HEALTH ACCESS UPDATE
Tuesday, August 9th, 2005

LEGISLATURE COMES BACK NEXT WEEK WITH FULL HEALTH AGENDA

  • Children’s Coverage, Consumer Protections, Prescription Drugs on Agenda for Final Month
  • Bills Have Final Hurdles Before Reaching Governor’s Desk by September 9th
  • Hospital Financing Waiver Hearings on August 16th on Mandatory Managed Care Requirement

Here in Sacramento, many legislative staff and lobbyists are taking vacations, and those that are here are often in their casual clothes. This is a rare summer hiatus, occasioned by the relatively early resolution to the budget. But this is merely the calm before the storm, since the legislature comes back into full swing next Monday, August 15th, for a final month of action, through September 9th.

FINAL LEGISLATIVE HURDLE AWAITS: Many bills of interest to health advocates are active and pending in the legislature, most awaiting a last vote in Appropriations Committee before going before the floor of the second house. In the next month, legislators will scramble to pass their bills out of both houses of the legislature before the deadline to get them to Governor Arnold Schwarzenegger’s desk, September 9th, when their recess until next year is scheduled to start.

MANY ACTIVE HEALTH BILLS: The active health bills pending include legisaltion big and small, on expanding health coverage for children, young adults, and all Californians; providing consumer protections for those buying individual health coverage or in a new Medicare prescription drug plan; addressing the rising cost of prescription drugs; providing more information around the use of public insurance programs by working families; streamlining public insurance programs so more people get the coverage they need; and disclosing more information about hospital charges and costs. These bills are listed BELOW, and are also listed on our website, at:
http://www.health-access.org/advocating/2005_bills.htm

STALLED BILLS, FOR NEXT YEAR: Many other bills, including those of interest to health advocates, have stalled at one point in the process or another, and were not able to pass the first house, or the policy committee in the second house. These bills, including important consumer protections around hospital overcharging and out-of-pocket costs, are now “two-year bills,” and are available to move only next year, the second year of the two-year legislative session. For a list of these proposals, including those bills that health advocates successfully stopped, visit the Health Access website, at:
http://www.health-access.org/advocating/stalled2005_bills.htm

HOSPITAL FINANCING: Perhaps the most profound and controversial bill on access to health care for the next month is one that has yet to be written, much less authored. The issue of hospital financing will be the focus of much activity by both health budget and policy committees, as they considered the Medi-Cal waiver negotiated between the Schwarzenegger Administration and the Bush Administration. Despite opposition and concerns from public and private hospitals as well as advocates, the state Department of Health Services agreed to a waiver that would fundamentally change the 15-year old formula for the way hospitals are funded.

The Governor’s proposal freezes Medi-Cal funding for public hospitals while creating an uncertain future for private hospitals that accept Medi-Cal patients. Many hospitals have been worried that they won’t be able to draw down the federal money needed to stay open. Yet in order to bring in any federal money for hospitals, the Governor is forcing the Legislature to pass a bill to implement this waiver by the end of the session. For more information on this waiver, take a look at the Health Access testimony on the subject last month, on our website:
http://www.health-access.org/preserving/hospital_financing_waiver.htm

HEARING ON MANDATORY MANAGED CARE: In addition, the federal government has placed conditions on the waiver, including the adoption of mandatory managed care for seniors and people with disabilities, which was rejected by the Legislature earlier in the year. The proposal for mandatory managed care is the subject of an informational hearing for NEXT TUESDAY, AUGUST 16th, by the joint Assembly and Senate Health Committees and Budget Subcommittees on Health.

HEALTH ACCESS SPONSORED BILLS: Health Access California, the statewide health care consumer advocacy coalition, has two active bills that are on track to being sent to the Governor’s desk. They include:

* CONSUMER PROTECTIONS FOR INDIVIDUAL INSURANCE: AB356 (Chan), which would require disclosure of the criteria and process for denying individuals health insurance coverage. This would provide more information for those in the individual insurance market, who may have “pre-existing conditions” that prevent them from getting needed coverage.

* CONSUMER PROTECTIONS FOR MEDICARE PRESCRIPTION DRUG PLANS: AB1359 (Chan), which would license prescription drug plans permitted under the Medicare Prescription Drug Act. This would ensure that senior continue to enjoy the consumer protections, from network adequancy to cultural and lingustic access, that other Californian HMO consumers have.

Health Access is also sponsoring some two-year bills, including AB774 (Chan), which would provide hospital patients basic consumer and financial protections and protect self-pay hospital patients from being charged more than the insured; AB977 (Nava), which would require the Department of Insurance and the Department of Managed Health Care to review and approve out of pocket costs for consumers in a public process with specific standards; and AB1111 (Frommer), which would help to provide consumer choice in the individual health insurance market. Health Access California plans to actively work to pass these bills in 2006.

OTHER IMPORTANT HEALTH CARE BILLS: Many consumer, health, and community organizations, including Health Access California and others, are working on a full agenda of legislation to move to the Governor’s desk. Below are the bills that are currently active:

COVERAGE EXPANSION

SB437 (Escutia), which would expand and protect health insurance coverage for children in order to assure that all California children have the opportunity to have health insurance coverage.

AB772 (Chan) which would expand and protect health insurance coverage for children in order to assure that all California children have the opportunity to have health insurance coverage.

AB1199 (Frommer/Chan), which was originally on individual insurance reform. It has since been amended to create a fund for the purpose of children’s health coverage.

AB1698 (Nunez), which would expand private coverage for dependents up to age 26.

SB840 (Kuehl), the California Health Insurance Reliability Act, which would create a publicly financed system of universal health benefits for every Californian.

PRESCRIPTION DRUGS

AB73 (Frommer, Chan), which would create a website with information on affordable prescription drug prices for Californians, including information about reimporting drugs from other countries.

AB76 (Frommer, Chan), which would create an office of pharmaceutical purchasing to purchase prescription drugs for state programs.

AB78 (Pavley, Bass) which would protect consumers by regulating pharmacy benefit managers (PBMs).

SB380 (Alquist), which would require reporting of adverse events for prescription drugs.

SB708 (Speier) which as proposed to be amended 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.

EMPLOYER DISCLOSURE

AB89 (Horton), which would require disclosure of employers of persons dependent on Medi-Cal and Healthy Families.

SB23 (Migden) which would provide information to all employees about the availability of Medi-Cal and Healthy Families. Health Access California seeks amendments to alter the provisions that would allow automatic deduction of Healthy Families premiums from paychecks because of privacy concerns.

STREAMLINING OF PUBLIC PROGRAMS

AB624 (Montanez), which would streamline the process for children to enroll into Medi-Cal or Healthy Families through the CHDP gateway.

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.

SB496 (Kuehl), which would allow school districts to draw down more federal funds for Medicaid activities.

HOSPITAL OVERSIGHT

AB1045 (Frommer) would clarify existing law by requiring that charges for the 25 most common inpatient hospital procedures and the 25 most common outpatient procedures be made public.

SB917 (Speier) which as introduced would clarify existing law by requiring that the charges for 25 most common inpatient hospital procedures be made public.

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