Health Access Updates
Wednesday, April 14, 2004
HEALTH ACCESS UPDATE
Tuesday, April 13th, 2004
GOOD AND BAD BILLS ON HEALTH COVERAGE TO BE CONSIDERED
From Health Access legislative advocate Beth Capell: The California Legislature is about to consider numerous bills affecting whether consumers can obtain health care when they need it. Letters to a committee are generally due 6 days prior to the hearing to be reflected in the analysis, but letters to committee members are timely up to the time of the hearing. Please click on the bill numbers below to view letter.
Bills That Expand Consumer Protections:
SB1192 (Chesbro) adds substance abuse coverage to existing law. Similar to mental health parity. Sen. Insurance. Wed 4/21.
SB1555 (Speier) adds maternity coverage to health insurance coverage. HMOs are already required to cover prenatal care but insurers can drop it. Prenatal care is cost-effective for the individual and for society. Sen. Insurance Wed 4/21.
AB2185 (Frommer) adds asthma devices such as nebulizers to coverage. Similar to law on diabetes supplies. Assembly Health Tues. 4/20.
Bills That Take Away Protections or Coverage:
AB2996 (Richman) eviscerates coverage by allowing employers and HMOs to pick and choose what to cover. Employers and HMOs can drop any therapy, service or other benefit, including cultural and linguistic access, coverage for broken arms (but not broken legs), prenatal care, family planning, lung cancer (but not skin cancer), etc. Assembly Health Tues 4/13.
AB2985 (McCarthy): suspends SB2, the California Health Insurance Act, for two years whenever unemployment is above 7% for one quarter. Puts at risk health coverage for millions of working Californians. Health coverage helps to fuel economic recoveries by preventing personal bankruptcies. Assembly Health Tues 4/20.
AB2990 (McCarthy): permits health savings accounts to be combined with high deductible HMO coverage. Health savings accounts are great for high income, healthy individuals but bad for people with chronic conditions, those with low or moderate incomes, and women and children who need frequent care. Assembly Health Tues 4/20.
AB2315 (Maldonado): authorizes state income tax deductibility of health savings accounts. Health savings accounts are great for high income, healthy individuals but bad for people with chronic conditions, those with low or moderate incomes, and women and children who need frequent care. Assembly Rev and Tax Mon 4/19.
AB1888 (Nakanishi): authorizes state income tax deductibility of medical savings accounts. Similar to health savings accounts, medical savings accounts are great for high income, healthy individuals but bad for people with chronic conditions, those with low or moderate incomes, and women and children who need frequent care. Assembly Rev and Tax, probably Mon 4/19.
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Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org
Tuesday, April 13, 2004
HEALTH ACCESS UPDATE
Monday, April 12, 2004
BUDGET SUBCOMMITTEES ON HEALTH CONSIDER CUTS
* Enrollment Caps Rejected Again, by Assembly Subcommittee
* New Scrutiny and Information on Medi-Cal Redesign
Earlier today, both the Assembly and Senate Budget Subcommittees on Health
considered a range of health care cuts, and heard testimony from numerous
organizations representing consumers, providers, and communities throughout
the state. ATTACHED is an UPDATED Health Cuts Budget Scorecard indicating
the actions to date on the proposed cuts.
ENROLLMENT CAPS REJECTED BY ASSEMBLY SUB: The Assembly Budget Subcommittee
on Health, chaired by Assemblyman Mervyn Dymally, followed the lead of its
Senate counterpart in rejecting the full range of proposed enrollment caps.
The committee rejected proposals to deny coverage to children applying to
get Healthy Families coverage; children with disabilities applying to get
into California Children's Services (CCS); recent legal immigrants applying
to get Medi-Cal; undocumented pregnant women and infants, as well as
long-term care to undocumented seniors, applying to get Medi-Cal; immigrants
with cancer applying to get into the Breast and Cervical Cancer Treatment
Program in Medi-Cal; and hemophelia patients and others applying to get into
the Genetically Handicapped Persons Program.
The Assembly Subcommittee heard a large amount of testimony on both the
enrollment caps, provide rate reductions, and the proposal Medi-Cal
redesign, from a full range of organizations, including people that packed
both the small hearing room and the overflow area. The Subcommittee decided
to hold the provider rate cut proposal open, and did not take a formal
action.
NEW INFO ON MEDI-CAL REDESIGN: Both subcommittees heard testimony regarding
concerns about the Medi-Cal redesign process and proposals, and new
information came out about the proposals. In both subcommittees, Director of
Health Services Sandra Shewry described the workgroups and processes, and
hinted at the proposal that is expected to be submitted to the legislature
by the May Revise.
She passed out documents that will be used for discussion at the April 14th
and 15th Medi-Cal redesign workgroups in Los Angeles. (For more information,
go to http://www.medi-calredesign.org) While she stressed that these were
not official proposals by the state and only for discussion, it was clear
that they represented the current thinking of what a potential Medi-Cal
waiver and proposal would look like.
One proposal was entitled "a conceptual framework for a tiered approach to
benefits and cost sharing," and also included charts indicating who got what
benefits and cost-sharing in each of the three tiers, but also the fiscal
analysis that presumes such changes would generate savings of over $111
million. This includes eliminating acupuncture and chiropractic services and
requiring co-payments for all Medi-Cal patients (and allowing providers to
refuse coverage if the co-pay is not paid.) It also includes higher co-pays,
premiums, and other cost-sharing for certain adult populations, including
paying 20% of the cost of benefits such as medical supplies and equipment,
nursing facility services, and many treatments. The documents are at:
http://www.medi-calredesign.org/eligibilityDocs.aspx
Another proposal under discussion is to geographically expand the reach of
Medi-Cal managed care, even though many of these counties have not proven to
be able to sustain managed care plans in either the private or Medicare
markets. The slide show of the discussion proposal is at:
http://www.medi-calredesign.org/managedCareDocs.aspx. The Assembly
Subcommittee explicitly rejected the notion to require aged, blind and
disabled populations to be enrolled in managed care. This was in response to
a Medi-Cal redesign discussion proposal to force seniors and people with
disabilities into managed care plans that may or may not include the
providers that they currently depend on.
SENATE EXAMINES OTHER COST SAVINGS: The Senate Subcommittee focused on a
range of proposals that had been enacted in past years to yield savings, but
seem not to have been implemented by the Department of Health Services. The
details are in the agenda, at:
http://www.senate.ca.gov/ftp/SEN/COMMITTEE/STANDING/BFR/_home/Agendas.htm
--
Anthony E. Wright
Executive Director
Health Access
1127 11th St., #234, Sacramento, CA 95814
Ph: 916-442-2308, Fx: 916-497-0921
awright@health-access.org
