Monday, August 29th, 2005


  • Hospital Financing the Major Outstanding Issue; Action Needed to Protect Safety-Net Hospitals
  • Bills on Children’s Health Coverage, Prescription Drugs, Consumer Protections Moving
  • Most Bills Survived Appropriations Committee: Floor Votes Scheduled Soon
  • Some Bills Making Way to Governor’s Desk; Actions Needed to Get Signature

As the legislature races to the close of session on Thursday, September 8, in less than two weeks, health care are taking center stage. The legislature is expected to consider legislation to ratify a Medi-Cal waiver that changes the way hospitals have been funded for decades. Legislators are also expected to pass legislation to expand health coverage to all children, to lower the cost of prescription drugs, and to provide consumer protections for seniors and those purchasing health coverage. Health advocates need to take action on these matters, and on getting key bills signed by Governor Schwarzenegger.


The Medi-Cal hospital waiver remains the major outstanding issue not just in health care but across the board. Intensive meetings are underway to craft legislation that will protect safety net hospitals within the context of a federal waiver that endangers county hospitals and puts private safety net hospitals at risk as well.

In addition to the insufficient funds for public hospitals, which are capped in the later years of the waiver, the waiver also includes a requirement that in order to get $360 million in federal money, the legislature must enact legislation requiring over 400,000 seniors and people with disabilities on Medi-Cal to enroll in managed care, whether they like it or not and whether HMOs are ready to care for people with disabilities or not.

While the Schwarzenegger Administration says that it supports “choice” for Medi-Cal beneficiaries, seniors and people with disabilities on Medi-Cal are now free to enroll in an HMO or to get care on a fee-for-service basis. In contrast, the Orwellian “choice” offered by the Schwarzenegger Administration is to force seniors and people with disabilities into an HMO.

As yet, there is no specific bill number for this legislation. There are eight legislative days left before the end of the session. Much of the proposal will require a two-thirds vote because it must be implemented immediately.

ACTION NEEDED: Health advocates can’t wait for a bill number or a specific legislative author to emerge. Advocates should contact all 120 legislators and Governor Schwarzenegger, to support:
* Adequate Medi-Cal funding for public and private safety net hospitals.
* Additional federal funding for these hospitals
* Protections for seniors and people with disabilities forced into Medi-Cal HMOs, protections such as wheelchair accessibility, sign language interpreters and enough of the right specialists.
* Protections for access for the uninsured who rely on safety net hospitals and who should not be overcharged for hospital care.


While the hospital financing bill does not have an author or a number, several other bills are making their way through the legislative process. Most of the bills tracked by health advocates that were on suspense in the Appropriations Committee were passed out last week, and they now head for final floor votes, the last hurdles before going to the Governor’s desk. Here are some specific issues of note:

CONSUMER PROTECTIONS IN MEDICARE DRUG PLANS: The Governor already has one bill on his desk sponsored by Health Access California: AB1359 (Chan), which would license prescription drug plans permitted under the Medicare Prescription Drug Act. This helps ensure that seniors get similar consumer protections as those in the HMO Patients’ Bill of Rights, including access to timely care and to culturally and linguistically appropriate care.

CONSUMER PROTECTIONS FOR INDIVIDUAL INSURANCE: Earlier today, AB356 (Chan) passed the Senate. The bill would require disclosure of the criteria and process for denying individuals health insurance coverage for so-called “pre-exisitng conditions.” The bill heads back to the Assembly floor for a final vote before heading to the Governor’s desk.

CHILDREN’S COVERAGE: AB772 (Chan/Frommer/Escutia) would expand public health insurance coverage for all California children. AB1199 (Frommer/Chan), creates a fund for the purpose of children’s health coverage.The bill authors, with legislative leadership, have decided to proceed with final floor votes in the Senate and then the Assembly, so that it can be sent to the Governor this year for action.

If AB1199 and AB 772 successfully pass out of the Legislature by the September 9th deadline, the Governor will have until October 9th to sign or veto the bills. Your voice in support of children’s health insurance is critical in the coming month. Please write or call the governor to urge him to keep his commitment to covering all kids in California by signing AB772 and AB1199.

COVERAGE EXPANSIONS: Another bill to expand coverage is AB1698 (Nunez), which would expand private coverage for dependents up to age 26, in recognition of older children staying at home longer, and needing health insurance. This bill is heading for a Senate vote.

Two other major bills are being held by their authors until next year: SB437 (Escutia), a companion bill to AB772, which would expand health insurance coverage for all children, will be ready if needed next year. SB840 (Kuehl), the California Health Insurance Reliability Act, which would create a publicly financed system of universal health benefits for every Californian, is being parked in the Assembly Rules Committee until the financing can be worked out.

PRESCRIPTION DRUGS: Even with two prescription drug ballot measures making headlines, the legislature is considering significant reforms in these areas, with votes on the full floor in these final weeks: AB73 (Frommer, Chan) would create a website with information on affordable prescription drug prices for Californians, facilitating safe and affordable reimportation of drugs from other nations. AB76 (Frommer, Chan) would create an office of pharmaceutical purchasing to purchase prescription drugs for state programs. AB78 (Pavley, Bass) would protect consumers by regulating pharmacy benefit managers (PBMs).

Given the recent headlines about drug safety, a lot of attention has been focused on SB380 (Alquist), which would require reporting of adverse events for prescription drugs. Already on the Governor’s desk is SB708 (Speier), which would allow non-profit hospitals to benefit from an existing federal prescription drug discount program and in return would obligate those that benefit to increase charity care by an unspecified amount.

HOSPITAL COSTS: Also scheduled for a floor vote is SB917 (Speier), which would clarify existing law by requiring that the charges for 25 most common inpatient hospital procedures be made public.

STREAMLINING PUBLIC PROGRAMS: Heading for a Senate vote, AB624 (Montanez) would streamline the process for children to enroll into Medi-Cal or Healthy Families through the CHDP gateway, and AB1533 (Bass) would allow individuals who lose Healthy Families coverage due to changes in age or income to enroll in private health insurance without waiting.

INFORMATION ON PUBLIC PROGRAMS: Other bills going to a final floor vote include AB89 (Horton), which would require disclosure of employers of persons dependent on Medi-Cal and Healthy Families; and SB23 (Migden) which would provide information to all employees about the availability of Medi-Cal and Healthy Families.

For all these bills that make it through the legislative process in the next two weeks, health advocates need to urge Governor Arnold Schwarzenegger to sign them. His address is: State Capitol Building Sacramento, CA 95814 Phone: 916-445-2841 Fax: 916-445-4633

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