HEALTH ACCESS UPDATE
Tuesday, September 28th, 2004

PROPOSITION 72 & LEGISLATIVE UPDATE

• Vetoes Likely on Prescription Drugs; Other Bills Signed
• Prop 72 Polls, Opposition Ads, and Events
• Conferences on Health Reform; Health Advocates Calendar

ADVOCATES AWAIT PRESCRIPTION DRUG VETOES BY GOVERNOR SCHWARZENEGGER

VETOES: Thursday is the last day that Governor Arnold Schwarzenegger can sign or veto bills sent to him this legislative year. As previously reported, the Governor has vetoed many bills of interest to health care advocates, including consumer protections for self-pay hospital patients, pregnant women in health plans, and community members that are seeing hospitals close in their area.

DRUG BILLS: The highest-profile measures left on the Governor's desk are the eight bills dealing with prescription drugs costs. These include four that facilitate the reimportation of drugs from Canada as a way to save on their very high costs. The Governor has signalled that he intends to veto these bills, calling them "illegal," even though Governors of both parties from other states has signed similar measures into law. On Monday, legislators, seniors, and consumer advocates urged the Governor to sign the bills, and referred to studies that show that the Administration's "alternative" proposal would not provide significant relief to seniors and others who purchase prescription drugs, especially in comparison to the legislation on the Governor's desk.

OTHER BILLS SIGNED: While many health consumer measures have been vetoed or are expected to be vetoed, there were a few bills supported by consumer groups like Health Access California that were signed into law. They include:

• CHILD ASTHMA: AB2185 (Frommer), to ensure that pediatric asthma devices such as inhaler spacers, nebulizers, and peak flow meters are included in health coverage.
• EXPRESS ENROLLMENT: SB1196 (Cedillo), to permit information from a school lunch application to be used to determine eligibility for Healthy Families and other insurance programs, with parental consent.

The lists of his signatures and vetoes is at the Governor's website, under "Press Room", then "Press Releases," and then in daily "Legislative Update" posts:
http://www.governor.ca.gov/state/govsite/gov_homepage.jsp

To keep on top of what health consumer legislation has been signed and vetoed, visit the legislative corner of the Health Access website, at:
http://www.health-access.org/legislative_info.htm

PROPOSITION 72 POLLS WELL; A SECOND OPPOSITION AD APPEARS; EVENTS UPCOMING

POLLS: Proposition 72, the referendum on the health care measure to protect and expand on-the-job health coverage, is faring well in recent polls. Last Friday's Los Angeles Times reports that 51% of voters would vote for the measure, while 31% would vote against it, and the rest are currently undecided. The poll was taken a week after the opposition started to run their first television ad, featuring a man and woman discussing Proposition 72 at a kitchen table. The LA Times poll is within the margin of error of other polls that have been released recently.

ADS: This week, a new opposition ad has appeared, featuring a woman discussing the impact of Proposition 72 on a small restaurant, one that would seemingly be exempt under the measure. Supporters of Proposition 72 have prepared a rebuttal, on their "Save Your Healthcare" website at:
http://www.yesonprop72.com/site/pp.asp?c=efIOISMEG&b=199245

SACRAMENTO RALLY: Supporters of Proposition 72 will join California Treasurer Phil Angelides, as well as leaders from the medical, consumer, senior, religious, and labor communities to rally for the measure and to "make sure that large corporations pay their fair share for health care." The mini-rally will be MONDAY, OCTOBER 4th, at 11:00AM, in front of the State Treasurer's Office at 915 Capitol Mall in SACRAMENTO. For more information, contact the Yes on Prop 72 Campaign at 510-663-4074.

LEGISLATIVE HEARING: Next week, the California State Assembly and Senate Health Committees are scheduled to convene an informational hearing on Proposition 72 on TUESDAY, OCTOBER 5th, in Sacramento. They plan to have a panels of impartial experts, supporters, and opponents, as well as time for public comment.

CONFERENCES ON HEALTH ISSUES; OTHER EVENTS OF NOTE

There are many events, actions, conferences, and activities of interest to health advocates being planned for October and November. The online Health Advocates Calendar lists many of these events and has the relevant information. You can peruse the calendar at:
http://www.health-access.org/calendarhome.htm

If your organization is planning a public event of interest to health advocates, please let Health Access know so we can help publicize it. You can add events to the calendar at:
http://www.health-access.org/calendar_request.htm

Three southern California conferences in October promise to discuss the big picture issues with regard to our health care system. They include:

• Monday, October 4th: UCLA conference: "Health Care in California: Confronting the Future, A Conference for California Leaders." A non-partisan conference at UCLA with other California leaders from government, business, labor, and the community and media interested in effectively confronting the health care issues facing the state. Co-chaired by California Assemblymembers Keith Richman, MD, and Joe Nation, PhD, confirmed speakers also include: Dr. Albert Carnesale, Chancellor, University of California, Los Angeles; Sandra Shewry, Director of CA Department of Health Services; Robert Brook, M.D., Vice President, RAND; Professor of Medicine and Health Services, UCLA; E. Richard Brown, Ph.D., Director, UCLA Center for Health Policy Research; Thomas Garthwaite, M.D., Director, Department of Health Services, County of Los Angeles; Daniel Higgins, M.D., President, Los Angeles County Medical Association; Thomas Priselac, President/CEO, Cedars-Sinai Medical Center. (Similar conferences will be held on November 18, 2004 at Fresno State, and December 1, 2004 at UC Berkeley). You can register on line for a conference at www.communicationsinstitute.org or call 626-796-4747 for information. The registration fee is $75 and includes the conference program, the special RAND Report, other publications, and meals.
• Tuesday, October 12th: Loma Linda University event: "American Health Care Congress: A Brighter Future for American Health Care" at the DoubleTree Hotel in Ontario, California. Organized by CodeBlueNow!, Loma Linda University School of Public Health, and West End Community Action Network, and sponsored by The California Endowment and First 5 San Bernardino. Speakers includ John Kitzhaber, MD, former Governor of Oregon; Richard Hart, Chancellor and CEO of Loma Linda University; Kathleen O'Connor, founder, CodeBlueNow!, and other academic and medical experts "in a dialogue of what a health care system should do and how it could be financed and managed." Telephone registration is at: 909-558-4595, or 800-854-5661. For more information, go to www.llu.edu/sphevents
• Wednesday, October 20th: Forum at UCLA: “Building a National Health Policy Plan for President Bush or President Kerry.” Roundtable topics will be discussed by senior elected officials, healthcare experts and representatives of advocacy groups and the healthcare industry, including those from Pacific Research Institute, Service Employers International Union (SEIU), RAND Corporation, California Medical Association, AARP, AFL-CIO, AstraZeneca, Aventis, UCLA Center for Health Policy Research, American Health Care Association, California Association of Nurse Practioners, Cedars Sinai Hospital, McKesson Corporation, California Healthcare Association, Alzheimer’s Association, Bush/Cheney 2004, Kerry/Edwards 2004, CapGemini, California Chamber of Commerce, WebMD Corporation, Milken Institute/Faster Cures, National Federation of Independent Business, Solucient, and Ernst & Young. REGISTRATION FREE FOR HEALTH ACCESS MEMBERS and allies, but it is on a first come first serve basis (seats are limited and the regular registration is $50.00). Registration includes coffee breaks, buffet lunch, forum materials and a post-event reception. Please register for the forum at event website: http://www.caforum.org (click on “free registration”).

JOIN HEALTH ACCESS ONLINE!

Do you appreciate these E-mail updates, and the other resources provided by Health Access California in your organization's health care advocacy? If so, please consider join dozens of other groups in becoming a member of Health Access California, the statewide health care consumer advocacy coalition. Our goal is to achieve quality, affordable health care for all, and to assist our member organization in their advocacy on behalf of their constituency. Your organization can join online, at:
http://www.health-access.org/signupform.htm

Labels: Updates

• Banned Hospital Overcharging
• Ensured Maternity Coverage
• Investigated Out-of-Pocket Costs
• Required Notice of Hospital Closures

Governor Arnold Schwarzenegger vetoed a range of health care consumer protection bills today, on issues as varied as hospital closures to maternity benefits. While the most high-profile bill the Governor vetoed was on the controversial subject of drivers licenses for immigrants, many of the health bills vetoed had gotten significant press attention in the past year. The list of his signatures and vetoes is at the Governor's website, under "Press Room", then "Press Releases," then "Legislative Update 09/22/2004":
http://www.governor.ca.gov/state/govsite/gov_homepage.jsp

By vetoing these consumer protections, Governor Schwarzengger is allowing hospitals to overcharge working families, HMO's to deny prenatal coverage, and emergency rooms to close without community notice. In making these decisions on this legislation, he has clearly sided with health industries, rather than consumer and patient groups.
Consumer and constituency groups, including Health Access California, strongly supported the following bills that were vetoed today:

• SB 379 (Ortiz): Provides consumer protections on hospital billing and collections practices, including prohibiting hospital overcharging of self-pay patients. http://www.governor.ca.gov/govsite/pdf/vetoes/SB_379_veto.pdf
• SB 1555 (Speier): Requires insurers to provide maternity coverage. http://www.governor.ca.gov/govsite/pdf/vetoes/SB_1555_veto.pdf
• AB 2289 (Chan): Produces a report on the out-of-pocket costs that consumers are being forced to pay. http://www.governor.ca.gov/govsite/pdf/vetoes/AB_2289_veto.pdf
• AB 2874 (Diaz): Requires community notice of hospital closures. http://www.governor.ca.gov/govsite/pdf/vetoes/AB_2874_veto.pdf (Governor

Schwarzenegger also vetoed SB 1540 (Margett), to enforce notice of emergency room closures.)For more information on these bills, such as arguments in support of these bills, or other health consumer bills that are pending on the Governor's desk, go to the Health Access website at:
http://www.health-access.org/legislative_info.htm

The Governor's veto messages mostly express his "concern" with the issues raised by the bill, or indicate that they are "well-intentioned." But each of them state a rationale for the veto. On SB 379, the Governor acknowledged that "large hospital bills can lead to devastating financial consequences for those least capable of bearing the costs of unplanned visits to the hospital." Yet he later writes that "ultimately, I decided that the voluntary guidelines must be given time to be implemented and reviewed." He did call on the hospitals to abide by them: "Nevertheless, it is my expectation that all hospitals in the state uphold their important commitment to the voluntary guidelines and that they are applied evenly, consistently, and without hesitation." The Governor did not cite the recently-released Health Access study that showed that only one of 40 hospitals surveyed abided by five specific guidelines. In fact, half of the hospitals didn't even post a sign to direct self-pay patients to financial assistance, perhaps the easiest to implement of the guidelines adopted in February.

On SB 1555, the Governor's message said that "the bill reflects a difficult policy choice: protect access to affordable health insurance products that an average Californians can purchase or mandate that every person who pays for their own health insurance buys coverage for maternity services.... Ultimately consumer choice and affordabiliy prevailed...." The Governor did not address arguments that insurers without prenatal coverage could cherry-pick and segment an already fragile insurance market. On AB 2289, which was sponsored by Health Access California, was cited in the Governor's message that it would "add to the existing regulatory morass." The Governor did not acknowledge the concerns with increasing out-of-pocket costs. On AB 2874, he said that "I encourage hospitals and counties to coordinate with one another with respect to hospital closures, but... I am unable to sign this legislation."

Labels: Updates

• Only one of the 40 hospitals surveyed fully complied with the five California Healthcare Association guidelines for which we surveyed.
• In nearly half (19) of the hospitals, our surveyors found a total lack of compliance with the guidelines on signage: they were not able to find a sign on financial assistance anywhere, including in the areas specifically designated, such as the emergency room and admitting area.
• Only 16 (40%) of the hospitals had a sign in the emergency room; only 14 (35%) had a sign in the admitting/registration area. Only 4 hospitals had signs in the three recommended locations: the emergency room, the admitting/registration area, and the billing area.
• When the signs were posted, the signs often did not contain the necessary information the guidelines suggest, including instructions on applying for financial assistance, and a telephone number. Less than a quarter of the hospitals had signs with this crucial information. Only 30% of the hospitals had signs that were bilingual.
• The survey showed that many staff were not knowledgeable about their hospitals' policies, and that the hospitals’ websites did not include the relevant information.

The survey results have direct implications for the fate of SB379 (Ortiz), a first-in-the-nation consumer protection bill pending on Governor Schwarzenegger’s desk, to end the routine practice of hospital overcharging of the uninsured, and to provide other patient protections. The voluntary guidelines adopted by California hospitals were seen as a way to head off this legislation. Earlier this year, Schwarzenegger’s Office of State Health Planning and Development opposed the bill, citing the voluntary guidelines, and stating that, “it is our understanding that many hospitals are planning to follow these voluntary guidelines. We feel it would most prudent to give this effort a chance to work before legislating in this area.” The Governor has until September 30th to sign or veto this bill, which has gotten national attention.

Labels: Updates

Labels: Updates