• Governor Schwarzenegger’s summit on health care affordability
  • Announcements on health policy issues: drug discounts, balance billing, school health centers
  • Treasurer Angelides releases his health care policy specifics
  • Mayor Newsom to sign San Francisco plan for expanded access to care today

The California Legislature comes back today, after a month of summer recess. Yet on health care issues, there’s been no vacation. In the last few weeks, health care has gotten an inordinate amount of attention, as the gubernatorial candidates both made health care a major part of their campaigns.

Governor Arnold Schwarzenegger made a series of statements and announcements on specific health care issues, on issues from prescription drug discounts to banning balance billing, and held a “summit” on the issue of health reform, with the promise to unveil a comprehensive plan in January 2006 if re-elected. Treasurer Phil Angelides unveiled the specifics of his own health reform plan that he would pursue if elected, from requirements on large employers to contribute toward their worker’s coverage, to more oversight over HMOs.


The statewide debate on comprehensive health reform was given a further push with the unanimous vote of the San Franscisco Board of Supervisors, to pass a major health expansion in that city and county. Mayor Gavin Newsom is expected to sign the health care proposal today, Monday, August 7th.

The proposal would require a minimum contribution from employers toward their worker’s health care; employers and individuals would have the option of participating in the San Francisco Health Plan, which would provide access to a medical hom and a comprehensive set of benefits through San Francisco health providers. Because of this action, other localities and state are more closely looking at efforts at health expansions.

A productive summer, to be sure, but it is not over. The summer of health will continue this month as the California Legislature deals with a host of health care bills currently pending, which must pass by the end of the month in order to reach Governor Schwarzenegger’s desk for a signature or veto.


Two weeks ago, on Monday, July 24th, Governor Arnold Schwarzenegger held a “health care summit,” where a roundtable of about 50 executives, academics, providers and advocates discussed the need for reform for a morning. A full telecast of the discussion is at the Governor’s website, at:

The actual conversation was similar to many other health care policy conferences of the past, where a variety of opinions were expressed, but given the time and the number of people in the conversation, at a level of generality to only raise issues, but not fully address them. The conference was different than most in that the Governor attended and listened through the discussion, though he did not ask any questions directly, although some of his staff did. In his remarks, the Governor did not propose any specifics on broad health reform issues, not endorsing any specific bill or approach. However, the event clearly set an expectation that health care would be at the top of a reform agenda in 2007.

While some are hopeful that both gubernatorial candidates have stated they intend to make health care a priority, others are suspicious. In fact, some groups protested outside the event, given the Governor’s record of having opposed the major health coverage expansion proposals that have been pending, in bills, the budget, or the ballot, in the past several years.

In this election season, the focus will not just be the candidates’ statements, but also on the record. In the week around the health care summit, Governor Schwarzenegger made several annoucements on specific health policy issues, to bolster that record:

* Prescription Drugs

On Saturday July 22, the administration announced that they would support a prescription drug plan that would eventually allow the state to enforce discounts to the uninsured. Under this proposal, a prescription drug discount plan that would run with voluntary participation from the drug companies for five years. If the drug companies do not provide sufficient discounts in that period, California would then be able to use it purchasing power through the Medi-Cal program to leverage deeper discounts for Californians.

The governor’s California Discount Drug Initiative would be accessible to uninsured Californians with incomes less than 300 percent of the federal poverty level ($60,000 for a family of four ) and to Californians with high medical bills and incomes that fall below the state’s median income ($68,310 for a family of four.)

The Governor’s proposal is being suggested as amendments to AB2911 and SB1702, which is being carried by legislative leaders Assembly Speaker Fabian Nunez and Senate President Pro Tem Don Perata, and supported by a range of senior, health and consumer organizations, including Health Access California. Their proposal called for the use of enforcement after three years, and would include Californians up to 350% of the federal poverty level ($70,000 for a family of four).

* School-based clinics

At the Monday health summit, Schwarzenegger announced his plan to expand 500 school-based clinics at elementary school. Currently, there are 147 school-based health clinics at K-12 schools statewide. California has 5,500 elementary schools serving 2.7 million children. The school-based clinics could help children who do not have health insurance or face other barriers to care.

* Prohibition of balance billing practices

On Tuesday, July 25th, the Governor signed an executive order directing the Department of Managed Health Care to increase enforcement of existing laws that prohibit providers from seeking additional compensation from patients, after they have received insurance reimbursements.

The basic principle, supported by consumer advocates, is that patients should not be caught up in financial disputes between doctors and insurers. This ban on “balance billing,” a practice that sends consumers to collections and worse, left key details to be worked out in the weeks and months ahead.

* Other announcements

The Governor’s office has also highlighted a number of other recent health care actions, including:

  • Issuing an executive order to outline a statewide plan for Health Information Technology;
  • Signing of SB1448, by Sen. Sheila Kuehl, which would implement the local “coverage initiative” of the Hospital Financing Initiative that was agreed to last year;
  • Appointing a new Director of the Office of the Patient Advocate, after three years of an acting director in the job.

The Administration has fact sheets on all these various policy announcements, at:


Treasurer Phil Angelides, who is competing with Schwarzenegger on the November ballot, released a list of health care actions he would take in his first day of governor – if elected.

The Angelides health platform, announced as a counterpoint to the Governor’s health summit, included:

  • Sponsor a bill to provide funding to expand the Healthy Families program to all children
  • Sponsor a bill to require large employers with more than 200 employees to provide health care to workers and their families;
  • Appoint new leadership at the Department of Managed Health Care, which regulates HMOs;
  • Sponsor a prescription drug discount plan;
  • Sponsor legislation allowing Californians to purchase safe and legal prescription drugs over the Internet.

In subsequent announcements, Treasurer Angelides also supported working at the federal level to remove the co-payments for dual-eligibles; regulating excessive administrative costs of health plans; implementing regulations to ensure timely access to care for patients; and requiring insurers to cover maternity services. Below are the press releases of these health care announcements:

For more information, please contact policy coordinator Hanh Kim Quach at 916.497.0923 x 206 or

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