She pointed out that in California, problems could be expected when shifting the drug coverage of over one million vulnerable patients in one day.

ACTIONS: This emergency action will require a 2/3 vote of both houses of the legislature, requiring votes from Democrats and Republicans, as will other future emergency actions and other remedies that require money. Senior, health, low-income, and consumer advocates are expressing their appreciation to these legislative leaders and members, but also preparing the groundwork that such emergency coverage be extended, and that ongoing gaps in the Medicare drug benefit need to be addressed to protect these vulnerable seniors and people with disabilities.

Labels: Updates

posted by Anthony Wright | Permalink | 8:06 AM


 

Tuesday, January 10, 2006

HEALTH ACCESS UPDATE
Tuesday, January 10th, 2006

GOVERNOR'S HEALTH BUDGET DOES NO HARM, BUT OFFERS NO NEW HELP

• Increases to Education and Other Areas; Cuts to Low-Income Programs
• Child Outreach Effort Restored; $72 Million for Enrollment and Retention
• No Health Cuts, No Health Coverage Expansions for Children or Adults
  

Today, Governor Arnold Schwarzenegger unveiled his proposed $125.6 billion budget plan for the 2006-07 fiscal year, which includes $97.9 billion in proposed General Fund spending.

While the Governor announced the budget does not raise taxes, the budget maintains an estimated operating deficit in 2006-07 of approximately $6.4 billion. The Governor acknowledged that the operating deficit would not exist if had hadn't made specific decisions, including to rescind the vehicle license fee increase earlier in his term, but that he stood by those decisions.

No major health cuts were announced. This was in contrast in other areas of the budget, such as parts of education, which got increases. Cuts were announced to some low-income assistance programs, most notably CalWORKS.

The full budget, with links to both the overall summary and specifics, is available at the website of the Department of Finance, at:
http://govbud.dof.ca.gov/

The detailed budget proposal of health care is available at:
ftp://ftpgovbud.dof.ca.gov/pub/GovernorsBudget/4000.pdf

NO HEALTH CUTS: The Governor's proposed health budget follows the rule of, first, do no harm. The Governor's budget does not include major cuts or program expansions in health care.

The only two savings proposals under the Department of Health Services was reform of the Adult Day Health Care Program and a freeze in count administration salary and overhead reimbursements, which would be a cut of $42.4 million (21.2 million general fund).

The only sginificant mention of the Governor's "Medi-Cal Redesign" proposal from last year was the continued effort to move seniors and people with disabilities into managed care. Yet the budget "builds upon recommendations from legislators and advocates that DHS take a more cautious and deliberate approach to achieving this end." So there is $2 million ($926,000 general fund) to work more to implement and increase enrollment in voluntary managed care for seniors and people with disabilties, as well as to initiate mandatory enrollment in two counties as a pilot project.

For links to various resources about the health budget, go to:
http://www.ebudget.ca.gov/StateAgencyBudgets/4000/agency.html#printable

A full description of the Health and Human Services Agency budget is available at the Agency's website, at:
http://www.chhs.ca.gov/CHHSABudget20062007/PDFs/Agency%20Book%20FINAL%201-10-06.pdf

CHILDREN'S HEALTH: In a press conference yesterday, and in his announcement today, the Governor focused on outreach, enrollment and retention of children into Medi-Cal and Healthy Families coverage. The budget includes $72.2 million ($3 million general fund) to restore programs to enroll the approximately 428,000 children that are eligible but not enrolled in public health insurance programs. The efforts include:

• Providing up to $20.8 million ($9.1 general fund) in grants to counties for outreach and enrollment activities. (Note that this is less than the cut to county health care administration.)
• Making the electronic application, Health-e-App, widely available and encourage application assistants and others to enroll children.
• Continuing to offer incentive payments--$2.5 million ($1 million general fund)--to encourage Certified Applicant Assistants (CAAs) to continuously enroll more children in Medi-Cal and Healthy Families. (Last year's budget restored these incentive payments after they were cut for two years.)
• Providing $3.4 million ($1.4 million general fund) for a public education campaign, partnering with the First 5 California Commission to promote awareness of the Medi-Cal and Healthy Families programs.
• Helping retain more children by simplifying the annual form needed to determine continued eligibility for Medi-Cal. The budget includes $45.5 million ($22.7 million general fund) for caseload growth.
  

While these are small but important steps to covering children, the Governor did not announce any expansions of eligibility. In his re-election year, the Governor is falling short of his campaign goal to cover all children, not offering an expansion to a single child. He vetoed a bill to meet that goal last year, and this relatively small investment in outreach won't even get California half-way there. Around half of the nearly one million uninsured children are already eligible coverage, and so may benefit for this additional outreach, but the other half are left without coverage.

The Governor's press release on this effort is available at his website, at:
http://www.governor.ca.gov/state/govsite/gov_homepage.jsp
A fact sheet is available at:
http://www.governor.ca.gov/govsite/pdf/press_release_2006/HF_Budget_Fact_Sheet.pdf

NO EXPANSIONS, OTHER MISSING ITEMS: The Governor did not include any proposal for health care expansion, to provide relief for the over 6 million children or adults that don't have health coverage, or others with health care needs.

The budget also does not restore the health cuts of previous years and from the federal government, so the actual patients and providers could be worse off this year. Three examples:

• Around one million low-income seniors (known as dual eligibles) are facing new co-payments and more restricted formularies for prescription drugs under Medicare starting January 1st of this year. This change was imposed by the federal Medicare bill some years ago, but some states are considering covering those costs to relieve this new burden on these vulnerable patients.
• Also as of January 1, doctors are facing a 5% rate reduction for treating Medi-Cal patients, a cut that was made at the beginning at the budget crisis, which is just now being implemented, and which the budget proposal does not rescind.
• Many safety-net hospitals have yet to get crucial federal funds as part of the new hospital financing waiver that Governor Schwarzenegger negotiated with the federal government. An important goal from last year was to hold these hospitals harmless, so that they don't find themselves losing critical funds.
  

More information on the budget and its implications will be forthcoming in the weeks and months ahead.

Labels: Updates

posted by Anthony Wright | Permalink | 1:41 PM


 

Thursday, January 05, 2006

HEALTH ACCESS UPDATE
Thursday, January 5th, 2006

STATE OF THE STATE LARGELY IGNORES HEALTH CARE & COVERAGE ISSUES

• Focus on "Strategic Growth Plan"; Governor Schwarzenegger: "I Say, Build It"
• Only Announcement on Health Policy: Letter to Congress on Prescription Drug Reimportation
• Third Year in a Row Health Crisis Not Made a Priority
  

Tonight, in his State of the State address, Governor Arnold Schwarzenegger laid out his proposals for 2006. After acknowledging "the mistakes I made" and "my defeat," he reviewed his accomplishments and then mostly focused on a "Strategic Growth Plan" for the future.

The plan would borrow money through $70 billion in bonds to fund construction projects to build highways and other transportation systems, schools, water and flood control projects, courts, and other public works. He also mentioned some other issues, including education funding and a minimum wage increase. The speech is available at the Governor's website, under "Speeches," at:
http://www.governor.ca.gov/state/govsite/gov_homepage.jsp

"Our systems are at the breaking point now. We need more roads, more hospitals, more schools, more nurses, more teachers, more police, more fire, more water, more energy, more ports... more, more, more," the Governor said.

HEALTH CRISIS IGNORED: Missing from his solutions, however, was any action on health care issues. For the third year in a row, the Governor ignored the health care crisis, or the problem that over six million Californians uninsured, and millions more are underinsured and thus don't get the care they need because of cost. Despite some early press reports, he did not mention anything about children's coverage, which he vetoed last year after stating during his campaign that he supported the goal.

Two peripheral references to health care was to his signing of the obesity-related legislation to ban soda and junk food in schools, and that since reducing traffic congestion reduces pollution, cleaner air can lower health care costs and prevent one in six children in the Central Valley from needing an inhaler.

PRESCRIPTION DRUGS: The Governor's one statement on health care focused on prescription drugs: "I ask myself, what's the quickest way that we can help the greatest number of people with the spiraling health care costs? I believe in the free market. I believe in free trade. I mean we buy food from overseas. We buy cars from overseas. Why not prescription drugs? So I call upon the federal government to permit the safe importation of prescription drugs. I say, let the free market work."

The only action from this statement was a letter sent to Congress earlier this week, urging legislators to support pending legislation to allow the reimportation of prescription drugs from Canada. This was not a new stance: the Governor stated his preference for federal action when he vetoed bills in both 2004 and 2005 to allow the state of California to facilitate the reimportation of prescription drugs. Governors in ten states, both Democrat and Republican, have already approved legislation at the state level to help their residents with reimportation. Governor Schwarzenegger's letter, which some see as punting the issue to the federal government, is available here:
http://www.governor.ca.gov/govsite/pdf/press_release_2006/01-06_Drug_Importation.pdf

While health advocates welcomed his voice in the federal debate, they were disappointed that he did not make any mention of taking action at the state level. The state has the power, not only through reimportation but through directly negotiating with the drug companies, to bring down the cost of prescription drugs. However, the fact that the Governor felt that he needed to mention prescription drugs means that the issue is very much alive. Senior, health and consumer groups will be working to negotiate with the Administration for a enforceable prescription drug discount program. For more information on this effort, contact Anthony Wright at Health Access California, at awright@health-access.org.

PREVIOUS STATE OF THE STATES: This is the third year in a row that Governor Schwarzenegger has yet to make any proposal on expanding health care coverage. This is unusual as many Governors, like those in Maine and Illinois, have made headlines with reforms they have championed, and most politicians across the nation have felt compelled to offer some health care reform plan. On the other hand, Governor Schwarzenegger has yet to acknowledge that there are over six million uninsured Californians, or the crisis of the health care system on which we all rely.

In 2004, the only reference to the words "health care" in the State of the State was as part of his discussion of worker's compensation reform. In 2005, his only statement on health issues was on prescription drugs, announcing his legislation that relied on voluntary from drug companies. The legislature and voters rejected that proposal. Neither speech ever mentioned the uninsured or health care coverage in general.

UPCOMING EVENTS: The Governor is expected next Tuesday, January 10th, to release his Budget proposal for 2006-07.

Later this month, the national organization Families USA will be holding its annual Health Action Conference, on January 26-28th, in Washington, DC. California usually sends a sizable delegation to get briefed on state and federal issues, and the discussion will be no less relevant, with Medicaid cuts pending, and the problems with Medicare Part D drug benefit surfacing. For more information, or to register, visit: http://ga3.org/familiesusa/events/conference_2006/details.tcl

Labels: Updates

posted by Anthony Wright | Permalink | 1:35 PM


 

Reserving my right to critique coverage later...

 

From small changes to BIG changes...

 

The view from 10,000 feet.

 

A Zen Sen

 

Bush Whacking Kids

 

A San Francisco treat

 

Fireworks of a different kind...

 

Building a fence at the border for whom...

 

International House of Health Care

 

Dept. of Insurance