Wednesday, April 28th, 2004


* Bills Move Forward on Prescription Drugs, Out-of-pocket Costs, Access to Coverage

In the last month, bills on prescription drug costs, out-of-pocket costs, access to coverage, and other matters of concern to health care consumers were considered and moved along in the legislative process. Below is a report from Health Access legislative advocate Beth Capell:

The first round of legislative policy committee hearings has concluded for the most part. For legislation to proceed this year, each piece of legislation needed to pass the initial policy committee by this past Friday, April 23. Legislation that has survived the first committee now moves to the Appropriations Committee for consideration of the fiscal impact on state and local governments. Most of these bills will await the determination of the “suspense” list on or about Friday, May 21: Use of the suspense list allows the leadership of each house to weigh priorities by subject area and determine what is worth spending money on given the fiscal situation of the state. Once a bill comes off suspense, it has less than a week to pass the house of origin (that is, Assembly bills have a week to pass the Assembly and Senate bills have a week to pass the Senate).

LINKED to our web site are the letters that Health Access California has sent on those bills, which can be used as sample letters.


Several bills this year, sponsored by a range of consumer, senior, labor, and health care organizations, attempt to address the rising costs of prescription drugs. Most have passed the first policy committee, and they now are pending in the Appropriations Committee. A full list of the bills is available at:

In Assembly Appropriations Committee:

– AB1957 (Frommer): Websites to advise purchase prescription drugs from Canada.

– AB1959 (Chu): Legislative oversight of Medi-Cal and other state government prescription drug rebate programs.

– AB1960 (Pavley): Regulation of “PBM”s

– AB2326 (Corbett): Prescription Drug Report Card on efficacy and safety

In Senate Appropriations Committee:

  • SB1149 (Ortiz): Website listing sources that are unsafe for purchasing drugs from Canada.
  • SB1144 (Burton): Department of General Services to use Canadian sources for drugs for Corrections, state hospitals, and other select state agencies.
  • SB 1170 (Ortiz): DHS to establish a Maximum Allowable Ingredient Cost lists within a year.
  • SB1333 (Perata): Medi-Cal and the AIDS Drugs Assistance Program to reimburse pharmacies that purchase drugs from Canadian pharmacies.
  • SB1765 (Sher): Codify the voluntary guidelines of Pharmaceutical Research and Manufacturers of America PhRMA)on gifts, meals, and other inducements offered to prescribers.


OUT-OF-POCKET COSTS: AB2289 (Chan), sponsored by Health Access California, begins to address the issue of out-of-pocket costs for the insured. Costs for consumers are skyrocketing: as premiums climb, employers are shifting costs to working families through higher share of premium, higher co-pays, deductibles and other out-of-pocket costs. AB2289 requires the Department of Managed Health Care and the Department Insurance to gather detailed information on what people with insurance are paying. This is a crucial step in getting costs for consumers under control. Please write in support! In Assembly Approps.

SB1192 (Chesbro) adds substance abuse coverage to existing law. Similar to mental health parity. Passed Sen. Ins. Goes to Sen. Approps.

SB1555 (Speier) adds maternity coverage to health insurance coverage. HMOs are already required to cover prenatal care but insurers can drop it. Prenatal care is cost-effective for the individual and for society. Passed Sen. Insurance. Goes to Sen. Approps.

AB2185 (Frommer) adds asthma devices such as nebulizers to coverage. Similar to law on diabetes supplies. Passed Assembly Health. Goes to Approps.

AB2324 (Chan), sponsored by California Pan-Ethnic Health Network and Latino Coalition for a Healthy California, requires collection of data on race and ethnicity plus effortes to eliminate determinants of disparities. In Assembly Approps.

AB2270 (Chan), sponsored by Consumers Union, streamlines school based Medi-Cal administrative activities.


AB2996 (Richman) eviscerates coverage by allowing employers and HMOs to pick and choose what to cover. Employers and HMOs can drop any therapy, service or other benefit, including cultural and linguistic access, coverage for broken arms (but not broken legs), prenatal care, family planning, lung cancer (but not skin cancer), etc. FAILED ASSEMBLY HEALTH.

AB2933 (Richman)seniors and persons with disabilities who depend on Medi-Cal into mandatory managed care without protecting against disruption of provider networks or assuring adequate services, including those appropriate for persons with disabilities. FAILED ASSEMBLY HEALTH.

AB2985 (McCarthy) suspends SB2, the California Health Insurance Act, for two years whenever unemployment is above 7% for one quarter. Puts at risk health coverage for millions of working Californians. Health coverage helps to fuel economic recoveries by preventing personal bankruptcies. NOT SCHEDULED FOR HEARING.

AB2990 (McCarthy) permits health savings accounts to be combined with high deductible HMO coverage. Health savings accounts are great for high income, healthy individuals but bad for people with chronic conditions, those with low or moderate incomes, and women and children who need frequent care. NOT SCHEDULED FOR HEARING.

AB2315 (Maldonado) authorizes state income tax deductibility of health savings accounts. Health savings accounts are great for high income, healthy individuals but bad for people with chronic conditions, those with low or moderate incomes, and women and children who need frequent care. On suspense list in Assembly Rev and Tax.

AB1888 (Nakanishi) authorizes state income tax deductibility of medical savings accounts. Similar to health savings accounts, medical savings accounts are great for high income, healthy individuals but bad for people with chronic conditions, those with low or moderate incomes, and women and children who need frequent care. Not scheduled for hearing.


A few bills have not yet been heard in the policy committees, but have gotten waiver to be heard this week or next. These include:

AB2354 (Levine): Bans phony discount programs for health services. In Assembly Health. Health Access supports.

AB2874 (Diaz): Limits closure of hospital emergency rooms if detrimental impact on community. In Assembly Health. Health Access supports. (No letter yet)

SB1509 (Alpert): Controls hospital costs through better disclosure of financial situation of non-profits plus allowing greater market power to purchasers like PERS. In Senate Health. Health Access supports. (No letter yet)

SB1349 (Ortiz): Separates regulation of HMOs by shifting regulation of financial viability of HMOs from DMHC to Department of Insurance but NOT shifting regulation of quality of care. Use rate regulation methodology similar to that for auto insurance without adapting it for health insurance. Health Access watch. (No letter yet)

SB1679 (Perata): Allows ER docs and hospitals to balance bill insured consumers, refer them to collections, and take other aggressive action even though the consumer reasonably sought emergency care and has insurance. Intended to facilitate payment of ER docs and hospital ERs. In Sen. Ins. Health Access oppose unless amended to protect consumers.

For more information, contact Health Access:

Oakland · (510) 873-8787 · 414 13th Street Suite 450 · Oakland · CA · 94612

Sacramento · (916) 442-2308 · 1127 11th Street Suite 234 · Sacramento · CA · 95814

Los Angeles · (213) 748-5287 · 3655 S. Grand Ave. Suite 220 · Los Angeles · CA · 90007

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