HEALTH ACCESS ALERT: Tuesday, August 25, 2014
KEY PATIENT PROTECTIONS UP IN LAST WEEK OF LEGISLATIVE SESSION
* Key health bills, including SB 964 (Hernandez) on network adequacy and timely access to care, are among hundreds of bills Legislature must pass by Sunday; If approved, Governor Brown would have September to sign or veto.
* Also pending: key Medi-Cal bills: limiting Medi-Cal estate recovery (SB1124), and allowing State to accept foundation money for Medi-Cal renewal assistance (SB18).
* Most closely-fought health bill SB1094(Lara), to expand the Attorney General’s authority to enforce conditions of non-profit hospital mergers and acquisitions, to assure that a nonprofit hospital will continue to serve its community after a transaction in which ownership changes. Advocates urged to call in support.
* POST-LEGISLATIVE SESSION RECEPTION to wish Health Access’ Beth Abbott well as she transitions to her new post as director of the revamped Office of the Patient Advocate. Please RSVP here for the reception Tuesday, September 2nd, 4-7pm, Ambrosia Cafe in Sacramento.
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In this last week of the 2013-14 legislative session, the Assembly and Senate will voted on hundreds of bills by Sunday, including those of strong interest to California patients and health consumers. Bills must pass out of the Legislature by the end of the week and if passed, the Governor has the month of September to decide their ultimate fate.
Below is a list of specific bill pending in this crucial week. On the Assembly floor for a vote as early as today is a key bill to ensure network adequacy and timely access to care, SB 964 (Ed Hernandez), a Health Access California-sponsored bill which would require DMHC to do annual reviews for timely access and network adequacy, separately for Medi-Cal managed care and the individual market so that consumers in Medi-Cal and Covered California get timely access to necessary care. Consumer groups are actively working to get this bill passed.
Two important Medi-Cal bills are also up for a vote on the Senate floor: SB 18 (Leno/Hernandez) would have the State accept $6 million from the California Endowment to fund Medi-Cal renewal assistance, and drawing down federal matching funds as well; SB 1124 (Hernandez) would limit Medi-Cal estate recovery to long-term care, so those getting Medi-Cal managed care services would not find that their family home had a claim on it after death. Advocates are gearing up to generate calls and letters to the Governor’s office on these important bills.
A new bill that is advancing in the Legislature, AB 1578 (Pan), would extend until June 30, 2016, the operative date of the California Health Benefit Review Program (CHBRP) and further expand its role to include an assessment of legislation that impacts health insurance benefit design, cost sharing, premiums, and other health insurance topics. This short-term extension will give the Legislature and other stakeholders the opportunity to consider how the role of CHBRP should be revised post-ACA. This bill requires bipartisan support because it requires a two-thirds vote to extend funding.
The most contested health bill this week seems to be SB 1094 (Lara), which would expand the Attorney General’s authority to enforce conditions of non-profit hospital mergers and acquisitions, to assure that a nonprofit hospital will continue to serve its community after a transaction in which ownership changes. SB 1094 failed passage on the Assembly Floor in a vote last week, but has been granted reconsideration, and advocates ranging from Consumers Union to Planned Parenthood to the California Labor Federation to Health Access California are making a strong push for passage. The debate on the Floor was contentious, with Republicans and some Democrats siding with hospitals in opposition. Democrats in support, like Assemblymember Holden expressed “this is about protecting the interests of consumers.” Consumer and community groups are urged to support this key measure in this crucial week.
Other key bills are listed below.
RECEPTION: We hope to celebrate next week, after the legislative session ends, as Health Access California will host a reception to recognize our director of administrative advocacy, Beth Abbott, as she is about to start working as the Governor’s appointment to direct a revamped Office of the Patient Advocate. The reception will take place Tuesday, September 2nd, from 4-7pm, at Ambrosia Cafe in Sacramento. Please RSVP at this link to join our advocates and colleagues to wish her well.
BILL LIST
Here’s a broader list of the bills of interest to health care advocates, pending floor votes in the state legislature this week. It’s the last week for consumer and community groups to weigh in to the Legislature:
NETWORK ADEQUACY OVERSIGHT OF HEALTH PLANS: SB964 (Ed Hernandez) requires the Department of Managed Health Care (DMHC) to do annual reviews for timely access and network adequacy to be done separately for Medi-Cal managed care and the individual market so that consumers in Medi-Cal managed care and Covered California get timely access to necessary care. Sponsored by Health Access California.
PRESCRIPTION DRUG COST SHARING: AB1917 (Gordon): would cap prescription drug co-pays at 1/12 of the annual out-of-pocket limit so that patients with HIV/AIDS, cancer, MS, and other diseases will not be forced to pay high upfront costs for their medication. Sponsored by Health Access California.
JUNK INSURANCE FOR LARGE EMPLOYERS: AB2088 (Roger Hernandez) while not banning limited benefit plans, makes them supplemental to comprehensive coverage. California law allows the sale of “insurance” that provides very limited benefits with a minimum actuarial value of less than 60%. This bill extends this consumer protection to large employer coverage, closing a loophole for some large employers to avoid offering comprehensive coverage to their employees. Sponsored by Health Access California.
SB1176 (Steinberg) makes the health plan or insurer responsible for tracking out-of-pocket costs for in-network providers, and reimbursing the consumer when they exceed their out-of-pocket limit. SUPPORT.
SB959 (Ed Hernandez) is the clean-up bill for the individual and small group market reform legislation to implement the ACA enacted in 2012 and 2013. SUPPORT.
AB 2533 (Ammiano) would seek to ensure timely access to necessary care at in-network cost sharing. SUPPORT.
Ø Cost/Quality Transparency
SB1182 (Leno) would provide claims data or other detailed data to large purchasers. SUPPORT.
AB1962 (Skinner) would make transparent what dental-only plans spend, as a percentage of premium, on patient care. It requires specialized dental-only plans to disclose a “medical loss ratios” as for medical coverage. The bill is sponsored by the California Dental Association. SUPPORT.
AB 1578 (Pan) would extend until June 30, 2016, the operative date of the California Health Benefit Review Program and further expand its role to include an assessment of legislation that impacts health insurance benefit design, cost sharing, premiums, and other health insurance topics. SUPPORT.
Ø Hospital Oversight and Consumer Protections.
SB1094 (Lara) amends existing law on Attorney General oversight of nonprofit hospital mergers and acquisitions. It extends the review period from 60 days to 90 days. It also gives the Attorney General authority to enforce conditions of hospital transactions. This bill is sponsored by the Attorney General. SUPPORT.
SB1276 (Ed Hernandez) updates the Hospital Fair Pricing law (which Health Access California sponsored in 2006) by: defining a reasonable payment plan as monthly payments that are no more than 10% of income after essential living expenses; allowing underinsured individuals with high health costs (over 10% of income) to receive the hospital fair pricing discount even if they receive a discounted rate on their cost sharing from their health plan or insurer. It is being sponsored by Western Center on Law and Poverty based on their experience assisting consumers. SUPPORT.
Ø Medi-Cal
SB18 (Leno) provides $6 million to the State from the California Endowment to fund Medi-Cal renewal assistance Sponsored by Health Access California.
SB1124 (Hernandez) limits Medi-Cal estate recovery. California is one of only ten states that impose estate recovery on more than long term care services, where the state, for those over 55, recovers the cost of all medical care from the estate of an individual after death. This has discouraged some from signing up for Medi-Cal coverage. Co-sponsored by Western Center on Law and Poverty (WCLP) and California Advocates for Nursing Home Reform. SUPPORT.
AB2325 (Speaker Perez) would create a Medi-Cal medical interpreter program. The bill was vetoed last year: this is a re-introduction of that measure. SUPPORT.
Ø Prevention
SB912 (Mitchell) would eliminate the sunset on the current requirement that vending machines in state buildings include 35% healthy food and drinks. Sponsored by California Pan-Ethnic Health Network. SUPPORT