END OF SESSION COUNTDOWN: Major bills pass; 25 hours to go…

  • Prescription drug discount bill heads to governor
  • Bill to ease children’s enrollment in health programs passes Assembly
  • Supporters of universal health care storm Capitol, Los Angeles
  • UPDATE: Where are bills in the Legislature?

Health care issues continued to loom large in the Legislature as session nears a close. Rallies to shame Wal-Mart and urge signature on universal health care convened on Capitol steps Wednesday. And lawmakers continued to shuffle through hundreds of bills still on file.

Lawmakers passed bills that would make it easier for children to obtain health coverage and sent a bill to the Governor to provide discount prescription drug discounts to six million Californians. A fuller description of key health consumer bills pending in the Legislature follows.

Tomorrow, Thursday, August 31st is the last day of the legislative session. The California constitution requires that the legislature adjourn by midnight of August 31st of even-numbered years. Any measure considered after midnight requires a two-thirds vote. Yet key bills are still pending in this last day of action.


Despite the drug companies’ spending of $80 milion last year, and an army of slick, PhRMA suits that blanketed the Capitol, the California legislature passed a major prescription drug discount plan to benefit uninsured, underinsured, low-income, seniors, and other Californians.

The state Assembly Wednesday voted 46-28 to pass AB2911 (Nunez/Perata), giving the state authority to negotiate discount prices for 6 million Californians who now pay more for prescription drugs than anybody else in the world. (An identical bill, SB1702 (Perata/Nunez) no longer needs to be passed, as AB2911 has cleared both houses.) The bill now heads to the governor’s desk for signature. Gov. Schwarzenegger, who joined with Democratic leaders in the Legislature on this issue, is expected to sign the measure.

“The important thing here is to look at what pharmaceutical companies have said all along, which is, given the opportunity – on a voluntary basis – they would provide discounts,’’ said Assembly Speaker Fabian Nunez. “Under this bill, we’d give them three years to (provide discounts) voluntarily.’’

After three years, the state would be permitted to steer some of the state’s $4 billion Medi-Cal purchasing away from companies who did not provide sufficient discounts. Assemblymembers Merv Dymally and Jackie Goldberg expressed their support for the bill, but stated their hope that Medi-Cal patients would be unaffected. “This is a big step forward,” said Goldberg, but she urged future legislators to watch that “if and when there are companies that don’t [participate], there is a timely response to Medi-Cal recipients” in getting the drug they need. “They all know they’ll get the help they need,” she said, but some are concerned about the speed of the bureacracy.

In a strange political twist, Republican Assemblymen Greg Aghazarian and Keith Richman also cited the same concerns for Medi-Cal recipients. “This hammer will have one effect. It uses the poorest, most vulnerable in society as hostages – as pawns – in a chess game to try and leverage and extort drug companies,’’ Aghazarian said. Despite the stated concerns, neither legislator has supported repealing the existing system of “prior authorization” in Medi-Cal–a process that AB2911 does not change–or the current mechanism that the state uses to win rebates from the drug companies. The bill does not change the access of Medi-Cal recipient to medications, but simply broadens the benefit of the existing Medi-Cal drug purchasing system to help the uninsured get fairer prices.

Democratic Assemblywoman Wilma Chan also pointed out that “as long as the drug companies provide discounts” that they promised, there’s no use of enforcement, and Maine’s program hasn’t had to even use their Medicaid’s purchasing power to get discounts. Assemblymember Dario Frommer argued this was a reasonable compromise, after many years of working on the issue.

In another critique, Republican Assemblymember Chuck DeVore argued that “we are putting price controls on an industry that will result in less money for research and development.”

In closing remarks, Nunez contrasted groups on either side of the bill. “I don’t know a pharmaceutical company in the country that’s filing for bankruptcy,’’ he said. “But I know a lot of poor people that don’t have any food – or enough money to put food on the table. If you really care about poor people, you are going to cast an ‘aye’ vote for the 6 million people who are going to benefit from this bill,’’ he said.

The bill passed on a straight party line vote, with Gloria Negrete McLeod being the only Democrat who abstained. Republicans abstaining included Lynn Daucher, Bonnie Garcia and Shirley Horton, according to the preliminary tally.

The bill now goes to Governor Schwarzenegger for his signature. Advocates hope this help influence the national debate on health reform, and encourage the principle–in Medicare and elsewhere–that government can negotiate for the best possible price for prescription drugs and other health care.


The state Assembly Wednesday evening passed SB437, which would streamline the process for poor children to seek medical attention and coverage through the state’s Medi-Cal or Healthy Families programs.

SB437(Escutia), supported by Governor Schwarzenegger, jockeyed by Assemblymember Cindy Montanez, passed 47-14 with mostly Democratic votes and four Republican Assemblymembers voting for the bill, including Lynn Daucher, Shirley Horton, Tim Leslie and Keith Richman.

This bill has been amended significantly, but would make enrollment easier through a WIC Gateway, and by expanding pre-enrollment for Healthy Families for county applications. It will also seek to keep more children retained on the program by simiplying annual renewals to allow self-certification of income for Healthy Families, and creating a pilot for self-certification in Medi-Cal.

While SB437 is expected to make it easier for low-income children to become enrolled in state programs, it is a far cry from the bill’s original intent — which was to provide full health coverage to the 800,000 California children who remain uninsured, bemoaned Assemblymembers Wilma Chan and Dario Frommer.

They cited the recent history, that Gov. Arnold Schwarzenegger and Democratic leaders withdrew a proposal earlier this year to provide an additional $23 million in the state budget to enroll 18,000 children — both documented and undocumented — in county health initiatives, often called Healthy Kids. When it became apparent that legislative Republicans, whose votes were needed to pass the budget, refused to support the proposal because it would have helped undocumented immigrants, Gov. Schwarzenegger and Democrats agreed to strip the funding from the budget and address the issue in August before the session ended. With hours left before the Legislature leaves for the year, “the money was not put back,” Chan said.

Frommer reminded lawmakers of the Schwarzenegger’s 2003 campaign promise during the recall – to provide health coverage to all children. “What we have at the last hour of this session is a bill that he’s sponsoring that makes a few good technical improvements to programs, but does not meet his pledge to the children and families of California to provide health care to all children’’ Frommer said.

In spite of SB437’s modest goals, Republican Sen. Ray Haynes said its intentions were too grandiose, likening its goal to “lining the street with gold.” He stated that, “we have made it so easy to sign up for government programs,” Haynes said. If children remain uninsured, “they’re uninsured because they want to be uninsured. If they don’t have it, they don’t want it. The problem isn’t that we’re not doing enough. It’s that they don’t want it.”

Frommer refuted Haynes’ argument and asked the governor to make good on his campaign promise. “I would really hope Governor that you would keep your promise to California children, who, Mr. Haynes, cannot make decisions about whether they get health care or not. They get born into whatever life they’re born into,” Frommer said. “Every child should be able to see a doctor if they are sick,” he said. “That should be a right.’’


The Senate passed a measure, AB1971(Chan), to extend the state’s high-risk pool so those with “pre-existing conditions” can get some coverage. It is pending in the Assembly.

One measure that faced significant debate was SB1534(Ortiz), a new measure to clarify counties’ ability to provide care to undocumented Californians, which passed the Assembly floor and Senate Health Committee.

Another measure was SB1414(Migden), to require employers of 10,000 or more to pay into a fund if they do not spend a minimum level on health benefits. That measure, which generated a lot of discussion about Wal-Mart and the benefits the company does or does not provide, is up for reconsideration.

Finally, SB1312(Alquist) as part of licensing reform, would allow hospitals to be fined for patient car violations, in a manner similar to nursing homes. That measure passed the Assembly 49-28, and is heading toward the Senate.


Celebrating the first time a single-payer health system legislation has ever made it to the governor’s desk, a boisterous crowd of 400 participants chanted “Sign this bill’’ outside Gov. Arnold Schwarzenegger’s Capitol office suite in support of SB840.

Speaker Fabian Nunez and Sen. Sheila Kuehl, the bill’s author, both addressed sign-toting crowd of advocates, thanking volunteers and advocates for the countless hours spent working on behalf of the bill.

The noon rally in support of Sen. Sheila Kuehl’s SB840 was the second health-related gathering of the day in Sacramento . That morning, hundreds of labor, health, and community advocates also gathered to shame Wal-Mart to do better for its workers, including to provide better health benefits.

UPDATE: Where the bills are.

Voted on Assembly Floor (Needs 41 votes to pass)

  • AB2911 (Nunez/Perata) PASSED 46-28. Allows the state of California to use its Medi-Cal purchasing power to negotiate discounted prescription drug prices for uninsured and underinsured Californians. To the Governor.
  • SB437 (Escutia) PASSED 47-14. Streamlines enrollment into children’s insurance programs. Back to the Senate.

Pending on the Assembly Floor

  • SB452 (Alarcon) Requires Medi-Cal to report to Governor on whether Medi-Cal prices are higher than prices for federal programs. (Reconsideration. Failed passage Tuesday on 35-37 vote)
  • AB2889 (Frommer) Concurrence. Allows patients in the individual market to transfer to similar health plans without underwriting that would lead to denial of coverage based on “pre-existing conditions.”
  • AB1948 (Montanez) Concurrence. Creates a feasibility study on simplifying application for Medi-Cal and Healthy Families using CHDP Gateway and electronic application.

Voted on Senate Floor Tuesday: (Needs 21 votes to pass)

  • AB1971 (Chan) PASSED 21-13. Extends the sunset for the Managed Risk Medical Insurance Program (MRMIP), which covers patients with “pre-existing conditions” unable to get coverage elsewhere. Pending in Assembly.

Still pending on Senate Floor:

  • AB774 (Chan) Provides consumer protections against abusive hospital billing and collections practices, including those that charge uninsured patients multiple times what insurers pay for the same service.
  • AB2667 (Baca) Allows the state to monitor Part D prescription drug plans in the same way it monitors health plans. (Reconsideration. Failed passage 17-10 on Wednesday night. Needs advocacy.)
  • AB2877 (Frommer) Establishes a website listing sources that are safe for purchasing more affordable drugs from other countries. (Reconsideration. Failed passage 15-14 on Wednesday night. Needs advocacy.)
  • SB840 (Kuehl) Concurrence. Called the California Health Insurance Reliability Act, creates a universal, publicly financed (single-payer) health care system for the state similar to Medicare.
  • SB1405 (Soto) Concurrence. Creates a Task Force on Reimbursement for Language Services to recommend actions for achieving linguistic access to care.

For more information, contact Hanh Kim Quach, hquach@health-access.org, or 916-497-0923 x 206.

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