The season has started…

Wednesday, April 19, 2007

· Overflow crowds show support as SB840 passes Senate Health Committee
· Update on week’s health legislative activity; preview of next week

New on the Health Access WeBlog: Medicare Drug Negotiations; Hospital Fair Pricing; Prague Spring and ERISA; Schwarzenegger in San Diego; It’s Our Healthcare; Wonks, Hacks and Flacks; The Connector and The Terminator; Blue Cross’ Bad Behavior; Book Club

Sen. Sheila Kuehl, standing before her own Senate Health Committee, presented (for a fifth year in a row) her legislation that would establish a universal single-payer health system in California .

Since 2003, Kuehl has carried this legislation. And since 2003, a growing legion of supporters makes the pilgrimage to the fourth floor Capitol hearing rooms to advocate for this universal system.

“Californians have been left helplessly stranded,’’ said Kuehl in her opening statements, detailing how health care costs have steadily risen, while quality and access has steadily declined. She cited a study, published this week by the online medical journal Open Medicine, which concluded that Canada’s single-payer health care system “produces health benefits similar or perhaps superior, to those of the US health system, but at a much lower cost.’’

SB840 passed on a party line vote, 6-5. Democratic Senator Gloria Negrete-McLeod, D-Chino, was not present when the vote was taken.

Kuehl said she continues to author the measure because she believes that the legislative system works. Since introducing her bill, it has gone through many changes – and gotten better, in her view. On why she keeps pushing the proposal in the legislative process, she said: “It’s better than backroom deals. It’s better than the ballot – where it’s a ‘take it or leave it’ situation,’’ she said. “This bill has been vetted and vetted.”


Since Kuehl first introduced her single-payer measure, the debate has shifted significantly, and steadily picked up more supporters. A full description of the atmosphere of the hearing is at the California Notes blog.

Opponents continued to argue against the bill, but their comments – compared with past years – were more tempered, perhaps in deference to the Kuehl’s new position as chair of the Senate Health Committee. The lobbyist for the Association of California Life and Health Insurance Companies, went to great lengths on Wednesday to “respectfully’’ oppose Kuehl’s measure, saying “We don’t agree that government would be the best’’ at running a health care system.

The Chamber said it disagreed, in principle, with the annihilation of the health insurance industry, (“We don’t support the banning of an industry because they’re not living up to your standards.”), and said it would be difficult to get Californians to agree to higher taxes to fund the system (even, as supporters argue, that those increased taxes would be lower than what we currently in premiums.)

Sen. Darrell Steinberg, D-Sacramento, asked the Chamber of Commerce representative whether business “had a position on the declining quality of health care, and increasing premiums.’’

The Chamber representative conceded that business was, in fact, struggling with the health care system. But then noted that the problem is partially due to the fact that California’s current health care “system’’ is actually a “cadre of systems” (public and private) that have been forced to work together without much consistency. The Chamber representative, however, questioned whether SB840, which would supplant the existing “systems’’ with a new and different one would succeed.


Sen. Sam Aanestad, R-Grass Valley , asked Kuehl why she continued to introduce her bill when it appeared as if Gov. Arnold Schwarzenegger would veto it – as he did in 2006.

Kuehl’s response: “I’m not sure I do expect a different result this year. But I do expect a different result eventually.’’

About 50 groups announced their support for SB840 at the hearing; 84 organizations have submitted letters of support. Meanwhile, 15 organizations – including business and insurers and providers – opposed the measure.


As the deadline for bills to pass policy committees loom, other bills of note that were up this week included:
* AB2 (Dymally) – Reforms and restructures the Managed Risk Medical Insurance Program for the medically uninsurable who are denied care by health plans because of “pre-existing conditions.” Passed.
* AB1554 (Jones) – Would regulate health coverage rates by requiring state approval before premiums, deductibles or other out-of-pocket costs are changed. Passed.
* SB350 (Runner) – Makes technical changes to last year’s landmark AB774 (Chan) which bans hospital overcharging, enabling patients who are uninsured or underinsured to pay the same rates as public programs or insurance companies. Passed.
* SB1014 (Kuehl) Establishes a financing mechanism and tax for SB840, the single payer system. Passed.

Also this week, the Senate Budget Subcommittee on Health also heard from health plans about the need to increase their reimbursement rates for their Medi-Cal enrollees. Health plans said the state’s low reimbursement rates made it difficult for them to adequately pay providers to care for Medi-Cal recipients. The committee left the item open until after the governor releases his May Revision.


Stay tuned next week as the health reform debate continues.
· AB8 (Nunez) – The Speaker’s health reform proposal will be in Assembly Health Committee on April 24th
· AB1 (Laird) – to provide universal children’s coverage will be in Assembly Health Committee on April 24th.
· SB48 (Perata/Kuehl) – Senate Leader Perata’s health reform proposal will be in the Senate Health Committee on April 25th.
· SB32 (Steinberg) – to provide universal children’s coverage will be in Senate Health Committee on April 25th.

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