Win and lose in Senate Health Committee

Thursday, April 16th, 2009

* Single-payer universal coverage bill advances again–despite past Schwarzenegger vetoes.
* Workers let go from the small businesses would qualify for health care assistance.
* Bill stalls to provide greater public access to unbiased data on prescription drugs

ALERT: Support Needed Next Week on Bills on Underinsurance, Overcharging

More Updates on the Health Access WeBlog: New Report Released on Underinsurance; Board of Equalization Asks Nonprofit Hospitals For Information; Assembly Health Committee Update; Opposition on Prop 1A; More on the Public Health Insurance Option

The Senate Health Committee, chaired by Senator Elaine Alqust (D), on Wednesday approved a measure to expand financial aid for continued health care coverage to workers laid off by small businesses through 2009. The bill taps into federal stimulus money from Washington to make COBRA coverage substantially more affordable.

Also, prodded by a roomful of over 100 Californians supporting a single-payer solution to the health crisis, Senate Health Committee members also voted to advance a bill that would set up a SB810(Leno).

At the same time, however, there was not enough support to pass a bill to establish “academic detailing” to offer the public unbiased consumer information on the safety and cost of pharmaceutical medications.

The following looks in more detail at these bills, which Health Access California is active in supporting:


* SB 810 (Leno) outlines a comprehensive reform to create single payer universal health coverage system in California. Such a system would extend health care services to all residents, through the existing network of largely private doctors and hospitals, but with the state negotiating and providing reimbursements.

The proposal has the support of advocates who say it would eliminate existing disparities in Californians’ access to health care, and save California money in the long run by keeping the citizenry productive and healthy, and eliminating an insurance company middleman.. Assemblyman Mark Leno (D) said the change is needed also because health care is costing too many consumers too much money, without delivering enough positive results. Single payer bills similar to SB 810–most recently SB840(Kuehl)–have been passed by the California Legislature before, only to be vetoed by Gov. Arnold Schwarzenegger, who has labeled such proposals “socialized medicine.” The proposal does not include the financing component at this time.

Supporters included a broad rage of several dozen organizations, including Health Access California. Many organizations that sent members to pack the committee hearing room of over 100 people who wanted to voice their support. In testimony in favor of the bill, leaders of the California Physicians’ Alliance and California Nurses Association made the case on both economic and health grounds.

A coalition of insurers, providers, and businesses opposed, including Anthem Blue Cross, America ’s Health Insurance Plans, Health Net, California Association of Health Underwriters and others voiced opposition to the proposal. A representative of California Chamber of Commerce predicted it would lead to fiscal chaos, and said the state should wait to see what the Obama Administration proposes for health care reform. Republican Senator Aanestad debated points with Senator Leno over the lessons of Canada and issues around cost.

Committee members voted along party lines in advancing the bill to the next Senate committee, with Democrats in support and Republicans in opposition.


* AB 23 (Jones)
got broad bipartisan support through the Senate Health Committee. The bill would tap into federal stimulus dollars to allow a greater range of laid-off Californians to qualify for COBRA subsidies to stay covered. The federal economic recovery package was designed to aid employees who were let go – through no fault of their own – helping them obtain subsides to extend their job-based health care coverage. The bill extends that assistance to workers of smaller businesses–from 2-19 people–in alignment with California’s specific Cal-COBRA law.

Senate Health Committee members noted the urgency of the measure and sent it along to the next committee. AB 23 will provide up to 65 percent of the cost of extending health care coverage through the federal COBRA program. It applies to people losing their jobs from September 1, 2008 to December 31, 2009.

No organization or person registered opposition to AB 23. Among those in support were a range of consumer, labor and provider organizations. The bill was sponsored by the California Department of Insurance, and did not have significant opposition.


* SB341 (DeSaulnier) proposed to have the University of California provide consumers and doctors the latest reliable information on the safety and cost-effectiveness of pharmaceuticals, including on a public website.

The bill also proposed to level the playing field in doctors’ offices by sending UC researchers or representatives to physicians’ workplaces to share unbiased information about drugs to doctors. Pharmaceutical companies have for years been taking advantage of opportunities for face-to-face access to doctors, by sending employees called “detailers” to talk to physicians directly about the drugs they are marketing as well as engaging in ceaseless advertising to consumers about those drugs.

SB 341 would remedy this at a time when some widely-marketed drugs, like Vioxx, have already been found to cause adverse side effects. Senator Mark DeSaulnier (D) said the bill is necessary because consumers need better, centralized access to unbiased information about prescription drugs in part to counteract expensive drug company marketing and advertising campaigns. In response to questions by his fellow Senate Health Committee members, he agreed to examine whether his proposal overlapped with federal efforts and, if so, amend the bill.

SB341 builds on the efforts of the Obama Administration to control health care costs by getting better information about the comparative effectiveness of prescription drugs. Vioxx was not only harmful, it was only marginally more effective than ibuprofen but it was lots more expensive.

In addition, a representative from the advocacy group Community Catalyst said “academic detailing” proposals such as SB 341 are already up and running in several other states, including Pennsylvania , Vermont and Maine . The California Alliance for Retired Americans is the sponsor, with other supporters including the Mental Health Association in California , the AFL-CIO and Health Access California , among others.

Opposition came from Pharmaceutical Research and Manufacters of America and other drug companies. They argued that UC is already the “partner” of the pharmaceutical manufacturers. Plus, they said, the information is already available if one knows where to look. Mainly, they argued against the fee to pay for this information, and that the bill was unnecessary because the recent federal stimulus package included funding for comparative effectiveness research. They failed to mention that the drug companies vigorously but unsuccessfully opposed those very provisions and then fought hard to make them meaningless, a fight that still continues in DC.

SB 341 was the only bill that did not win enough votes to advance out of committee. With a party line vote, with Democrats in support but Senators Cedillo and Negrete-McLeod present in the room but not voting, it failed to pass. It was granted reconsideration and could be heard as early as next week. It also needs to pass Senate Revenue and Taxation before April 30.

UNDERINSURANCE BILLS ALERT: Earlier today, Health Access co-released a national report on “underinsurance” with Community Catalyst, while spotlighting AB786 that directly addresses the issue. Next week, the Assembly Health Committee will consider two crucial consumer protection bills sponsored by Health Access California


* AB786(Jones) to set standards for coverage, allowing for apple-to-apples comparison shopping and limiting “junk” insurance.

* AB1503(Lieu) to prevent overcharging of the uninsured and underinsured by emergency room physicians.

Please get your organizational letters of support faxed to the Assembly Health Committee, chaired by Assemblymember Dave Jones, State Capitol, Room 6005, Sacramento , CA 95814 . The fax is: 916-319-2197.

For more information on these two bills, check out the one-sheet on medical debt on our website, or contact Jessica Rothhaar at 510-873-8787, x107, or need to pass policy committees by April 30.

Health Access will continue to provide updates on actions taken in the Legislature. For a broader list of interest to health advocates and Health Access California , check out the bill list on our website.

For more reports on legislation, visit the Health Access WeBlog, at

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