Real harm to health care consumers…

Wednesday, October 1, 2008

* Single-payer, medical loss ratio, high-risk pool, balance billing, anti-rescission bills vetoed
* Benefit bills (maternity, durable medical equipment and mental health parity) also rejected
* A few bills signed, on balance billing, broker accountability

Click for What’s New on the Health Access WeBlog: More on Health Bill Bloodbath of Vetoes; Court Victory on Healthy San Francisco Examined; Going Backwards on Health Reform; Hospital Infections; The Governor’s Health Care Legacy; Revisiting Prop 56; McCain’s Mistakes: Individual Market Mayhem; Regulating the Insurance Industry Like the Banking Industry?; The Risks of Reforms of the Presidential Candidates; Line-Item Vetoes; Governor Makes a Bad Budget Worse; Budget Back-and-Forth; and More…

After a self-imposed delay dealing with the historically late state budget, Gov. Arnold Schwarzenegger got down to business signing and vetoing with abandon in the past week, to meet the deadline of midnight of September 30th. The Governor signed 771 bills and vetoed 415 bills, a historically high percentage.

After a tough budget fight, which will result in more than 250,000 children without health care coverage and another delay in a discount prescription drug program for the uninsured, health advocates were dealt more disappointing blows on the legislative front. The governor vetoed a number of consumer protection bills – in some cases citing his opposition to any piecemeal approach and in other cases citing costs.

The impacts of these vetoes will be felt by all California health consumers, insured and uninsured. Around one thousand Californians, denied coverage by insurers, will continue to sit uninsured and uninsurable, on a waiting list for the state’s “high risk” pool–and those with such coverage will continue to be at risk of bumping up against a low $75,000/year cap on services. Insurers could continue to retroactively cancel consumers’ coverage when they deem it is necessary, without review. Insurers will be able to continue spending more of their premium dollars administration and profit, rather than on health services for consumers. And emergency room patients are at more risk of being balanced billed, with consequences for their credit and their financial future.

Below is a list of bills that Health Access California supported and the governor’s final action:


* AB 2 (Dymally) HIGH-RISK POOL: Would have reformed the Managed Risk Medical Insurance Program (MRMIP), which provides coverage for “un-insureables” who have “pre-existing conditions.’’ Efforts would make the high risk pool more affordable and available and eliminate the annual $75,000 cap on benefits.

* SB 1379 (Ducheny) USE OF INSURER PENALTIES: Would use some of the fines levied on insurers for improper rescissions to subsidize MRMIP and repay loans for physicians working in underserved areas.


* AB 1150 (Lieu) BONUSES: Would outlaw the industry practice of paying bonuses to insurance company employees when they rescind policies, for setting targets for rescinded policies and/or setting financial goals based on savings on health care claims.
* AB 2569 (De Leon) BROKER ACCOUNTABILITY AND FAMILY COVERAGE AFTER RESCISSION: Requires brokers who take applications to attest, under penalty of perjury, that the information is complete and accurate to the best of their knowledge. Also ensures that family members whose coverage depends on that of the rescinded person may be offered another individual policy.

* AB 1945 (De La Torre) INDEPENDENT REVIEW: Would establish an independent review process if an insurer wants to rescind coverage, and raises the standard in existing law so that coverage can only be rescinded if a consumer willfully misrepresents his health history.


* AB 2842 (Berg) UNFAIR SOLICITATIONS: Would protect Californians from insurance agents trying to sell them private Medicare plans through cold calls and bait-and-switch tactics.

* SB 1633 (Kuehl) DENTAL CREDIT CARDS: Would prohibit dentists’ offices from offering high-interest loans to patients while they are under the influence of anesthesia. Would also prohibit dental offices from charging lines of credit before services have been rendered.


* AB 2400 (Price) HOSPITAL CLOSURES: Would require public notice before closing a hospital.

* AB 2697 (Huffman) BOUTIQUE HOSPITALS: Would require so-called “boutique hospitals’’ to asses their impact on a community’s health system annually, specifically whether they siphon doctors, workers, providers from hospitals caring for less affluent populations.


* AB 1203 (Salas) EMERGENCY ROOM BILLS: Would prevent emergency departments – which do not have a contract with a patient’s insurance company — from directly billing the patient for care administered after the patient is stabilized, requiring the hospital to seek payment directly from insurers.

* SB 981 (Perata) ER DOCTOR BILLS: Would prevent emergency physicians – who do not have a contract with a patient’s insurance company — from directly billing the patient, requiring providers to seek reimbursement directly from insurers.


* AB 1887 (Beall) MENTAL HEALTH PARITY: Would require health plans to provide coverage for all diagnosable mental illnesses
* AB 1962 (De La Torre) MATERNITY COVERAGE: Would require all individual insurance policies to cover maternity services.
* SB 1198 (Kuehl) DURABLE MEDICAL EQUIPMENT: Would require group health plans and insurers to offer coverage for durable medical equipment, such as wheelchairs and shower seats.


* SB 1168 (Runner) DEPENDENT CARE: Would allow adult dependent children, who are still covered under their parents’ health plan, to stay on that coverage even if the child takes a medically necessary leave of absence from school.

* SB 1440 (Kuehl) CAPPING ADMINISTRATION AND PROFIT: Would set a minimum medical loss ratio – requiring every insurer to spend at least 85 percent of premiums on patient care.
* SB 973 (Simitian) PUBLIC INSURER: Would create a statewide public insurer, connecting existing regional, county-based health care plans, to compete with private health care plans and provide consumers more affordable coverage choices.
* SB 840 (Kuehl) SINGLE PAYER: Would establish a process to create a single-payer health care system in California that would enable all residents to have health coverage.

For information, contact Hanh Kim Quach at

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