Changing of the guard…

The press has made a lot about the turnover in the Governor’s office, with major figures leaving such as press secretary Margita Thompson and legislative director Richard Costigan. Costigan’s departure matters in next year’s health reform debate, given his history on the issue: In 2003, he was the Chamber of Commerce’s top lobbyist and the main opponent of SB2(Burton), the bill to expand employer-based coverage.

Under the radar for the mainstream press, but hugely important for health policy, is the just announced departure of Stan Rosenstein, the Director of Medi-Cal (California’s version of the federal Medicaid program). In a thoughtful E-mail, Stan reports he is retiring from state service after three decades–and in Executive positions under four Governors. He reports that he will “establish a Sacramento office for one of the nation’s leading healthcare consulting firms, Health Management Associates, and will start work on January 15, 2007.”

In his long history, there certainly have been many times when we as health and consumer advocates have strenously disagreed with Stan’s positions and statements, but let me simply point our three positive and memorable events from just this year.

* Stan had a big role in a celebration of Medi-Cal’s 40th anniversary, but even for that event it was hard to overstate how important the program is, providing coverage for over 6.8 million Californians–many seniors, people with disabilities, children & many of their parents, and providing significant funding for the health system on which we all rely. He was appropriately proud of the program, and at the celebration, Medi-Cal adopted a logo that represented these patients, as well as all the California counties that are important participants. All year, I never have seen Stan without the new Medi-Cal lapel pin, or without one of his trademark purple ties.

* When the initial implementation of Medicare Part D was clearly faltering, Stan was seen as taking an active role in having California adopt emergency “coverage of last resort,” to ensure that low-income seniors and people with disabilities got their medications until the problems were fixed. While advocates have an unfinished agenda in preventing these “dual-eligibles” from being worse off under Part D, these quick actions may have saved lives.

* The last time I saw Stan was at the signing ceremony for AB2911 (Nunez/Perata), the much-discussed prescription drug discount bill, an issue he was involved in for many years. [Here is a picture from the ceremony, from left to right, of Stan, Assembly Speaker Nunez, myself, and Governor Schwarzenegger.] The Governor (wearing a matching pink tie to Stan’s purple tie) made an explicit point of ensuring that Stan got one of the signed copies of the bill. Maybe he knew something that we didn’t?

Health Access California promotes quality, affordable health care for all Californians.

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