2006 SESSION RECAP: HEALTH HIGHLIGHTS OF BILLS SENT TO GOVERNOR

  • Passage of Universal Healthcare Framework (SB840); Statement on Need for Reform
  • Fair Prices on Rx Drugs (AB2911) & Hospital Charges (AB774) for Uninsured
  • Addition Oversight Over New Medicare Part D Plans (AB2170 & AB2667)
  • Other Measures: Streamline Kids Coverage; Help Those with “Preexisting Conditions.”
  • UPDATE: The Final Results on Pending Bills: What Made It to the Governor?

With the 2005-06 California legislative session having ended last night, Thursday, August 31st, several landmark health care bills now make their way to the Governor’s desk. In this current political environment, many (though not all) are expected to be signed.

HEALTH HIGHLIGHTS: These groundbreaking bills would bring down the cost of prescription drugs, prevent hosptials from overcharging self-pay hospital patients, provide greater state oversight over private Medicare Part D plans, and provide health security for all Californians. Among the highlights:

* UNIVERSAL HEALTH CARE: SB840(Kuehl), the California Health Insurance Reliability Act, would create a universal health care system for all Californians, to provide comprehensive benefits, choice of doctor, better health outcomes, increased system savings, and financial security for California residents. The bill creates a framework and a timetable to establish the system and determine a financing structure.

* DRUG DISCOUNTS: AB2911(Nunez/Perata) would create a prescription drug discount program that would use the purchasing power of the state to bargain for signficant discounts for up to over 6 million Californians with no or inadequate prescription drug coverage. This compromise from last year’s ballot battles of Prop 78 & 79 is seen by many advocates as a workable, enforceable, and verifiable plan to bring down those costs for Californians.

* HOSPITAL BILLS: AB774(Chan) would prevent self-pay hospital patients from being overcharged, and provide other landmark consumer protections. Uninsured patients who go to the emergency room get charged several times what an insurance company pays, and this allows these self-pay patients to pay a fair rate, at the level of Medicare, Medi-Cal or worker’s compensation. It would also prevent bills from going to collections or court prematurely. The result of a five-year effort by health advocates, this bill could prevent many from needless going into medical debt and bankrtupcy.

* MEDICARE PART D: AB2667(Baca) would increase state oversight over Medicare Part D drug plans. AB2170(Chan) would create a report card on them. When Congress decided not to have the federal government negotiate directly with the drug companies for the best price, they instead turned over the Administration of the Medicare prescription drug program run to these newly created private plans, with little oversight over them. These bills attempt to place some state oversight over these private plans that now have little accountability.

NATIONAL & HISTORIC CONTEXT: The passage of these measures in the legislature of the largest state will not just benefit millions of Californians, but are expected to have national implications for impacting policy in other states and with the federal government. The passage of many of these key bills show renewed political will in providing significant help to those Californians without insurance.

Even without signature, health advocates scored a historic victory as lawmakers passed SB840(Kuehl) to create a universal, publicly funded, comprehensive health care program. Gov. Schwarzenegger has indicated that he is likely to veto this bill, but the mere fact that it cleared both houses of the Legislature sends a strong message that major health reform is needed.

FAIR PRICING FOR THE UNINSURED: Many health advocacy organizations were finally successful, after multi-year, parallel efforts, to protect patients against overcharging by pharmaceutical companies and hospitals. These bills prevent uninsured, underinsured and low-income patients–oftentimes those with the least–from paying the most for the hospital care and medications needed to keep them alive.

STREAMLINING KIDS COVERAGE: Efforts to make it easier to enroll and retain children on public insurance programs made their way to the Governor, with SB437(Escutia) and AB1948(Montanez).

HELP FOR THOSE WITH “PRE-EXISTING CONDITIONS”: AB2889 (Frommer) would allow patients with “pre-existing conditions” to transfer between similar plans from one insurer to another. Yet for those “uninsurable” Californians without coverage, they suffered a setback with the failure of AB1971(Chan). That bill would have extended the Manged Risk Medical Insurance Program (MRMIP) for four years, as well worked through the waiting list, extended the coverage, and made the financing more stable and equitable among insurers. Due to a late opposition push, the measure stalled. In its place, SB1702(Speier/Cox) will go to the Governor, to simply extended the sunset on MRMIP for four months through the end of 2007, to allow policymakers to address the ongoing issues next year, and not leave those on the MRMIP program in a bind.

EMPLOYER COVERAGE: AB1840(Horton) would produce information about the employers of the families on the Medi-Cal and Healthy Families programs. SB1414(Migden), dubbed the “Wal-Mart bill,” would require employers of 10,000 or more to pay into a fund if they do not spend a minimum level on health benefits. Both go to the Governor.

DRUGS: The high-profile agreement on prescription drug discounts AB2911(Nunez/Perata) did not mean that the drug companies came away without stopping consumer-backed legislation. Two bills on prescription drugs died in the last days, including AB452(Alarcon), to require a report to the Governor about the prices paid by Medi-Cal for medications; and AB71(Chan), to establish a clearinghouse for unbiased information about the safety and effectiveness of widely-used drugs. However, AB2877(Frommer) did pass, to create a website to assist consumers in comparison shopping about the retail cost of drugs between pharmacies. (While it was amended to take out references to the re-importation of drugs from other countries, it envisions a useful resource for consumers.)

OTHER MEASURES: Other items that passed included SB1534(Ortiz), a new measure to clarify counties’ ability to provide care to undocumented Californians. SB1312(Alquist) as part of licensing reform, would allow hospitals to be fined for patient care violations, in a manner similar to nursing homes–a major step in hospital accountability.

CALL TO ACTION: Organizational and individual letters are needed to urge the Governor to sign these bills, and those below. The governor’s address is:

Gov. Arnold Schwarzenegger
Capitol Building
Sacramento, CA 95814
FAX: 916-445-4633

COMPREHENSIVE LIST: HOW HEALTH CONSUMER BILLS FARED

Following is a list — by category — of bills health advocates have worked on this year, and that were supported by Health Access California:

HEALTH CARE COVERAGE
Major coverage expansion

SB840 (Kuehl) As the California Health Insurance Reliability Act, creates a universal, publicly-financed (single-payer) health care system, similar to Medicare Sent to Governor

Measures on Access and Coverage

AB1840 (Horton) Requires the state to disclose names of employers who, rather than providing health coverage, have their workers and their families on Medi-Cal and Healthy Families Sent to Governor.
AB1948 (Montanez) Creates a feasibility study on simplifying application for Medi-Cal and Healthy Families using CHDP Gateway and electronic application.Sent to Governor.
AB1971 (Chan) Extends the sunset for the Managed Risk Medical Insurance Program (MRMIP) and the Guaranteed Issue Pilot, which covers patients with “pre-existing conditions” unable to get coverage elsewhere Failed, but a narrower version was passed at the last minute in SB1702 (Speier)
AB2889 (Frommer) Prohibits health plans from discriminating against people who have been insured, but who have chronic or serious illnesses in certain instances. Sent to Governor.
SB437 (Escutia) Streamline and simplifies enrollment into children’s insurance programs. This is an extremely tame version of the bill, which was originally intended to expand coverage to all children in California Sent to governor.
SB1702 (Speier) Extends sunset for current Managed Risk Medical Insurance Program.
Sent to Governor.

CONSUMER PROTECTIONS AGAINST MEDICAL DEBT
Hospital Overcharging of uninsured patients

AB774 (Chan) Provides consumer protections against abusive hospital billing and collections practices, including those that charge uninsured patients multiple times what insurers pay for the same service. Patients under 350 percent of poverty, or with inadequate insurance qualify for discounts. Sent to Governor.

Affordable Prescription Drugs

AB2911 (Nunez/Perata) Authorizes the state to negotiate for the best possible price for up to 6 million Californians. The first three years, the program is voluntary. However, after August 1, 2010, if drug companies are not participating or their discounts are still insufficient, the state may use the purchasing power of its Medi-Cal program to steer some business away from less cooperative drug companies. Sent to Governor.
AB2877 (Frommer) Establishes a website for consumers to compare prices on prescription drugs, but no longer links to Canadian websites. Sent to Governor.
SB452 (Alarcon)Requires Medi-Cal to report to Governor on whether Medi-Cal prices are higher than prices for federal programs. Failed.

PATIENT PROTECTIONS
Medicare Part D Patient Protections

AB2170 (Chan) Creates a consumer report card on Medicare Part D prescription drug plans
Sent to Governor.

AB2667 (Baca)
Allows the state to monitor Part D prescription drug plans in the same way it monitors health plans. Sent to Governor.

Insurance Oversight

SB1405 (Soto) Creates a Task Force on Reimbursement for Language Services to recommend actions for achieving linguistic access to care. Pulled from vote. Author & advocates working with Administration.
SB1704 (Kuehl) Extends sunset for the existing California Health Benefits Review Program to 2011. Sent to Governor.

Prescription Drug Safety

AB71 (Chan/Frommer) Establishes a clearinghouse for information about the safety and effectiveness of prescription drugs that are advertised on television. Failed.

For questions or information, please call Hanh Kim Quach, policy coordinator at 916-497-0923 x 206 or hquach@health-access.org.

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

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