HEALTH ACCESS UPDATE
Monday, October 12, 2009
HEALTH BILL ROUNDUP: GOV SIGNS KEY MEDI-CAL IMPROVEMENTS,
VETOES MOST CONSUMER PROTECTIONS AND INSURER REGS
* Signed Bill To Draw Down Over $2.3 Billion in Federal Matching Funds for CA Hospitals and Children’s Coverage; Additional Legislation Needed
* Signed Measure To End Gender Discrimination in Premium Pricing
* Vetoed Bills Would Have Prevented Rescissions; Require Maternity, Mental Health Services; Give Communities Notice Before ER Closures
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Governor Arnold Schwarzenegger signed and vetoed over 700 bills yesterday, including several of interest to California’s health care consumers.
Governor Schwarzenegger’s actions on end-of-year legislation was mixed for health care consumers. He signed some key proposals to maintain and improve the Medi-Cal program, from getting more federal funds to improving hospital reimbursements, to helping prevent balance billing of Medi-Cal patients, to extending a program for people with disabilities who are working.
But the Governor sided with the insurance industry to veto most of the consumer protections before him. He did sign a key measure to stop women from being charged more than men for premiums, but vetoed other insurance regulation measures to prevent coverage from being rescinded, and ensure that key services, like maternity, mental health and other treatments, are covered.
The Health Access website has a full list of the bills Health Access California tracked this year, including those that were on the Governor’s desk.
Here are some of the highlights of the health bills. All bulleted bills were supported by Health Access California.:
MEDI-CAL IMPROVEMENTS, INCLUDING MORE FEDERAL FUNDS
Perhaps the biggest health news was the Governor’s signing of a measure to draw down $2.3 billion in federal funds to increase Med-Cal reimbursement rates as well as support children’s coverage.
* AB 1383 (Jones): HOSPITAL DIVIDEND FEE: would, per federal approval, impose a coverage dividend fee on hospitals for the purpose of drawing down federal funds for increased reimbursement and children’s coverage expansion. SIGNED.
There is more work to do on this issue. In the Governor’s signing message, he indicated the need for additional legislation to implement the change.
With a tough budget year, a struggling health care system, and Medi-Cal rates that are some of the lowest in the nation, AB1383(Jones) is especially urgent given the enhanced match under the economic stimulus period of the American Recovery and Reinvestment Act.
Other bills that improved the Medi-Cal program included:
* AB 1142 (Price): PROOF OF ELIGIBILITY: To prevent “balance billing” of Medi-Cal patients, would require hospitals, as soon as they have proof of a person’s Medi-Cal eligibility, to provide all information regarding that person’s Medi-Cal eligibility to all other providers. SIGNED.
* AB 1269 (Brownley): DISABLED WORKERS: Would allow, to the extent that federal financial participation is available, workers with disabilities who are otherwise eligible for Medi-Cal but are temporarily unemployed to elect to remain on Medi-Cal for a period up to 26 weeks. SIGNED.
KEY CONSUMER PROTECTIONS
The Governor vetoed most of the key health care bills on the Governor’s desk would provide consumer protections for patients and needed oversight over health insurers, but signed some notable exceptions.
The biggest surprise was the Governor’s signing of AB119(Jones), to ban gender discrimination in the pricing of health policies.
Bills that were vetoed included regulations of insurer rescissions, and mandating key benefits like maternity care and mental health services. These were high-profile issues that have been significantly discussed in the national health reform debate, and included in the major health reform proposals in Congress, like H.R. 3200. The bills included:
* AB 119 (Jones): GENDER RATING: to prohibit insurers from charging different premium rates based on gender. SIGNED
A few bills addressed the controversial insurance company practices of retroactively denying coverage, or rescissions.
* AB 2 (De La Torre): INDEPENDENT REVIEW OF RESCISSIONS, to create an independent review process when an insurer wishes to rescind a consumer’s health policy, create new standards and requirements for medical underwriting, and requires state review before plan approval. Also raises the standard in existing law so that coverage can only be rescinded if a consumer willfully misrepresents his health history. VETOED (See attached veto message)
* AB 730 (De La Torre): POSTCLAIMS UNDERWRITING PENALTIES: Would increase and direct fines on insurers unlawfully engaging in rescissions and post-claims medical underwriting. VETOED (See attached veto message)
* AB 108 (Hayashi): RECISSION TIME LIMIT: Would make clear a 24-month time limit in which insurers have to rescind, cancel, or limit individual health care policies or charge higher premiums because of fraud once a consumer’s application is approved. SIGNED (See attached signing message)
The Governor largely vetoed virtually all the bills that required that health insurance include key benefits, so patients who have been paying premiums don’t find themselves without needed coverage or care. They included:
* AB 98 (De La Torre): MATERNITY COVERAGE, to require all individual insurance policies to cover maternity services. VETOED (See attached veto message)
* AB 244 (Beall): MENTAL HEALTH PARITY, to require most health plans to provide coverage for all diagnosable mental illnesses. VETOED (See attached veto message)
Other coverage benefit mandates that were vetoed included SB 158 (Wiggins), for cervical cancer screening of the human papillomavirus vaccination (See attached veto message); AB 56 (Portantino) for mammographies (See attached veto message), and AB 513 (de León) for breast-feeding consultation (See attached veto message). One insurer benefit mandate that was signed was SB 630 (Steinberg) for cleft palate reconstructive surgery.
Other pending consumer protections regarding providers included:
* AB 171 (Jones), on DENTAL CREDIT CARDS – 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. SIGNED
* SB 196 (Corbett): HOSPITAL/ER CLOSURE NOTICE: Requires public notice of hospital closure or reduction/elimination of emergency medical services. VETOED (See attached veto message)