HEALTH ACCESS UPDATE
Thursday, June 2nd, 2005
HEALTH CARE CONSUMER PROTECTIONS PASS ASSEMBLY
- Prescription Drug Bills, Hospital Consumer Protections, Other Measures Pass; Some Stall for Year
- Coverage Expansions Advance for Children (AB772/SB437), Universal Care (SB840)
- Also: Budget Conference Committee Adopts Emergency Drug Coverage for Medicare Dual Eligibles
Today, both the Assembly and Senate ended the first half of the legislative year, both passing and rejecting a variety of bills. Of interest to health care consumers, bills passed today on the issue of prescription drugs, hospital overcharging, and the disclosure of hospital cost and quality. BELOW is a quick report on the outcomes. For links to the actual bills discussed, and more information, visit the Health Access website, at:
At the same time, the Budget Conference Committee began deliberating and making decisions on the Legislature’s proposal for the state budget, including the issue of Medi-Cal managed care, and drug coverage for “dual-eligible” seniors and people with disabilities. FURTHER BELOW is a quick report.
HEALTH COVERAGE: Earlier in the week, the legislature passed various bills to extend health coverage.
- SB840 (Kuehl), to establish a universal health care system, passed out of the Senate earlier this week on a party-line vote.
- Yeterday, both AB772 (Chan) and SB437 (Escutia), to expand coverage to all California children, were passed by the Assembly and Senate, respectively. The votes were largely party-line votes, with just two Republicans, Bonnie Garcia and Shirley Horton, supporting the children’s measures.
- Other bills passed around the subject of health coverage included SB38 (Alquist), to expand the Healthy Families program, and AB1698 (Nunez), to extend dependent coverage to a higher age level. AB89 (Horton) would report on employers with workers on public insurance programs.
HOSPITAL OVERCHARGING & MEDICAL DEBT:
- In a tight vote, the Assembly earlier today passed AB774 (Chan) which would be the first bill in the nation to prevent hospital overcharging. The bill will provide many consumer protections for self-pay patients to prevent them from falling into medical debt and bankruptcy.
- Health advocates were disappointed that AB977 (Nava), to provide public oversight on high deductible plans and other out-of-pocket costs, did not get the needed votes, due to an aggressive opposition by a full team of HMO lobbyists. It is stalled for the year. Those voting against the bill included all Republicans, and Democratic Assemblymembers Arambula, Matthews, Nation, Parra, and Wolk. Those explicitly not voting included Canciamilla, Calderon, Chavez, Cohn, and Jerome Horton.
PRESCRIPTION DRUGS: The Assembly also just passed some of the pending bills to address the cost and safety of prescription drugs,
- Bills passed today include AB71 (Chan), AB73 (Frommer), AB74 (Gordon), AB75 (Frommer), AB76 (Frommer), AB78 (Frommer).
- A few other prescription drug bills, including AB8 (Chu), AB78 (Pavley), SB380 (Alquist), SB401 (Ortiz), and SB708 (Speier), had already passed the first house earlier in the year.
- One of the prescription drug bills, AB72 (Frommer), to require transparency of clinical drug trials, failed to get the needed votes. It is stalled for the year. Off the unofficial count, those voting against the bill or not voting included all Republicans, and Democratic Assemblymembers Arambula, Calderon, Canciamilla, Dymally, Liu, Matthews, Nation, Negrete McLeod, Parra, Umberg and Wolk.
Other measures passed out of the first house of the legislature include:
HOSPITAL DISCLOSURE: AB1045(Frommer) and SB917 (Speier), to disclose common hospital charges, and AB1046 (Frommer), to create a web-based hospital quality report card.
INDIVIDUAL INSURANCE REFORM: AB356 (Chan) and AB1199 (Frommer) would require disclosure of criteria for denying someone health coverage due to “pre-existing conditions.”
ENROLLMENT: AB624 (Montanez) would streamline public program enrollment through the CHDP Gateway; SB23 (Migden) would provide enrollment information to employees; AB1533 (Bass) would allow easier enrollment for those who lose public program coverage.
MEDICARE DRUG IMPLEMENTATION:
* LEGISLATION: Last night, the Assembly passed on a bipartisan vote AB1359 (Chan), to have the California Department of Managed Health Care license the new prescription drug plans, under existing state HMO Patients Bill of Rights. This potentially includes such consumer protections as requirements for an adequate network, timely access to care, and access to culturally and linguistically appropriate care.
* BUDGET: Today, the Budget Conference Committee voted, as part of the legislative proposal for the budget, to require the California Department of Health Service (DHS) to develop a process for providing drug coverage for dual eligibles (Medi-Cal/Medicare enrollees) for up to 60 days during the first year of implementation of the federal Part D Drug Program.” If properly implemented and funded, this will ensure that vulnerable seniors and people with disabilities continue to have access to needed medicines, as they get shifted from a comprehensive drug benefit under Medi-Cal, to a Medicare benefit that may not cover the drugs they need. The Committee voted “to adopt the Senate trailer bill language” to create this process, although no funds were attached.
Advocates had also been urging some financial assistance for “dual eligibles” who will now have to face premiums and co-pays for this Medicare drug coverage, but that issue was not brought up. The Committee also rejected another Senate proposal to continue to pay the HMO premiums of dual-eligibles during a transition period for this new Medicare Part D. Finally, the Committee did adopt Senate trailer bill language to require the DHS to work with counties on their part in assisting seniors and people with disabilities in enrolling into these new prescription drug plans.
BUDGET CONFERENCE COMMITTEE:
Beyond issues regading Medi-Cal and Medicare Part D, the Budget Conference Committee has been working through the differences between the Assembly and Senate budgets. Many of the “Medi-Cal Redesign” proposals, and other budget items of interest to health advocates, are not “in conference,” since the Assembly and the Senate budget committees took similar actions. Both houses were similar in rejecting mandatory enrollment into Medi-Cal managed care for some aged, blind, and disabled populations. The Committee adopted additional trailer bill language on plan readiness, other language to “retain the integrity of the California Children’s Services program,” and a requirement to have DHS report to the Legislature quarterly on the progress of the managed care expansion.
Some health issues that were still held open include the issue of new acute long-term care projects in three counties, a $10 million augmentation for trauma centers, a $5 million augmentation for a prostate cancer program, and whether to book $3.5 million in long-awaited savings from prescription drug rebate contracts.