HEALTH ACCESS UPDATE
Thursday, June 19th, 2008
BILLS CLEAR HEALTH POLICY COMMITTEES IN OPPOSITE HOUSE
* SB1522 to ban junk insurance passes Assembly Health Committee
* AB1945 would impose new rules on insurers who cancel insurance policies
* AB2967 to collect cost and quality data from medical providers passes
Click Here for What’s New on the Health Access WeBlog: Continued Real-Time Budget Conference Committee Reports; A Predictable LAO Analysis on Single-Payer; Following the Bills in Health Committee; Also: Thursday June 19th Events: San Francisco Lunchtime Rally Against AHIP & Insurance Companies; Los Angeles TCE Panel Discussion on Health Reform
Key bills of interest to health advocates were heard in the last two days, in, respectively, the Assembly Health Committee, chaired by Assemblymember Mervyn Dymally, and Senate Health Committee, chaired by Senator Sheila Kuehl.
Hundreds of bills that passed the house where they were introduced must now clear the second house; and the first step of that is to pass policy committees by June 27. A number of bills that would benefit health care consumers were in Assembly and Senate Health committees this week, including a number of key bills that would lay the foundation for comprehensive health reform in the next couple of years. An updated list of bills is available on the Health Access website, at:
INSURANCE STANDARDS: Among those bills was SB1522 (Steinberg), sponsored by Health Access California, that would weed out junk insurance from the individual insurance market by ensuring that every plan covered doctor, hospital and preventive services. It would also place a cap out-of-pocket costs. The bill would organize the market into five tiers so that consumers could make apples-to-apples comparisons between plans and require that pricing of those plans was consistent with the level of benefits the plans offered.
In an interesting admission, the Association of California Life and Health Insurance Companies noted that “more transparency would be good.” This bill passed out of Assembly Health Committee with little debate on a party line vote. It heads next to the Assembly Appropriations Committee.
On Wednesday, the Senate Health Committee heard more bills being tracked by health advocates including:
DEBATE ON ANTI-RESCISSION BILL
AB1945 (De La Torre) would create an INDEPENDENT REVIEW process when an insurer wishes to rescind a consumer’s health insurance policy. The Department of Managed Health Care and Department of Insurance would also have the final say on whether a policy could be rescinded. Lastly, the bill would standardize health plan questionnaires for consumers applying for coverage in the individual market.
The issue of rescissions has received much attention in the past couple of years as the LA Times and other papers have written a number of stories about patients who have had their policies unilaterally cancelled while in the middle of expensive chemotherapy or other medical treatments. Rescissions (or reviews to rescind coverage) have been triggered when a patient begins an expensive course of treatment, and then insurers have allegedly scoured applications looking for a rational to deny their care–any hint that the consumer omitted information about their health status–whether related to the current treatment or not.
Earlier this year, the Department of Managed Health Care had 1,200 policies that were illegally cancelled reinstated. Kaiser, who supported the bill, was one of the insurers that agreed to a settlement with the state to reinstate coverage for rescinded patients. HealthNet–and annoucned earlier today, Pacificare–also reached agreements with the DMHC.
A number of health plans did not oppose, but had concerns about two issues. First, they preferred not to have a uniform questionnaire, but rather a “menu” of approved questions from which they could pick and choose so they could control the length and scope of the application. Secondly, health plans did not want all rescissions to automatically go to independent review, but rather something that the consumer could opt out of. While some consumer groups, including Health Access California, supported the bill, some organizations raised concerns about the impact on consumers’ rights to bring a court proceeding against health plans. The bill heads next to the Senate Judiciary Committee, where some of these questions will be addressed. The bill passed on a bipartisan vote.
DEBATE ON TRANSPARENCY BILL
Another bill heard Wednesday that would help lay the foundation for comprehensive reform in the coming years is aimed at collecting data so that skyrocketing health care costs could be better controlled. Medical errors cost millions annually and result in thousands of unneccessary deaths.
AB 2967 (Lieber) would provide greater TRANSPARENCY AND DISCLOSURE for health care purchasers. The bill would require public reporting of cost and quality by doctors, hospitals HMOs and others in the health care industry. In order to funnel health care dollars more appropriately into treatments that work, the state needs to first gather data. Recognizing that there are many factors that contribute to a patient’s health, the data would be adjusted to take into account income, geography, cultural and linguistic issues and other factors.
Collecting data, said author Assemblywoman Sally Lieber, would be “better than driving in the dark with no headlights, which is what we’re doing now.”
In an unusual coalition, consumer, labor and business groups all joined together to support this. The California Association of Health Plans were also in Support if amended. Some of the questions that arose came from representation on the baord that collects the information. As constituted in the bill, providers make of half of the board, while consumers, labor and employers make up the other half.
Strong opposition came from the physicians and hospitals, however, who said they did not want “non-scientific people” collecting data and “releasing it to the public.” Providers did not trust that data would properly take into account the fact that some patients are poor and have many health issues. Assemblywoman Sally Lieber, however, countered that information to be collected will take into account poverty, health status and cultural issues, which will then be factored in reporting, which can be measured and adjusted. Studies about health disparities that contain this information are regularly published and the data that would be collected through this bill would help the significant work in place now to reduce the health disparities seen in race and income.
Sen. Sheila Kuehl acknowledged the fear that providers had, but said “I like the idea of data collection and knowing to be able to compare.” The bill passed.
OTHER KEY BILLS: Other bills heard in Assembly or Senate Health Committee this week included the following, listed by bill number (author name) VOTE OUTCOME in Commitee. SHORT DESCRIPTION. Description of Bill. Position of Health Access California:
* SB 1168 (Runner): PASSED Assembly Health. DEPENDENT COVERAGE. Would allow adult dependent children, who are still covered under their parents’ health plan, to stay on that coverage even if the child takes a medically necessary leave of absence from school. Support.
* SB 1633 (Kuehl): PASSED Assembly Health. DENTAL DEBT PROTECTIONS Would prohibit dentists’ offices from offering high-interest loans to patients while they are under the influence of anesthesia. Would also prohibit dental offices from charging lines of credit before services have been rendered. Support.
* SB 1525 (Kuehl): PASSED Assembly Health. MEDICAL NECESSITY. Requires health plans to explain how they determine medical necessity. Also requires health plans to report their rates of denial of care or modifications to care because of medical necessity. Support.
* AB 1203 (Salas) PASSED Senate Health. EMERGENCY ROOM BILLS: Would prevent emergency departments – which do not have a contract with a patient’s insurance company — from directly billing the patient, requiring the hospital to seek payment directly from insurers. Support
* AB 1887 (Beall) PASSED Senate Health. MENTAL HEALTH PARITY: Would require health plans to provide coverage for all diagnosable mental illnesses. Support.
* AB 1962 (De La Torre) PASSED Senate Health. MATERNITY COVERAGE: Would require all individual insurance policies to cover maternity services. Support.
* AB 2220 (Jones) PASSED Senate Health. BINDING ARBITRATION: Requires providers and health plans to resolve contracting and payment disputes through binding arbitration. More on this legislation must be resolved in the Senate Judiciary Committee. Watch.
* AB 2400 (Price) PASSED Senate Health. HOSPITAL CLOSURES: Would require public notice before closing a hospital. Support
* SB 1096 (Calderon): FAILED Assembly Health. PRESCRIPTION INFORMATION. Would allow pharmacies to send mailers to consumers about the drugs they have been prescribed without the patient’s authorization. Oppose.
A final wave of legislation will be heard next week before the June 27th policy committee deadline. Health Access will keep advocates updated on the progress of consumer-related health bills.
For more information, please call the author of this report Hanh Kim Quach, policy coordinator at Health Access, at email@example.com.