Senate Health Committee held its deadline week hearing this afternoon. With members in and out of committee due to other committee meetings, most bills were held on call until the end of the meeting – making for a suspenseful 6pm finish.
Passing out of committee was SB1313 (Lieu) on deceptive marketing. Senator Lieu’s bill is intended to prevent deceptive marketing and other issues that might hinder Californians from enrolling in quality health coverage in 2014 as a result of the Affordable Care Act. Projections suggest that between one-third and one-half of these individuals will be limited English proficient. The bill sets a standard for marketing and representation of options and requirements of the ACA so that bad actors are not allowed to take advantage of consumers who may be confused by new provisions of the law and trick them into paying into plans that do not meet the requirements of the law. This bill is sponsored by our colleagues at Consumers Union, California Pan Ethnic Health Network, and the California Immigrant Policy Center.
Betsy Imholz of Consumers Union testified to the importance of assuring that consumers are given clear notice if they are purchasing plans that do not cover the minimum essential health benefits, which would put them at risk for tax penalties. Ronald Coleman of the California Immigrant Policy Center testified that immigrants are particularly vulnerable as they are frequently targeted based on their limited English proficiency, and their frequent reluctance to report crime perpetrated against them and the high need for health coverage in these communities.
Some Senators wanted additional amendments, but moved the bill forward for the time being. The bill passed out of Health Committee with Senators Hernandez, Alquist, DeLeon, DeSaulnier, Rubio, and Wolk voting in support.
Also making it out of Health Committee and moving on to Appropriations is SB1431 (DeLeon). Senator DeLeon’s bill, sponsored by the Department of Insurance, seeks to better regulate “stop-loss coverage,” which is offered to those employers that self-insure their workers. For small businesses, this can be a risky proposition, and so this bill protects consumers in the small group insurance market, and protects the market from instability and adverse selection.
Another bill successfully moving forward is SB1487 (Hernandez), Senator Hernandez’ bill which is intended to, in the author’s words “signal the legislature’s intent to enact any measures necessary to implement the ACA” no matter what happens on the federal level because of the millions of Californians already benefiting from federal health reform and the millions more that are waiting. The bill also extends Medi-Cal to former foster youth up to age 26 – while the federal law and previous state legislation give parents the right to cover their children on their insurance policies up to age 26. This bill passed out of Committee along party lines.
SB1195 (Price) establishes new standards surrounding the audits of pharmacies by pharmacy benefit managers. Proponents of the bill testified that they are interested in ensuring that audits can continue but in a more fair way. Opponents testified that the bill would make it difficult for purchasers such as pharmacy benefit managers to detect fraud and abuse and work to save money for their clients, and the health system in general. Health Access joined unions, insurers, and other purchasers of health care in opposing this bill, but the bill passed out of Senate Health and moves on to Rules Committee.
Two measures did not proceed:
SB1373 (Lieu) did not garner enough votes to move out of committee. This consumer group-supported measure would have required hospitals to provide notice to consumers to inform them that the care they are receiving might involve out-of-network providers and that they should contact their health plan about additional costs. It was opposed by hospitals and other providers, and Chairman Hernandez did not support it, saying it was not ready to proceed.
SB1320 (Harman) purportedly addresses health care access issues by defining and legitimizing “retainer practices,” also known as “concierge medicine,” where doctors require up-front annual payments to be seen. While these practices give consumers the option to pay physicians directly for primary care, they do not have to provide access to any other necessary medical services. These practices also give consumers the impression that their health care needs are covered, but are exempt from regulatory oversight. Senator Alquist vocalized opposition to the bill, expressing concern that the lack of regulation would mean patients would have no recourse if they encountered fraud or discrimination. Senator Hernandez also highlighted a concern that this would rob the regular insurance pool of needed primary care physicians. SB1320 failed.
With that, all of the bills that will move forward this year have moved out of the first policy committee. Most of these bills move on to Appropriations Committee in the following weeks.
For a refresher on the legislative process in California, check out this handy guide to How a Bill Becomes a Law in California.
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