Tuesday, June 29, 2004

HEALTH ACCESS UPDATE
Tuesday, June 29, 2004

SB2 GETS A BALLOT NUMBER: VOTE YES ON PROPOSITION 72
- A YES vote would protect and expand employer based health coverage
- 14 Proposition measures on the ballot this November 2

The Secretary of State's office yesterday announced proposition numbers for the 14 measures that will appear on the November 2, 2004 general election ballot.

The referendum to repeal the Health Insurance Act, SB2, has been deemed Prop. 72. Health advocates urge a YES vote on Prop. 72, to protect employer based health coverage for millions of California workers and their families, while expanding coverage to over a million more. To find our more information about the YES on Prop. 72 campaign, please visit:
http://www.saveyourhealthcare.com

Over 100 organizations representing consumers, seniors, doctors, nurses, and communities around the state have endorsed the YES on Prop. 72 campaign. In order to have your organization listed as the endorser, fax back the form:
http://www.health-access.org/SupportSB2-OpposeRepealSignOn.doc

Prop. 72 is one of the more discussed Proposition for this fall. It will be on the ballot as one of 14 measures in addition to the races for the Presidency, US Senate and state legislative seats. Below is a list of the Propositions that will be on the ballot.

Prop. 59: SCA 1 (Resolution Chapter 1, 2004). Burton. Access to government information.

Prop. 60: SCA 18 (Resolution Chapter 103, 2004). Johnson. Primary elections: surplus state property.

Prop. 61: Children's Hospital Projects. Grant Program. Bond Act. Initiative Statute.

Prop. 62: Elections. Primaries. Initiative Constitutional Amendment and Statute.

Prop. 63: Mental Health Services Expansion and Funding. Tax on Incomes over $1 Million. Initiative Statute.

Prop. 63: Limitations on Enforcement of Unfair Business Competition Laws. Initiative Statute.

Prop. 65: Local Government Funds and Revenues. State Mandates. Initiative Constitutional Amendment.

Prop. 66: Limitations on "Three Strikes" Law. Sex Crimes. Punishment. Initiative Statute.

Prop. 67: Emergency and Medical Services. Funding. Telephone Surcharge. Initiative Constitutional Amendment and Statute.

Prop. 68: Tribal Gaming Compact Renegotiation. Non-Tribal Commercial Gambling Expansion. Revenues, Tax Exemptions. Initiative Constitutional Amendment and Statute.

Prop. 69: DNA Samples. Collection. Database. Funding. Initiative Statute.

Prop. 70: Tribal Gaming Compacts. Exclusive Gaming Rights. Contributions to State. Initiative Constitutional Amendment and Statute.

Prop. 71: Stem Cell Research. Funding. Bonds. Initiative Constitutional Amendment and Statute.

CLARIFICATION:

This is a quick clarification of last week's vote on SB921 (Kuehl), a groundbreaking bill to establish a universal single-payer health system in California. The Health Access Update on June 22 gave a preliminary vote from the Assembly Health Committee. The final vote was 12 to 5 in favor.

Assemblymembers Cohn, Goldberg, Lieber, Nakano, Wolk, Dymally, Koretz, Montanez, Ridley-Thomas, Salinas, Chavez, and Negrete-McLeod voted for the bill. All Republican Assemblymembers voted against it. Assemblymember Frommer did not vote.

Labels: Updates

posted by Anthony Wright | Permalink | 8:32 AM


 

Tuesday, June 22, 2004

HEALTH ACCESS UPDATE
Tuesday, June 22nd, 2004

UNIVERSAL COVERAGE BILL PASSES ASSEMBLY HEALTH COMMITTEE
- Prescription Drugs Bills Advance Through Committees
- Update on Consumers Protections for Uninsured Patients
- Supreme Court Decision on Managed Care Lawsuits

In a boost to the goal of quality, affordable health care for all, SB 921 (Kuehl), a groundbreaking bill to establish a universal single-payer health system in California, was passed in Assembly Health Committee Tuesday. Having passed the full Senate last year, this new vote raises the profile of this comprehensive health reform solution. The vote was not a given: When Senator Sheila Kuehl decided to schedule the bill in this committee a few weeks ago, she did not know if she would get the votes.

SUPPORT TESTIMONY: Senator Kuehl opened her testimony by stating how "very proud" she was to author SB 921. After describing the "perfect storm" crisis in health care, she described that the bill "imagines a system that provides high quality, affordable health care for all." Her stated emphatically that "this bill is possible," pointing to Medicare and the Veterans Administration.

Dr. L. Paul Smith, who practiced and taught at McGill University in Canada and now is a member of AARP California, followed on that point, stating that "America is no stranger to single-payer health plans." He mentioned key benefits of such a plan, including universality, comprehensiveness, and consolidated administration, leading to cost effectiveness. Dr. Bill Durston, a Sacramento emergency room doctor also with significant credentials, talked of his personal experiences, both with uninsured and underinsured patients. He also highlighted the significant administrative hassles of the current system.

Dozens of organizations came forward to declare their support, as Senator Kuehl joked, half in fun and full in earnest, "I apologize that there are over 500 organizations in support of this bill." When closing on the bill, she again stated how she had "never seen anything" like the support SB921 has, and simply said that this the bill "is in the interest of California."

OPPOSITION TESTIMONY: Opposition witnesses used several arguments. The Chamber of Commerce representative stated "we do not support the concept of universal health coverage." The Chamber stated their belief that the bill would entail "significant costs" beyond what Californians currently spend, but did not produce research to back up that argument. She referred to the recent Oregon ballot initiatives for a single-payer plan, where 79% of the state voted no. She claimed that SB 921 does "nothing to address the underlying cost of health care."

A representative of health plans challenged the belief that "in order to get to universal coverage, you must junk the concept of private competition." He argued that we all rely on vital services, such as "food, clothing, and housing," which are "delivered best by a private, competitive approach." Finally, he cited that this was a "danger" in thinking there were "easy options" to the health care crisis, and that instead, there are "very difficult tradeoffs."

Other business associations railed against "government-run health care," and instead argued for health savings accounts and association health plans. Representations of manufacturers pointed out that the bill removes employers from the "control and cost of utilization of health care," and the employer would be stuck with "whatever bill that the state sent them." Health underwriters noted that the United States spends more than most countries with single-payer systems, and "what services will be rationed to reduce our costs?"

LEGISLATOR COMMENTS: Assemblyman Frommer raised concerns that there were "no limits on revenues collected," "no controls on costs," and "a Cadillac benefits package." He also questioned the timing, with the upcoming referendum to repeal SB 2, the Health Insurance Act passed last year. Senator Kuehl responded that she was a co-author of SB 2 and strongly supported its passage and will work to defend it this fall, and that there is no contradiction to support both.

Assemblywoman Goldberg referred to her experiences in Los Angeles with a health system that is unraveling: "If we don't do something, nobody will have health care." Assemblyman Dymally supported the bill and urged the people to challenge the monied interests.

Assemblyman Richman stated that he supports "universal coverage" but does not support a single-payer system, and does not believe the terms are interchangeable. He raised concerns about "no limits what the income tax would be, the payroll tax," etc. He cited provider rate reimbursement concerns, citing the low reimbursement in Medi-Cal, another "government run" health insurer. Senator Kuehl responded that she was not surprised that a program directed at the poor is "nickel and dimed," and the bill seeks to insulate the health plan from the political concerns of the Governor and legislature.

Assemblywoman Wolk stated she would support the bill to "move it forward," but had concerns about it being "not cooked," especially with the lack of clarity on the revenues to fund the system, and the potential legal challenges. Having lived in other countries, she also has expressed concerns about "the choices and limitations that others live with that would not be put up with here" in America. Finally, Assemblywoman Rebecca Cohn, Chair of the Assembly Health Committee, gave her support, "since everybody has a body," and each body eventually breaks down.

NEXT STEPS: The bill will not move forward this year. Senator Kuehl will continue to work to develop the revenue package to fund the health system, based in part on economic studies are in the works. This will be a challenge: while the tax system to fund this universal health plan would replace the billions Californians currently spend in premiums, deductibles, and other costs, it still would be considered a tax increase and thus need a two-thirds vote. Yet Senator Kuehl has committed to reintroduce this bill next year, and the organizing and advocacy from this session has created a strong base of support to move forward.

Assemblymembers Cohn, Goldberg, Lieber, Nakano, Wolk, Dymally, Koretz, Montanez, Ridley-Thomas, and Salinas voted for the bill. All Republican Assemblymembers voted against. Assemblymembers Frommer, Chavez, and Negrete-McLeod did not vote.


PRESCRIPTION DRUGS BILLS MOVE FORWARD

The "OuRx Bill of Rights," a package of over a dozen bills and resolutions to help increase access to and reduce the cost of prescription drugs was successfully released out of a series of policy committees in the last week. The policy committees in the second house have often been a sticking point, and this the farthest that bills on these topics have moved forward in the legislative process.

The bills include, SB 1144 (Burton), SB 1149 (Ortiz), SB 1333 (Perata), and SB 1765 (Sher), all moving through the Assembly, as well as AB1957 (Frommer), AB1959 (Chu), AB1960 (Pavley), and AB2326 (Corbett), all moving through the Senate. A large coalition of senior, consumer, labor, and health care organizations are in support of this "OuRx Bill of Rights" legislative package.


CONSUMER PROTECTIONS FOR HOSPITAL PATIENTS ADVANCE

Last Tuesday, the Assembly Health Committee again supported legislation, SB 379 (Ortiz) to provide consumer protections for self-pay hospital patients, putting them only a floor vote away from the Governor's desk.

Before the hearing, Senator Ortiz amended her bill to include strong prohibitions against hospital overcharging for self-pay patients. With these amendments, Health Access California strongly supported the bill; Health Access continues to be the legislative sponsor of a similar bill, AB 232 (Chan). Both bills ensure that uninsured self-pay patients:
- Are informed of their consumer rights and financial options
- Have 150 days before being sent to collections
- If they are under 400% of the federal poverty level, don't pay more than the Medicare, Medi-Cal or worker's compensation rate for treatment.

MOVEMENT ACROSS THE NATION: There continues to be movement on the federal level. On Thursday, the U.S. House Energy and Commerce Committee will hold an oversight and investigations hearing on "Hospital Billing and Collection Practices" toward the uninsured. The hearing will be online, and information will be posted at:
http://energycommerce.house.gov/108/Hearings/06242004hearing1299/hearing.htm

An issue brief summary on this issue, which talks about developments in California and other states, has just been published by the Commonwealth Fund, at:
http://www.cmwf.org/programs/insurance/pryor_medicaldebt_749.asp


SUPREME COURT STRIKES DOWN CALIFORNIA HMO PROTECTION

On Monday, the Supreme Court decision on the case Aetna v. Davila invalidated laws in Texas, California and at least eight other states that allowed patients to sue their HMOs in state court. A copy of the opinion is at:
http://a257.g.akamaitech.net/7/257/2422/21june20041210/www.supremecourtus.gov/opinions/03pdf/02-1845.pdf

The patient impact of the decision is clear: managed care patients have lost an important consumer protection to ensure their health plans are accountable to provide the health care that they need. The California Department of Managed Health Care will need to be additionally vigilant, even with one less tool at their disposal, in protecting patients' access to care. Health Access California was the legislative sponsor of the many bills that made up the California Patients Bill of Rights.

When California took the lead in passing laws to protect HMO patients in the last decade, many states followed, but the federal government regretfully did not. This Supreme Court decision places a harsh spotlight on the lack of action of the President and the Congress. The federal government has yet to enact a strong federal HMO Patients' Bill of Rights, despite this issues prominence in the presidential campaign four years ago, when both candidates promised to pass a bill.

Labels: Updates

posted by Anthony Wright | Permalink | 9:32 AM


 

Tuesday, June 01, 2004

HEALTH ACCESS ALERT
Tuesday, June 1, 2004

POST-DEADLINE REPORT: HEALTH AGENDA MOVES FORWARD
- "Save Your Healthcare" Campaign Launched to Save SB 2
- Budget Process Moves Forward: Additional Health Care Cuts Rejected
- June Calendar of Events
LEGISLATIVE UPDATE- Bills on Prescription Drugs & Health Access Move to Next House
- New Round of Hearings Upcoming; Action Needed


On Friday, a significant legislative deadline has passed, and BELOW is a report on the progress of bills impacting health care consumers. Shorter updates on the budget, the SB 2 campaign, and the health advocacy calendar follow.


OVER 100 ORGANIZATIONS JOIN TO "SAVE YOUR HEALTHCARE"

On Tuesday, over 100 health care consumer and provider organizations announced their support of "Save Your Healthcare," the campaign to save the Health Insurance Ace (SB 2), which protects and expands employer-based coverage, from repeal by referendum this November. To have your organization join this growing list, fax back the organizational sign-on form at:
http://www.health-access.org/docs/HAOrgMembershipForm.doc

At the press conference at the California Medical Association headquarters, the campaign unveiled its official website, at http://www.saveyourhealthcare.com. Organizations in support are encouraged to direct their members to the web site, using their newsletters, E-mails, and their own web sites.

The campaign announced a grassroots effort to distribute a million flyers this summer to educate people on this Health Insurance Act. An initial flyer is posted on the web site, at http://www.saveyourhealthcare.com/atf/cf/{CAE4519D-D50D-4D1B-B9F7-396345BA4651}/million_flyers.pdf


BUDGET COMMITTEES REJECT HEALTH CARE CUTS

In the last week, both the Assembly and Senate Budget Subcommittees on Health have gone through Governor Schwarzenegger's May Revision of the Budget and voted on key issues regarding health care funding. (For a full breakdown of the Governor's May Revise, see the last Health Access Update, archived at: http://www.health-access.org/2004_05_01_Sac_archives.htm#108454876691291780.

Since the Subcommittees had previously rejected the proposals to cap enrollment in Healthy Families and other public insurance programs, block grant immigrant programs, and cut other health programs, the legislators concurred with the Governor's withdrawal of those proposals, including the Medi-Cal provider rate reductions.

The committees also made other changes to the budget, including rejecting a significant to community clinics, by voted against the Governor's proposal to eliminate the "alternative payment methodology" for such clinics. That and other decisions are reflected in an update Health Care Budget Cuts Scorecard, at:
http://www.health-access.org/docs/HealthCuts04ScorecardJune1.doc

The Budget Conference Committee, chaired by Senator Wes Chesbro, is scheduled to begin Wednesday, June 2nd, and end its business on Friday, June 11th. This year, there is a concerted effort for the Legislature to pass a budget by the June 15th Constitutional deadline.


HEALTH ADVOCACY EVENTS IN JUNE

A new June calendar of health and budget advocacy events is available at http://www.health-access.org/calendarhome.htm. Please feel free to submit other events and activities.

Health advocates invited to all these events, and to three we spotlight here:
- WEDNESDAY, JUNE 2nd, 5-7pm: An Opening Reception of a Capitol Art Exhibition, "The Crisis of America's Uninsured," which will be showing at the Capitol Basement Gallery in SACRAMENTO for the month of June. For more info, contact Talking Eyes Media, at 415-641-4636.
- FRIDAY, JUNE 11th, 9am-3:30pm: A Community Forum, "A Vision for Universal Health Care: Health Access in the Latino Community," at St. Vincent's Catholic Church Auditorium in LOS ANGELES. For more info, contact Latino Issues Forum at 415-547-9124.
- SATURDAY, JUNE 19th: A March Across the Golden Gate Bridge for Health Care, in SAN FRANCISCO, coordinated with bridge crossings in cities around the U.S. For more info, contact SEIU at 408-464-3724.


LEGISLATIVE UPDATE: MAJOR FLOOR VOTES; UPCOMING HEARINGS

In the last few weeks, bills on prescription drug costs, out-of-pocket costs, access to coverage, and other matters of concern to health care consumers were voted on in the legislative process and either passed or failed. Below is a report from Health Access legislative advocate Beth Capell:

The deadline for legislation to pass the first house of the legislature, the house in which that legislation originated, passed Friday May 28. In other words, Assembly bills must have passed the Assembly by today (and Senate bills the Senate) or the legislation is dead for this year. (Doing anything else requires a two-third vote for various rule waivers.)

The next big deadline for legislation is the deadline to pass the policy committee in the second house: that's Friday June 25. Assembly bills must pass the Senate policy committee (mostly Health or Insurance for health legislation) and Senate bills must pass Assembly Health by that date or fail for this year. Because summer recess begins on Friday July 2, a few bills may slip over to the week of June 28 and still survive. Bills that pass the policy committee then proceed to the Appropriations Committee in the second house.

You ask yourself: why is there a two-house process? Why do we have to do this all over again? The fundamental answer is that Senators are more skeptical about legislation by Assemblymembers than about bills by other Senators--and that not surprisingly, Assemblymembers are more likely to criticize bills by Senators than those by other Assemblymembers. It often makes these few weeks a tense time. This is a particular peril for the prescription drug bills which had guardian angels over our shoulder until now but which are vulnerable to second-house second guessing.

LINKED to our web site are the letters that Health Access California has sent on those bills, which can be used as sample letters.

DRUG LEGISLATION PASSES FIRST HOUSE

A package of legislation, sponsored by a range of consumer, senior, labor, and health care organizations, attempts to address the rising costs of prescription drugs. All have now passed the first house, albeit some with many amendments, and proceed to the second. This is a major victory on the drug bills, most of which had died in the first house in the first committee in past years. Those who worked in support should be pleased: now they need to get through the second house and then onto the Governor. A full list of the bills is available at: http://www.health-access.org/ourx_bill_rights.htm.

Now in Senate policy committees:

AB1957 (Frommer): Websites to advise purchase of prescription drugs from Canada. Senate Business and Professions and/or Senate Health.
AB1959 (Chu): Legislative oversight of Medi-Cal and other state government prescription drug rebate programs. Senate Health.
AB1960 (Pavley): Regulation of pharmaceutical benefit managers Senate Health.
AB2326 (Corbett): Prescription Drug Report Card on efficacy and safety. Senate Insurance.

Now in Assembly policy committees:
(Mostly in Assembly Health Committee on Tuesday 6/15, as well as Assembly Business and Professions.)

SB1149 (Ortiz): Website listing sources that are unsafe for purchasing drugs from Canada.
SB1144 (Burton): Department of General Services to use Canadian sources for drugs for Corrections, state hospitals, and other select state agencies.
SB 1170 (Ortiz): DHS to establish a Maximum Allowable Ingredient Cost lists within a year.
SB1333 (Perata): Medi-Cal and the AIDS Drugs Assistance Program to reimburse pharmacies that purchase drugs from Canadian pharmacies.
SB1765 (Sher): Codify the voluntary guidelines of Pharmaceutical Research and Manufacturers of America (PhRMA) on gifts, meals, and other inducements offered to prescribers.
SJR24 (Ortiz): Resolution on drug advertising.
SJR25 (Ortiz): Resolution on Medicare prescription drugs.


SOME GOOD CONSUMER BILLS MOVE FORWARD, VOTES UPCOMING

HOSPITAL OVERCHARGING OF THE UNINSURED:
- AB232, by Assemblymember Wilma Chan, sponsored and supported by Health Access California, is in Senate Appropriations and needs to move forward in August. Please send letters of support to Senator Dede Alpert, Senator John Burton, and the other members of Senate Appropriations Committee.
- SB379 by Senator Ortiz would provide some protections to consumers, but does not include price caps on overcharging the uninsured. In Assembly Health 6/15. Health Access supports if amended to include price caps for uninsured.

OUT-OF-POCKET COSTS: AB2289 (Chan), sponsored by Health Access California, begins to address the issue of out-of-pocket costs for the insured. Costs for consumers are skyrocketing: as premiums climb, employers are shifting costs to working families through higher share of premium, higher co-pays, deductibles and other out-of-pocket costs. AB2289 requires the Department of Managed Health Care and the Department Insurance to gather detailed information on what people with insurance are paying. This is a crucial step in getting costs for consumers under control. Please write in support! In Senate Insurance

UNIVERSAL HEALTH CARE: SB921 (Kuehl), to establish a universal, single-payer health care system in California, was passed on a majority vote last year by the state Senate, but held until more amendments were made to the substance of the bill. The bill is in Assembly Health Committee on 6/22. Please write in support, to continue the momentum for quality, affordable health care for all!

OTHER BILLS OF NOTE ON ACCESS TO CARE:

SB1192 (Chesbro) adds substance abuse coverage to existing law. Similar to mental health parity. In Assembly Health.
http://www.health-access.org/docs/SB1192_hac_sen_ins.doc

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. Passed. In Assembly Health
http://www.health-access.org/docs/SB1555_hac_sen_ins.doc

AB2185 (Frommer) adds asthma devices such as nebulizers to coverage. Similar to law on diabetes supplies. In Senate Insurance.
http://www.health-access.org/docs/AB2185_hac_assm_health.doc

AB2874 (Diaz): Limits closure of hospital emergency rooms if detrimental impact on community. Passed Assembly floor after considerable controversy. In Senate Health. Health Access supports.


OTHER BILLS STALLED:

AB2324 (Chan), sponsored by California Pan-Ethnic Health Network and Latino Coalition for a Healthy California, requires collection of data on race and ethnicity plus efforts to eliminate determinants of disparities. Failed in Assembly Appropriations due to costs.
http://www.health-access.org/docs/ab2324_hac_assm_health.doc

AB2270 (Chan), sponsored by Consumers Union, streamlines school based Medi-Cal administrative activities. Failed in Assembly Appropriations due to costs.
http://www.health-access.org/docs/ab2270_hac_assm_health.doc

AB2354 (Levine): Earlier version banned phony discount programs for health services. Amendments taken in Assembly Health caused Health Access and other consumer groups to drop support. Failed on Assembly floor 31-31, 18 abstentions.
http://www.health-access.org/docs/ab2354_hac_assm_health.doc

SB1509 (Alpert): Controls hospital costs through better disclosure of financial situation of non-profits plus allowing greater market power to purchasers like PERS. In Senate Health. Health Access supports. Not proceeding this year because of CalPERS-Sutter controversy.

SB1349 (Ortiz): Separates regulation of HMOs by shifting regulation of financial viability of HMOs from DMHC to Department of Insurance but NOT shifting regulation of quality of care. Use rate regulation methodology similar to that for auto insurance without adapting it for health insurance. Health Access watch. Failed in Senate Insurance.

SB1679 (Perata): Allows ER docs and hospitals to balance bill insured consumers, refer them to collections, and take other aggressive action even though the consumer reasonably sought emergency care and has insurance. Intended to facilitate payment of ER docs and hospital ERs. Health Access oppose unless amended to protect consumers. Senator Perata chose not to proceed due to opposition from Health Access and other consumer groups.
http://www.health-access.org/docs/sb1679_hac_sen_ins.doc

Labels: Updates

posted by Anthony Wright | Permalink | 9:43 AM


 

Digging a bigger whole for reform...

 

Scoring at home...

 

We are hiring, to make a difference...

 

Field Poll: strong opposition to the health cuts.....

 

An Unhealthy Trend

 

Dressing up the Individual (Market)

 

A great debate on the great divide...

 

Jones to be chair of Health Committee...

 

Bass on the budget...

 

Pretty soon, the insureable will be a pretty exclu...