HEALTH ACCESS ALERT
Monday, April 25th, 2005

ASSEMBLY HEALTH COMMITTEE TO CONSIDER KEY CONSUMER BILLS TUESDAY

  • Consumer Groups to Support Children’s Coverage, Hospital Disclosure, Individual Insurance Reforms
  • Consumers Groups to Oppose Individual Mandates and So-Called “Discount Health Plans”
  • Other Key Issues on Medi-Cal/Healthy Families Changes, Medicare Prescription Drug Plans


The Assembly Health Committee, chaired by Assemblywoman Wilma Chan (D-Oakland), will consider a wide range of bills of great interest to health care consumers this Tuesday, at 1:30pm in the State Capitol in Sacramento.

Big issues will be discussed on Tuesday, as the roster includes bills that are both actively supported and opposed by consumer groups, with wildly differing notions of how to expand coverage to the uninsured, improve the Medi-Cal and Healthy Families programs, regulate insurers who buy coverage as individuals, and how to deal with so-called “discount health plans.” The full roster of bills to be considered, as well as the names and contact information of legislators on the committee, is listed in the Assembly Daily File, which can be viewed at the Assembly website, at:
http://www.assembly.ca.gov/

Below is a list of some of those bills, along with the position of Health Access California, the statewide health care consumer advocacy coalition. Health Access’ website has links to many of the bills it is tracking this year, along with copies of the support and oppose letters described the organization’s position, at:
http://www.health-access.org/2005_bills.htm

COVERAGE FOR ALL CHILDREN
The ongoing effort to cover all children in California is gaining momentum, most recently with a massive Californians for Healthy Kids town hall earlier this month of over 4,000 people rallying for legislative action, and the movement of a companion bill through key Senate committees. About 90% of California children are covered, and this effort is to complete the job by covering the over one million uninsured children still left in our state.

* AB772 (Chan): Strong Support. The California Healthy Kids Program would attempt to cover all California children, by streamlining and building on existing programs like Medi-Cal, Healthy Families, and the various initiatives at the county level. You can get more information at the 100% Campaign website, at: http://www.100percentcampaign.org/priorities/healthy-kids-main.htm

INDIVIDUAL MANDATE PACKAGE
Assemblymembers Joe Nation (D) and Keith Richman (R) have a package of bills that would impose an “individual mandate” to buy health coverage. As opposed to the many other bills like Healthy Kids that would expand coverage, this concept “blames the victim” by imposing the cost burden on those that don’t have health coverage, by requiring them to pay for substandard coverage.

* AB1670 (Nation/Richman): Oppose. It requires every Californian to purchase health insurance regardless of ability to pay. It would set a $5,000 per person deductible as minimum benefit, and allow a reduced benefit package. The bill subsidizes employers of low-income families, not the employees.
* AB1671 (Nation/Richman): Oppose Unless Amended. Intended as an effort to streamline public insurance programs, the bill would allows privacy violations by allowing DHS to search tax records and other sensitive individual information.

“DISCOUNT” HEALTH PLANS/PROVIDER NETWORKS
So-called “discount health plans” are today unregulated entities, with the most abusive offering phony discounts on phony fee schedules for phony networks of providers, who are often unaware that they have agreed to offer discounts. These abusive plans mislead consumers and even some employers into believing that a discount health plan is an alternative to health insurance, one that is cheaper and more readily available. For example, these plans advertise in multiple languages that “no medical exam required”, “no pre-existing conditions”, “no waiting period”, all terms associated with actual coverage, not merely illusory discounts. They also prey on disadvantaged populations: consumer groups obtained translations of the flyers from Spanish and Chinese and found that these were even more misleading than the English versions. Health Access California and other groups would prefer to ban such plans; regulations should at least provide clear consumer protections against fraud and abuse.

* AB562 (Levine): Support if Amended. This bill would regulate discount plans through the Department of Managed Health Care and provide key consumer protections.
* AB1091 (Parra): Oppose Unless Amended. While the bill provides for various disclosures, it does nothing to assure a genuine discount. It provides few consumer protections for refunds or complaints.
* AB757 (Chan): Support. The bill would prohibit the selling of health provider networks without the provider’s consent. If a provider is not aware that they have agreed to participate in a network, consumers can get caught in disputes over payment rates and other contract terms and conditions.

INDIVIDUAL INSURANCE CONSUMER PROTECTIONS
The individual insurance market is the last refuge for those who are not eligible for employer-sponsored coverage or a public insurance programs. Yet for most of the uninsured, buying health insurance as an individual is either unaffordable, or unavailable. Health Access California is working to provide some assistance to those who are denied individual insurance because of “pre-existing conditions.” Always on the lookout for STORIES, Health Access organizers would appreciate any assistance in finding people who have been denied coverage because of “pre-existing conditions.” Please contact any of our offices if you can help!

* AB1111 (Frommer): Sponsor/Support. The bill would allow consumers to switch among individual insurance products within specific categories of individual insurance, which is now difficult for many consumers.
* AB1199 (Frommer): Sponsor/Support. This bill would ensure that people denied because of “pre-existing conditions” could find out exactly why they were denied, and possibly correct any mistakes. It would provide the equivalent of a consumer credit report for individual insurance health status.

HOSPITAL REPORTING
Consumer advocates are continuing their efforts to use better data reporting and public disclosure to improve quality and address the rising cost of health care.
* AB1045 (Frommer): Support. A follow-up to previous legislation, this bill would require hospitals to disclose their 25 most-used charges on their price lists, or “chargemasters.”
* AB1046 (Frommer): Support. This bill would create a web-based hospital quality report card for consumers and purchasers of health care.

MEDICARE DRUG PLANS CONSUMER PROTECTIONS
While the recently-passed Medicare Modernization Act creates a Part D prescription drug benefit, there are many questions about its implementation in the next year. There are great concerns with the actual level of the benefit, how low-income seniors will fare, and how the transition will be accomplished. While many of these issues are at the federal level, senior and consumer advocates are working to ensure oversight here in California.

* AB1359 (Chan): Sponsor/Support. The bill would require the new Medicare Rx plans to abide by existing law realting to similar health plans, including the consumer protections in the Knox/Keene Act.

MEDI-CAL/HEALTHY FAMILIES CHANGES
Advocates for low-income Californians are continuing their ongoing efforts to streamline and improve public insurance programs so that more people who are eligible the program can get on and stay on Medi-Cal and Healthy Families. At the same time, advocates oppose efforts that would restrict access to care for those on these important programs.

* AB699 (Chan): Support. The bill would eliminate costly semiannual reports that disrupt coverage of Medi-Cal enrollees at cost to the person, the provider and the State.
* AB1533 (Bass): Support. The legislation would facilitate enrollment in private insurance for children graduating from Healthy Families due to higher age or income.
* AB1481 (Richman): Oppose. The bill would force seniors and people with disabilities on Medi-Cal into managed care plans, possibly deprinving them of their current doctors and providers.

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

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