With next Friday’s (July 17) deadline for policy committees to meet and consider bills from the opposite house, critical patient protection bills will be debated and voted on in the Assembly Health Committee this Tuesday and in Senate Health Committee on Wednesday. Community groups have the next few days to mobilize networks to encourage committee members (Assembly Health Committee members and Senate Health Committee Members) to vote for the bills (find your legislator here).
For details on each bill, and where we are in the process, see our weekly bill matrix.
Also see our blog on bill hearings for the week of July 6-10.
#HEALTH4ALL NOW RUNNING ON MULTIPLE TRACKS
After the recent victory in the state budget covering children in Medi-Cal regardless of immigration status, health and immigrant advocates are continuing their efforts to take additional steps to #Health4All, at the county and state levels, administratively and legislatively.
Beyond the budget, the state legislative push continues for #Health4All although in a different form than previously. This week, Senator Ricardo Lara announced he was splitting his bill, SB 4 (Lara) into two parts: one bill, SB 10 (Lara), would include the capped program to expand Medi-Cal to adults regardless of immigration status. SB 4 would no longer include that part, and would proceed with technical improvements to the children’s coverage expansion and the waiver request to the federal government to allow undocumented immigrants to purchase coverage with their own money in Covered California. That part is expected to be heard in Assembly Health Committee on Tuesday, July 14th, starting around 1:30pm.
Because of the questions by Governor Brown (and the Appropriations Committee) about the potential costs of a Medi-Cal expansion for undocumented adults, even after significant offsets were identified, SB 10 will not proceed this year. As a two-year bill, It could be considered as early as January or as late as June of next year. SB10 previously served as a vehicle to help immigrants apply for DACA and DAPA deferred status through the creation of an “Office for New Americans. Since this priority was funded in the budget, SB 10 was no longer needed. Now SB10 has another life, and a new purpose: to extend #Health4All under Medi-Cal.
SB4, to be heard in Assembly Health Committee next Tuesday, would seek a special Section 1332 waiver (a formal request to the federal government), to allow all Californians, regardless of immigration status, to purchase coverage through Covered California with their own money. A waiver is needed so that Covered California can offer California qualified health plans that are look-alike plans, identical in every respect to the products offered on Covered California—with the same insurance market rules that currently apply to Covered California products.
Talking Points for SB 4 (and SB 10)
-Immigrants are a fundamental part of our workforce and communities; they should therefore be fully included in our health system.
-A majority of undocumented Californians are in “mixed-status” families: it makes sense to allow the Covered California staff to help the entire family sign up for coverage, even if not everyone is eligible for subsidies at this point.
-No one should suffer or die from a treatable condition because of where they were born.
BILLS LIMITING OUT-OF-POCKET COSTS FACE CRUCIAL VOTE NEXT WEEK
The following Health Access-sponsored bills preventing unfair out-of-pocket costs will be heard next week.
*Preventing Surprise Bills: AB 533 (Bonta), which would protect patients from “surprise” bills from out-of-network doctors when they did the right thing by going to an in-network hospital, imaging center, or other facility, passed out of the Assembly with a vote of 74-1. While that vote provided momentum, the California Medical Association and other provider groups continue to oppose the bill in print.
Talking Points for AB 533
-If consumers do the right thing by visiting in-network hospitals or facilities, they should not get stuck paying “gotcha” bills from out-of-network providers.
-Consumers should not get stuck in the middle of a business dispute between health plans and providers. It is up to the health plans to build adequate networks that include the different types of providers (radiologists, anesthesiologists, etc.) that may be seen in a given clinical encounter.
* Limiting Prescription Drug Cost Sharing: AB 339 (Gordon): AB 339 would prevent discrimination against consumers with health conditions by setting stronger standards for cost sharing on prescription drugs. The bill passed out of the Assembly with a vote of 48-29. As recently amended, the bill would now cap prescription drug costs per month at the levels negotiated by Coverage California–$250 for everything, except for bronze, which is $500. Originally AB 339 had a cap set to 1/24th of the out-of-pocket maximum.
Talking Point for AB 339
-People living with chronic conditions should not have to face excessive cost sharing, i.e. the current policy on cost sharing is inherently discriminatory and in conflict with the broader goals of health reform.
*Requiring Accurate Provider Directories: SB 137 (Hernandez) would set higher standards for updated and accurate provider directories and establish more oversight on accuracy so people know whether their doctor and hospital are in network when they shop for coverage, change coverage, or try to use their coverage. SB 137 passed out of the Senate with bipartisan support (33-0) and will be heard Tuesday July 14 1:30 PM.
Talking Points for SB 137
-Consumers need up-to-date provider directories so they can understand their options for care, get timely care, and avoid visiting costly out-of-network providers.
-The industry (and federal law) is moving away from paper-based directories—at last. AB 533 puts higher standards in place for easily accessible online provider directories.