Health Access California has a long and proud tradition as an independent state coalition here in our state, without a national parent. Our policy decisions are made by Californians, for Californians.
But we are pleased to have good, strong connections with national groups that provide useful assistance and resources, including information and linkages with DC-based groups and with other state consumer advocates across the country. During this past health reform effort, these connections were essential in our efforts to integrate the on-the-ground field work with national advocacy.
For example, we were proud to be the lead partner organization in California for the Health Care for America Now! coalition, working with national groups like USAction. We have a long history working with Families USA, co-releasing reports and speaking at their annual DC conference. And we have greatly appreciated the work with Community Catalyst, on both federal health reform, and on projects that we lead in California, the Consumer Voices for Coverage effort and the Hospital Accountability Project. All of these groups are useful resources for us and our partner organizations, and their websites are useful resources for you, too, to find out more about health reform.
We thank these and other national experts, advocates and groups who have helped us in the last two years make a difference in the health reform debate. The Community Catalyst folks sent their own message of appreciation to advocates in the states as well. (I would say it's NSFW, but you would get the wrong idea.) It's even more strange when you know these people. So, with affection:
The tweet that links to this blog post will be Health Access' 4000th.
We have taken pride that in our efforts to inform and engage people in health reform, policy, and budget issues, Health Access has supplemented our organizing, coalition building, media outreach, and public education efforts with an aggressive push as an early adopter of social media, from Twitter to blogs to Facebook.
On our Twitter account @HealthAccess, at www.twitter.com/healthaccess, we have been posting a regular stream of updates. These 4,000 tweets include retweets of updates from others, links to interesting articles, live reports from committee hearings and regulatory meetings, and commentary on legislative debate. We've been doing this since early 2009, and have built up nearly 1,350 followers. If you are getting into Twitter, you might want to check out who we are following for updates about state and federal health policy news, and our lists as well. Our first post on this Health Access Blog, at http://blog.health-access.org/, was May 2002, just about 8 years ago, and over 2,000 posts ago.
We started way back when just posting our E-mail Updates, so that they could be read not just by those to which we E-mail. We have produced over 400 such updates since 2002, averaging about 50 a year, providing comprehensive reports on health budget, legislation, and policy. You can sign up to subscribe to our Health Access E-mail Updates on the front page of our website, at http://www.health-access.org/.
Health Access started a more concerted effort to provide more daily blog reports and commentary in fall of 2006, when there was a new effort to pursue health reform at the state level. That effort under Governor Schwarzenegger got a lot of attention but ultimately fell apart, but it helped set the stage for the national conversation we have just experienced.
Finally, we have a Facebook page, at www.facebook.org/healthaccess. We've been posting photos and video from various health reform and budget events, as well as relevant newspaper clips, including those that feature our work and comments. Join the over 1333 "fans" on Facebook to access this infomation and get more updates, including reposting of our tweets, media clips, and blog posts.
Whether you are reading this post on our Facebook page, or on our blog, we invite you to get the full Health Access experience, and join on on all these platforms... each has its own benefit. In every platform, we strive to make sure you are up-to-date and have the information and tools to work to advance the goal of quality, affordable, health care for all.
Yesterday, we put out a quick "year in review" for 2009. Many are taking the opportunity to look back at the decade of 2000-2009 (even if technically the decade goes into 2010.)
It is striking to see how the conversation has evolved from ten years ago. In California, the health policy debates were focused on (and that Health Access was active in) was the establishment of the HMO Patients Bill of Rights (and the creation of the Department of Managed Health Care to enforce them), and the implementation of the new Healthy Families program for low-income children. Although in the case of Healthy Families, the issue back then was that the program was undersubscribed, and the state was not taking advantage of 2:1 federal matching funds, and so efforts were focused on boosting enrollment like simplifying the overlong application and training application assisters. (Governor Davis didn't run on health issues, but he highlighted both children's coverage and patients' rights as part of his re-election bid in 2002.)
These issues are still with us: * The Department of Managed Health Care recently implemented language access regulations and will officially put in place standards for timely access to care in a few weeks. They've begun a regulatory process on regualting so-called discount health plans. * Healthy Families has grown steadily and been a success story in reducing the number of uninsured children--although there are still hundreds of thousands of children without coverage that are even eligible but unenrolled. Yet as opposed to a time of budget surplus, the budget crisis has meant that simply keeping the program's doors open is a victory. State funding for those application assisters has been zeroed out, and the entire program was proposed to be eliminated last year.
The boom times allowed for incremental improvements in access to health care. What was not in the conversation was the major health reforms and expansions in the debate now--perhaps there was still a caution and a recovery from the failure to pass major health reform in the early Clinton years. The 2000 presidential election between Vice President Gore and Governor Bush did not focus on health care issues--and when it did, it was about issues like incremental expansions of children's health coverage and passing a national version of an HMO Patients' Bill of Rights. Both elements are parts of the much bigger reform package that is being discussed now.
At the beginning of the decade, California started an effort to invest and get federal money to expand our Healthy Families program to cover the parents of those children--but when we finally got federal permission, an economic downturn--along with 9/11 and the energy crisis--caused a budget crisis we have never really recovered from. Our budget crisis was not helped by the various reductions in revenues that were approved--from the vehicle license fee that Governor Schwarzenegger campaigned on to win the recall to the corporate tax giveaway in the last budget. So much of this decade has been about preserving existing health care public programs through tough budget times. And the last budget--that eliminates various Medi-Cal benefits and much more--is more of a blow because it is a defeat after a decade of defense.
But at the same time, California provided the template for the broader reforms we had now. In 2002, a health care options process generated some ideas on health reform. In 2003 saw the first reintroduction of a single-payer bill, SB921 by Senator Sheila Kuehl--and the passage of an employer mandate, SB2 by Senate President Pro Tem John Burton. That bill was signed by Governor Davis days before his recall in 2003, which set the stage for a referendum campaign in 2004. While unsuccessful, the close vote (49.2%) showed that health reform was achievable, which led to other efforts, like the successful passage and implementation of Healthy San Francisco. Governor Schwarzenegger opposed Prop 72, and vetoed both universal children's coverage (AB442 in 2005) and single-payer bills (SB840 in 2006), before putting forth his own reform proposal in 2007.
Whatever people thought of the details, the final proposal negotiated with Assembly Speaker Nunez was ambitious, and has similarities to what it now being discussed in Washington, from much bigger Medicaid expansions to insurance reforms including guaranteed issue. We have also seen, however, that a failure means that politicians can quickly move on to many other issues.
So ten years later, some things haven't changed, but a lot has. We have made some progress, in policy (like HMO consumer protections), and also in what is politically possible. The question is whether, despite the budget and other barriers, we can build on that base for the next ten years.
2009 YEAR IN REVIEW ON HEALTH ACCESS ISSUES * The Hope of Federal Health Reform: Further Than We've Been Before * California's Budget Blues: Medi-Cal Benefits Eliminated, Clinic Funding Zeroed * Some Progress on State Consumer Protections...
For health care in California, the year 2009 was the best of times, and the worst of times.
The year began with the hope and excitement of new Obama Administration—especially, for health advocates, for a new president that made health reform a central part of his campaign. The good news from Washington, DC, started quickly, with the reauthorization of the SCHIP program that covers low-income children, which had been vetoed in previous years.
But the California budget crisis loomed, with nothing more symbolically showing the disconnect between the federal possibilities and state problems than Governor Schwarzenegger’s budget proposal to eliminate the state’s SCHIP coverage for a million low-income children in its entirety—and actually have that program, Healthy Families, close enrollment and be a week away from sending out hundreds of thousands of disenrollment notices. That roller coaster continued as the same Governor and Legislature that approved steep cuts in the program earlier in the year then passed a fix to temporarily prevent kids from being kicked off coverage—and then wait with concern about federal approval. Given everything, it’s gratifying that at year’s end, Healthy Families’ waiting list has been cleared and children are being covered and enrolled—even if some families are now paying more, and future funding in uncertain.
The work started in 2009 is not yet finished, but here are some other highlights:
HEALTH REFORM: It’s not done, but comprehensive health reform has never made it so far in the legislative process, going through five policy committees and full floor votes in both the House of Representatives and the Senate. It’s not finished, but the final product is likely to provide more security and stability for people with health coverage, and include be the biggest expansion of health coverage (both public and private) ever, to around 30 million Americans—and nearly 4 million Californians.
Health advocates, including the state's Health Care for America Now! campaign, succeeded in having our two Senators be champions on key issues, and getting all Democratic Representatives from our 53-member House delegation—including all 7 “Blue Dogs”—to vote for the House version of reform. With the exception of the anti-abortion Stupak amendment, the House reform is a very strong bill that meets consumer advocacy principles, from affordability and employer responsibility to providing a public health insurance option. Californians took the lead in the House, and were in leadership positions—Chairmen Miller, Waxman, and Stark—in each of the three House committees of jurisdiction. From Speaker Pelosi to the chairs of the key Asian, Black, and Progressive caucuses, the House did its job and is looking to make final bill better than what passed the Senate, which needs improvement in key areas.
The work for health advocates now is to help our sizable California House and Senate members improve the final bill while passing it in early 2010, and then begin the longer effort to implement and improve it here at the state level, through legislation and regulation.
CALIFORNIA'S BUDGET CRISIS: In both February and July, the Legislature passed and the Governor signed two budget packages to solve a combined $60 billion deficit—with many cuts, including to health care—for the year-and-a-half period of January 2009-June 2010.
The first February package of $42 billion included significant health and human service cuts that were "triggered"—including the full elimination of ten benefits for three million adults with Medi-Cal coverage, including dental, vision, podiatry, speech therapy—as well as some temporary taxes. The package also placed six propositions on the May ballot, including a spending cap (and two others to divert funding away from mental health services and health and social services for young children). The only one that passed was to prevent increases legislator salaries in deficit years.
A July package was needed to address over $20 billion more in deficits, and that led to even steeper health and human services cuts, and no new revenue. The reductions in health included cuts to coverage, hospitals, AIDS and mental health programs, and the zeroing out of state funding for community clinics.
For 2010, a new $20 billion hole is projected for the next year-and-a-half. Health Access plans to release a report next week, “The Damage Already Done,” to start to document the effect of the cuts in just six months. This will be part of sustained coalition efforts this year to detail the impact of these budget choices on California families, on our health system, and on our economy.
As for state legislation that was considered, the budget did take up much of the attention and energy. Key legislation was passed and signed into law, attempting bring in more federal money for children’s coverage, hospital Medi-Cal reimbursement, and individual’s COBRA coverage.
Some consumer protection bills were vetoed, on issues like insurers rescinding coverage, and proposals to mandate key benefits, from maternity coverage to mental health parity. But a few good bills were passed and signed into law, including a prohibition on gender rating—which will stop insurers from charging men and women differently.
If you read this blog, you know the remarkable moment we are in, both in terms of the challenges and opportunities. We have much we can win, and much we can lose... and that's why we need your help.
We are on the cusp of history. Congress is poised to pass landmark legislation to provide more security and stability for those who have health coverage, and to dramatically extend access to affordable, comprehensive health care for those who don’t. It would prohibit insurers from denying coverage for pre-existing conditions, or placing arbitrary caps on coverage.
But there is so much more to do to fulfill the promise of reform in 2010. Health Access needs your help to make the promise a reality.
Health Access will continue to lead efforts in California—including the Health Care for America Now campaign in our state—to pass health reform, and the right reform. Across the state and in Washington, DC, Health Access provides information and analysis to elected leaders to help them understand the impact and implications of the reforms they are working on. We are continuing organizing and advocacy efforts to include the strongest possible provisions on everything from affordability to consumer protections. If you read this blog, you know we also educate the public about what these changes will mean for them individually, and why comprehensive reform is so important California and the nation. Hopefully, you've looked at our materials, and hopefully they have been helpful to you.
We need your help not just to help pass reform, but to do the all-important work afterwards. We will have major opportunities to implement and improve health reform to make sure it works well here in California--from putting in place the right regulations to protect patients from insurance company abuses, to pursuing a public health insurance option for California.
But with these opportunities come significant challenges. Under California’s budget deficit, Governor Schwarzenegger threatens to undermine our progress by proposing massive cuts to existing programs like Medi-Cal and Healthy Families. Health Access has been on the front lines of the fight to prevent these ugly cuts to the safety net and the health system on which we all rely; to offer alternatives to cuts; making sure that the real cost and impacts of these cuts are understood, and working with grassroots groups to make sure the voice of their constituents are heard.
Your year-end gift to Health Access Foundation will help us finish the work of passing the best possible health reform at the national level; start the work of fulfilling the promise of reform here in California; and guarding against significant setbacks of budget cuts that threaten to cripple our health system, our families, and our economy.
Health Access California congratulates John Perez on winning the unanimous support of the Democratic caucus to become the next Speaker of the California Assembly.
John Perez has been known to us for many years. While the many media accounts took note of his roots in the labor movement, we first met John when he was appointed by Senate President Pro Tem Bill Lockyer in 1997 to serve as a consumer representative on the Managed Care Advisory Task Force. Then-Governor Pete Wilson created the Managed Care task force as a means of thwarting the campaign for the HMO Patient Bill of Rights, sponsored by Health Access California.
John Perez was a forceful voice for consumers during the months of meetings of the managed care taskforce. We are pleased to note that when Governor Gray Davis signed the HMO Patient Bill of Rights in 1999, it was an even stronger package than the original proposal---in part because of the willingness of a broad range of consumer advocates to speak up for even stronger reforms of HMOs.
We also know John Perez because he led the Stonewall Democratic Club in Los Angeles along with Anne Marie Staas Niedorf. Health Access California was one of the many beneficiaries of Anne Marie’s long history of activism: she hosted more than one house party devoted to health care, including the HMO Patient Bill of Rights. We are saddened to report that Anne Marie finally lost her long battle with her various ailments last month. May she rest in peace.
John Perez has also served on the President’s Council on HIV and AIDS as well as on the board of AIDS Project Los Angeles, giving him insight into a key health issue that shows many of the flaws in our health care system.
And we would be remiss if we did not note that John was political director of UFCW during the very difficult grocery workers strike in Los Angeles in 2003, a strike over health benefits that helped to set the political context for the fight for an employer mandate in SB2(Burton)/Proposition 72 of 2003 and 2004--which in turn led to the passage of Healthy San Francisco and the employer reponsibility elements of proposed state and national health reforms. Health Access California is proud to have worked with the California Labor Federation and the California Medical Association on that pivotal campaign that restarted the health reform conversation in our state, and eventually nationally.
We greatly look forward to working with Speaker-elect Perez in his new role, which will include the massive amount of work to implement federal health reform at the California level.
Speaking of Twitter, if you aren't on it, you should be! For why and how, read this piece in the California Pan-Ethnic Health Network's online newsletter, which I co-wrote with the prodigious Rachel Larson of CPEHN. It answers such burning questions as: * Why Tweet? * What Is Twitter? * How Do I Get Started? * How Do I Find People to Follow? * How Do I Get People to Follow Me? * What Are All of the Symbols I See in Other People's Tweets? * How Do I Keep Up with Twitter?
This technology enhances in-person communications, but doesn't replace it. We are happy to be having our holiday party at Max's in Oakland this evening with our colleagues at CPEHN and elsewhere. But if we don't see you there, we look forward to tweeting with you!
SENATE VOTES TO START FLOOR DEBATE ON HEALTH REFORM: The U.S. Senate will come back from Thanksgiving today and start floor debate on health reform, after a crucial vote before the break. If you follow us on Twitter, you'd have gotten the real-time updates as Senators voted affirmatively, 60-39, on a "motion to proceed" to debate health reform. The House of Representatives passed their own version of health reform three weeks ago.
Health advocates thanked California's Sen. Barbara Boxer and Sen. Dianne Feinstein for voting, with all Democrats and independents, to move health reform to the next stage.
The next day, on Sunday, Senator Feinstein went on to appear on NBC's Meet the Press, where she made strong points on the urgency of reform, the problem with our for-profit insurance industry, and the fabrication of opposition facts. Watch it and read about it on our blog.
Much more to come in the next few weeks, as Senate leadership hopes to finish debate and get the necessary 60 votes to stop debate before Christmas.
Governor Schwarzenegger is expected to release in January both a mid-year cuts package and a 2010-11 proposed budget. Many crucial health program are expected to be in jeopardy, as elected leaders seek to address another massive anticipated shortfall of upwards of $20 billion for the next year-and-a-half. Health Access will be actively organizing to prevent the worst of these cuts, and to advocate for the revenues that are needed prevent the cuts and sustain these programs.
MEDICAID WAIVER GETS LEGISLATIVE HEARING: Meanwhile, an administration proposal for a federal Medi-Cal waiver was given a hearing by the Senate Health Committee. This process would reshape for the next five years the Medi-Cal program, which provides coverage to seven million low-income Californians, largely children, parents, seniors and people with disabilities, and provides core funding to safety-net hospitals and other providers.
The Assembly Health Committee is expected to have its own informational hearing on Thursday, December 10th. Health Access' new paper discussed how the waiver may offer a bridge to health reform.
HOLIDAY PARTY: There's lots going on during December, but if you are in the Bay Area, take the time to join Health Access California and the California Pan-Ethnic Health Network for a holiday celebration in the Bay Area. Health Access and CPEHN are hosting our annual holiday celebration in Oakland on Wednesday, December 9.
The location is Max's of Oakland, 500 12th Street, at the Oakland City Center. (12th Street BART). Here's a map. It'll be from 4 p.m. to 7 p.m. Please RSVP to Pam Flood at firstname.lastname@example.org. Hope to see you there!
Any suggestions about the new update format, or questions about its content, should be directed to Cynthia Craft at Health Access, at email@example.com.
The Senate Finance Committee is starting its public deliberations on health reform today. If you don't have C-SPAN, you can follow some of the action on Twitter, by journalists and bloggers like @jcohntnr, @ktumulty, @NewHealthDialog and @wonkroom.
We at Health Access (@healthaccess) are following it as well, and will RT (re-tweet) posts from these and other observers, as well as add our own observations. Follow us at @healthaccess!
Schwarzenegger also uses video to display a mischievous side. One in particular landed on national news networks – a 27-second spot of Schwarzenegger waving a giant knife in July before telling followers that they gave him great ideas.
The governor intended for the clip to be humorous, as if the camera caught him in the middle of his everyday big-knife-waving routine.
Of course, critics also use Twitter. Social-services advocates took offense as the video came during tense budget talks in which Schwarzenegger sought deep cuts.
Health Access, which represents low-income Californians, wrote: The video adds insult to injury, literally.
Days later, Schwarzenegger told reporters, "You've got to have a little sense of humor. That's me. You sent a governor to Sacramento, not El Stiffo."
Today, the UCLA Center for Health Policy Research put out its biannual report compiling data from the California Health Interview Survey (CHIS), the most comprehensive look at health coverage and issues in our state. It's a seminal source of information for health policymakers and advocates, and we'll have a lot to say and post about its findings--especially about the new and disturbing information about medical debt--in the next few days and months. But we should take a moment to send not just our congratulations but our good wishes to E. Richard Brown, UCLA Professor in the School of Public Health, the Director of the Center for Health Policy Research, and the Principal Investigator for CHIS. Beyond being one of California's foremost academic experts on health policy, he's been a good resource, friend, and colleague of Health Access over many years.
On August 10th, Rick had the unfortunate opportunity to experience the health care system first hand when a brain aneurysm ruptured. The good news is that we have heard he has just recently been transferred out of the ICU to a regular hospital bed at UCLA.
We wish him the best for a safe and speedy recovery, and our thoughts are with him. He's an important and valued member in the health policy and advocacy communities, and we look forward to working with him soon!
We are also participating in a new Healthy Ideas online forum, sponsored by KQED Public Radio and HealthDialogues. Lots of smart people have kicked things off with beginning posts... It should be an interesting conversation.
If the website looks different, it is! We've been working for months to redesign this site to make it a better resource for advocating on behalf of quality, affordable health care for all Californians.
The changes add new resources and materials, make our existing fact sheets and information easier to find and easier to read, and generally increase our ability to educate and activate Californians to get involved in improving our health system.
If you are suspicious about an insurer being "for reform," you should be. The story correctly says that Anthem Blue Cross strongly opposed health reform here in California in 2007 and had a hand in its defeat. More information about their role is at our website, http://www.sickofbluecross.com/.
There were other opponents that made a difference as well, such as the tobacco industry that opposed the late addition of a tobacco tax to the financing. Did the opposition of Blue Cross matter? Of course. Was it decisive? Not in our experience. We believe that we can win federal national reform, too, even if Wellpoint/Anthem/BlueCross attempts to oppose it. But only if win make clear what the insurance companies' interests are, and how they differ with the interests of consumers.
But more amusing to us, was that one of the Blue Cross members they called was Joan Pirkle Smith, a long time member of the Health Access California Board. As indicated in the Bee, she's been a supporter of single payer health care, such as HR 676 and SB810 (Leno). Joan has also supported comprehensive reform efforts from SB2/Prop. 72, the employer-based coverage expansion in 2003 and 2004, to AB 8 and AB x1 1 in 2007. I first met Joan during the fight for Prop. 186, the single payer ballot initiative here in California in 1994. She worked hard on HMO reform during the 1990s. We are proud of the Health Access community of organizations and individuals who, like Joan, keep trying to fix our broken health care system.
On Monday evening, Health Access will join many other key organizations to honor Frank Russo and the work of the California Progress Report. With the decline of newspapers, the California Progress Report has provided a vital independent progressive voice on a wide range of policy issues. We appreciate that it has republished many of our updates and posts from Health Access and other health related posts, and it has been a useful place to keep up what other groups are doing on other issues.
Frank Russo founded the California Progress Report and made it a heavily tracked website for California news and information, from a range of sources--citizen activists, legislative leaders, and key constituency organizations. As a result, it reports the stories at the state Capitol and throughout California that no one else is covering. Frank has moved on to work in the Capitol, but we should try to ensure that the California Progress Report continues.
We are supporting the Consumer Federation of California Education Foundation's efforts to maintain and develop the site. If you are in Sacramento Monday, or if you or your organization can otherwise help, we hope you can too.
We at the Health Access WeBlog will be hosting Health Wonk Review on Thursday. It's a bi-weekly compendium of the best of the health policy blogs. After a long while of being cited and linked, such as in the last compilation at HealthBlawg, we felt we should contribute, and recognize some of the really good analysis and commentary on the web.
After a Senate session that lasted all night. featured a leadership change in the Republican caucus, and a day of press conferences, national media appearances, and floor debate, the Senate *and* Assembly are scheduled to come back at 10pm tonight.
The rumors continue to fly about whether the 27th vote will come from Senator Cox or Senator Maldonado, and what they may ask for in return. For health advocates, we have to be concerned about what else the 27th vote may ask for.
In this hostage situation, the ransom for a budget has already been high: $15 billion in cuts, a spending cap that would force cuts into the future, corporate tax giveaways to further take resources from health and education, undoing voter-approved funds for children's services and mental health services, and changes to labor and environmental rules. A budget deal that includes all these elements is no victory. It's defeat.
The consequences for health and human services of no budget deal are significant, but so are the consequences of a deal. The difference is that the the budget deal is a negotiated terms of surrender, rather than allowing the carnage of continued war.
Thanks to references on Calitics, personal Facebook friends and Twitter followers, what started out as a few snide comments when staying up in the Capitol on Saturday night has turned into ongoing coverage with an emphasis on health issues (with my regular, personal asides on my two-year old son, television, the Tour de California, and turtles).
Twitter will be down at 10pm for a short bit when we go into session, so I'll post any quick updates here on this blog, as we have done for over nearly seven years. After the budget issue settles, we at Health Access will figure out if we should add Twitter to our communications arsenal, in our effort to help you best advocate for health care in California. If you have thoughts, share them with me, at firstname.lastname@example.org.
The most exciting proposal that acts as a "down payment" on health reform is the provision that will allow states to expand Medicaid, temporarily, for unemployed adults. Many people think our public coverage programs cover the poor, but the truth is that they only cover some of the poor. Medicaid largely covers low-income children and parents, and the "aged, blind, and disabled." But there are many adults who don't have a child at home, who are not eligible for any public program-even if they are under the poverty level, which is $10,400/year for an individual, $14,000 for a couple. Sometimes called "medically indigent adults," they are left to whatever their county decides to provide in terms of a safety-net service.
The stimulus would authorize such a Medicaid expansion only temporarily. But many of the reform plans now circulating in Washington, spanning the ideological spectrum, envision childless low-income adults getting coverage through Medicaid anyway. So by enrolling them in Medicaid now, the stimulus would basically jump-start the reform process--making the long-term job of getting everybody covered that much easier.
Health Access is pleased to co-sponsor the Working Families Summit, for this Tuesday, January 13th, from 9am-4:30pm.
Organized by the California Center for Research on Women & Families, the agenda at the Sacramento Convention Center has panels and plenaries on the budget, the safety-net, health care, and the broad range of issues impacting California's families. We will be presenting, and it's a conference where we can't just show up and wing it... a lot of work was required of all presenters to make the day a meaty policy discussion.
The California Endowment is hosting the screening, which will feature Larry Adelman, the series Executive Producer. The documentary series was shown last year on PBS, and is now available on DVD.
The big event is Governor Schwarzenegger's State of the State on Thursday, January 15th. There's lots of speculation of what he will say on the budget crisis, his rationale for vetoing the latest budget package, and even what he might say on health reform. Stay tuned.
We have just passed 1500 posts since putting up our updates starting May 2002, and since we posted on a daily basis over two years ago.
For 2009, we resolve to continue to provide timely updates about what is going on with health policy that would impact California consumers: the bills, the budget, the ballot box propositions, and beyond.
We resolve to provide reports, commentary, and action items on the push for health reform, not just at the state but at the federal levels. We expect (and will encourage) a lot of activity in both Sacramento and Washington, DC.
We resolve that we will have a broader range of voices from the Health Access California community. We resolve to make other improvements and changes to this website soon. If you have other suggestions for the new year, please let us know...
It is with sadness that we wish farewell and good luck to Hanh Kim Quach, as she moves on to other career opportunities.
Over the last several years, she has served as our policy coordinator, researching and writing many of our reports, fact sheets, analyses, and E-mail updates. Readers of this Health Access WeBlog know she has also been my co-blogger, chronicling the inner workings of the Capitol, and highlighting the interesting news on health policy and politics from around the web and the world.
Today is her last day here, both on the blog and with Health Access, as she moves across the street into the building, to work in the office of Assemblywoman Mary Hayashi, who has been a great ally on health reform even before her election two years ago.
Hanh came to us after many years in journalism around the state of California, working most recently for six year a Capitol Bureau reporter for the Orange County Register, leaving that noble profession just before the recent rounds of downsizing. Her background enabled her to be invaluable in finding information, whether from the web or from her many friends and sources around Sacramento.
We'll miss her writing skill, her doggedness and willingness to work into the night to get our coalition members information and updates in the most timely manner possible; her innate sense of justice; and her warm and fun presence as part of our family here.
We know our blog readers will miss not just her byline but her style and substance. We are hiring, other staff members have already begun contibuting to this blog, and we have some exciting improvements for this blog and website planned for upcoming months.
But for today, we just want to say thanks for her service, and good luck.
But we know her from many other fights for health care here in California: * HMO Reform: Then-Senator Solis carried important legislation on requiring coverage of diabetes supplies and devices. * Hospital finance: Solis carried multiple pieces of legislation on behalf of public hospitals * Office of Multicultural Health * Expansions of Healthy Families * Medi-Cal improvements
Like all good advocates, Hilda Solis was willing to take on good fights and lose in order to move an issue forward. Not all her health care bills became law, something that we at Health Access California, often experience ourselves but that never deterred Solis from fighting to get Californians, all of them, the health care they need.
It is not a surprise to those of us who knew Hilda Solis when she was a California legislator that she would be Secretary of Labor: here in California, she carried legislation creating a Labor Agency, she carried minimum wage bills, and she fought year after year to improve working conditions and workplace safety in the garment industry.
From all of us at Health Access: good luck, Madame Secretary!
HEALTH ACCESS UPDATE Thursday, December 4th, 2008 NEW LEGISLATIVE SESSION STARTS * Full Coverage on New Legislature, Budget, and Reform News at Health Access WeBlog
HEALTH ACCESS ANNOUNCEMENTS: * Health Access/CPEHN Holiday Party in Oakland: THURS, DEC 11th, 4-7pm You are invited! Drinks and good company, including with CA Pan-Ethnic Health Network Max's Diner & Bar, 500 12th St; RSVP to Jessica Rothhaar, email@example.com
Here in Sacramento earlier this week, a new legislature was sworn in, with appropriate ceremony, and the feeling of both the hope of a fresh start and new leadership, and dread of a looming budget deficit that went unresolved--if not made worse--in the last legislative session. Assembly Speaker Karen Bass (D-Los Angeles) has many new members, and gained three more Democratic seats since last session, although three shy of a 2/3 majority. She is joined by new Senate President Pro Tem Darrell Steinberg (D-Sacramento), who set new prioirities and initiatives for the Senate, including on the budget, and health care reform.
In the last two weeks, much has happened with regard to the budget crisis, from the failure of a proposed package of mid-year cuts and revenues in the lame-duck legislative session, to the threat of a waiting list in the Healthy Families program; with regard to new regulations prohibiting "balance billing" on consumers; and with regard to new leadership of the legislative health committees, and of the state's Medi-Cal program.
Finally, there's been a lot of action with regard to federal health reform, from appointments by President-elect Obama, to movement in Congress in the House and Senate.
All of these stories have been fully reported and are being updated regularly on our blog, at the Health Access WeBlog, which you can click to get more details on the following stories:
Major staff changes aren't just happening at the federal level.
Governor Schwarzenegger has announced big news on health care, effective December 19th. * Sandra Shewry is leaving her position as the director of the Department of Health Care Services (DHCS), to be replaced by David Maxwell-Jolly, PhD. * Stan Rosenstein is leaving his position as deputy director of DHCS, which includes responsibility for the hugely important Medi-Cal program, to be replaced by Toby Douglas.
This is a big deal. Sandra and Stan have long histories in California health agencies, not just during the whole of the Schwarzenegger era, but previous Administrations as well. Along with Secretary of Health and Human Services Kim Belshe, these are the folks that run Medi-Cal, which provides health coverage to over 6.5 million Californians , and is an integral part of the heath care system on which we all rely.
We wish Sandra and Stan the best in their new endeavors.
We congratulate David Maxwell-Jolly and Toby Douglas on their promotions. Some might question, given the bleak budget times, whether congratulations are in order. But we need people in government who can make the case for the value of these programs and services, as economic and political forces determine whether we have the resources to sustain and expand them. And so despite the bad budget situation, we hope that David and Toby will have the opportunity to make progress, as the conversation on federal and state health reform continues. We've worked with them in the past, and look forward to doing so in their new roles.
We'll post more in the next few days about our 20th Anniversary event.
Some quick highlights: Incoming Assembly Health Committee chair Dave Jones reported on a long list of issues he's interested in tackling, from continuing comprehensive health reform, to specific reforms on both coverage and care. Incoming Senate President Pro Tem Darrell Steinberg also put forward some lessons he learned from last year's health reform effort, and stated the beginnings of a plan to make progress on the issue.
Despite the deficit and other issues, the panel and speakers conveyed a sense of optimism in the air. In one word: Obama.
Not just the man, but the moment and all it represents. The mandate he has on health care, after spending over $150 million in ads on the health care issue alone. The fact that people are "paying attention" to health care issues. The renewed sense that government has an important role, to act as a regulator. The potential appointment of former Senator Tom Daschle as HHS Secretary, with his interest and skills in passing reform. The campaign infrastructure and organizing energy to continue beyond the election. The reception on Capitol Hill, with expanded Democratic majorities, and the support already signalled by everyone from conservative Senator Max Baucus, chair of the Senate Finance Committee, to California's Congressman Henry Waxman, the newly-minted chair of the House Energy and Commerce Committee. The notion that health care reform can and should be seen as economic relief during tough times. The belief that the federal government will be a partner to state reform efforts, rather than an obstacle.
I was also pleased that we were able to honor our past founders and directors of the organization. I am the fifth executive director of this organization, and recognize I am holding, in trust, an organization built by many before me. I was glad we were able, as a community, to recognize some of those past leaders: Lois Salisbury, Maryann O'Sullivan, Bruce Livingston, and Melinda Paras.
I loved that given the chance to ask the incoming Senate President Pro Tem a question, it was these honorees who seized the opportunity to ask the question.
We'll post more specifics from the speakers and discussions in the next few days.
Given the budget crisis over the past many years, it's probably accurate that despite the consumer protections won and the reform battles fought, Health Access is best known as "a group dedicated to staving off such spending reductions." But does it have to be in such a downer of an update?
Here's the grim news, in their words:
The Legislative Analyst's Office will release a new report today analyzing the woeful state of California's finances. It will flesh out last week's estimate that the state faces a $27.8 billion deficit over the next 19 months.
But a new report from Beacon Economics predicts things will look even glummer in the future: * Labor markets are showing increased signs of stress. * There is little sign of a recovery in housing, and foreclosure rates are growing worse by the day. * Consumer markets have fallen off a cliff. * Corporate profits are taking a serious beating.
The report commissioned by California Forward, the nonpartisan government reform group, describes itself as "decidedly more pessimistic" than the LAO or Schwarzenegger administration projections, largely due to lower projections for corporate taxes.
The report also predicts the first year-over-year decline in statewide property taxes "since the Great Depression," according to Fred Silva, fiscal policy adviser to California Forward. "Our forecast implies that we are quite literally on the edge of a fiscal cliff," the report says, rather bluntly.
Then there is this gem of analysis: "At the moment, California's budget strategy seems to adhere to a slightly different logic, one that might be summed up as: Hope for the best and ignore the obvious."
And they write that as if it's a bad thing.
In her visit with the Capitol Bureau on Wednesday, Assembly Speaker Karen Bass gave her own take on the role of partisanship, ideology and political futures on the budgetary stalemate: "One of the reasons why it's hard for my Republican colleagues to vote for revenue -- more important than their tax pledge -- is their next primary," Bass said.
"If they vote for revenue, then they're going to be easily challenged in another primary. But the Democrats face the same thing: If we vote for deep, permanent cuts in health and human services, then we have to face our next primary, too."
Bass said putting aside self-interest would be key to break the logjam. "When you're in the middle of a national and international meltdown, you have to get beyond your career."
Speaking of deep cuts to health care, Health Access, a group dedicated to staving off such spending reductions, celebrates its 20th year of existence today with an event at the Sacramento Convention Center.
Among the speakers set for the event are Sacramento reps Darrell Steinberg and Dave Jones, the incoming pro tem and chair of the health panel, respectively.
Not bad allies to have in these times...
Hopefully, we'll balance the bad news with the good news this afternoon at the event.
A Health Access homecoming, with an All-Star team...
Tuesday, November 18, 2008
HEALTH ACCESS UPDATE Monday, November 3rd, 2008
HEALTH ACCESS FORUM THURSDAY: Learned Lessons, Future Prospects for State and Federal Reform
* "Many Paths, One Goal: Toward Quality, Affordable Health Care for All Californians." * State Reform Prospects from Incoming Sen. Pres. Steinberg, Assm. Health Chair Jones * RSVP for Nov. 20th Forum with All-Stars of Seasoned Vets, Obama Advisors * Tickets Available; Comped Tickets Available for Health Advocates, Community Groups
* Panel includes: Rick Brown, Wilma Chan, Jacob Hacker, Larry Levitt, and Robert Phillips * Reception to Honor Past Leaders & History of Health Access and CA health advocacy * Honorees: Lois Salisbury, Maryann O'Sullivan, Bruce Livingston, Melinda Paras
Click Here for What's New on the Health Access WeBlog: Healthy Families Up for a Waiting List; The Economic Impact of Bad Budget Cuts; Obama's Health Reform Mandate; Dr. Stephen Colbert on Drug Costs; New Info on the Baucus Plan; Kennedy Moves on Federal Health Reform
There's lots going on with federal health reform: Senator Ted Kennedy has returned to the Hill, vowing to work on health reform; Senate Finance Committee Chairman Max Baucus released the outlines of a health reform plan; and President-elect Obama has reiterated his commitment. At the state level, there's significant health care cuts on the table, and increased calls for federal help, whether through increased Medicaid matching funds or increased SCHIP funds.
To celebrate 20 years of health advocacy and, more importantly, prepare for these challenges and new opportunities of the next few years, Health Access will be hosting a forum and reception on Thursday, November 20th, in Sacramento. With an election that has opened up new possibilities for health reform and more, we will seek to honor the history of health reform in California and learn its lessons, but also get the latest from top experts about the propects for state and federal reform.
Health advocates and community organizations can get comped tickets, by request, to Marin Nakasone, firstname.lastname@example.org.
The program, entitled “Many Paths, One Goal: Moving Toward Quality Affordable Health Care for All Californians" starts at 2pm, with an impressive program of speakers, including incoming Senate President Pro Tem Darrell Steinberg, and incoming Assembly Health Committee Chair Dave Jones, who may share their future goals.
A panel of distinguished California-based experts with national reputations will speak, including UCLA professor Rick Brown; former Assemblywoman Wilma Chan of Children Now; UC-Berkeley professor Jacob Hacker; Larry Levitt of the Kaiser Family Foundation, and Robert Phillips of The California Endowment. Some have advised President-elect Obama on health issues, others were advisors of President Clinton during his effort, and all are veterans of past health reform efforts, and expected to be active participants in the upcoming state and national debates.
Afterwards, we will have a reception that will honor past heads of our organization, including Lois Salisbury, Maryann O’Sullivan, Bruce Livingston, and Melinda Paras, leaders who helped nurture and build Health Access as an organization, and the broader health reform movement, and who each have had broader careers advancing social justice in multiple ways. A full program is available on the Health Access website, as well as a form to buy tickets.
Beyond recognizing the past work of the organization and the broader health advocacy community, our discussion will restart efforts at the state and federal level around the budget, consumer protections, and comprehensive health reform. Please join us.
AFTER THE ELECTION: Health Access 20th Anniversary Forum THURS, NOV. 20th * "Many Paths, One Goal: Moving Toward Quality, Affordable Health Care for All Californians."
* Nov. 20th Post-Election Forum to Preview Renewed Efforts, Share Lessons on Reform * Key Elected Leaders to Speak, Provide Insight on Prospects for State and Federal Efforts * Reception to Honor Past Leaders & History of Health Access and CA health advocacy
Click Here for What's New on the Health Access WeBlog: Vote!; Arizona's Anti-Health Reform Measure; Severe Budget Cuts Sought in Special Session; Montana in the Middle; Living Wage, and Benefits; California's High-Risk Pool; Debating Why the Young are Uninsured in Swampland; McCain's October Surprise; The Multi-Pronged Budget Fight After the Election; The Big Event; Obama's Investment in Campaign Ads on Health Issues; LA Times on the Individual Insurance Market; Baseball's Beane on Health Data; Health Wonk Reviews; Campaign Ads; Budget
The election tomorrow brings with it new opportunities and challenges. We are pleased that soon afterwards, Health Access will be hosting our 20th Anniversary Event, not just to celebrate our past but to prepare for the future, whether the immediate budget crisis that threatens additional cuts to California health reform in the next few days, or the camapign to win comprehensive health reform at the federal level next year.
The program, entitled “Many Paths, One Goal: Moving Toward Quality Affordable Health Care for All Californians" starts at 2pm, with a program of speakers, including incoming Senate President Pro Tem Darrell Steinberg, incoming Assembly Health Committee Chair Dave Jones, and distinguished leaders in state and federal health policy and health reform.
Beyond recognizing the past work of the organization and the broader health advocacy community, our discussion will restart efforts at the state and federal level around the budget, consumer protections, and comprehensive health reform.
If you are, find at least one person who may not be registered (for example, someone who recently turned 18, or moved, or just a politically disconnected friend), and make sure they are. Send them the link to the California Secretary of State's office: http://www.sos.ca.gov/elections/elections_vr.htm
Why does this matter for health care?
Key issues will be decided about the future of the health care system in the next few years, at the state and federal levels, and all citizens need to be involved in choosing a direction. California's debate on health reform has been hindered by the fact that the voting electorate differs from the actual population.
The Public Policy Institute of California has a report a couple of years back called "California's Exclusive Electorate," indicating "the likely voters who decide who's elected and the fate of the state's many ballot initiatives, but who do not represent the size, the makeup, or the preferences of the state's adult population."
That's why I'm stunned by the attacks on ACORN this political season for its voter registration effort, to bring over 1.3 million citizens around the country into the political process. In an effort that big, there's bound to be problems: applications not properly filled out (and state law appropriately requires even those to be turned in.) As impartial observers point out, there's no evidence that these errors translate to fraudulent or inappropriate voting. (After all, "Mickey Mouse" is not showing up at a polling place on Election Day.)
I can't claim any direct knowledge about any issues with ACORN's voter registration effort, but I know its incredibly important. And so while I can't say I know all their activities and policy positions, I know that ACORN, with their representation of low-income communities, is an important voice in health care. Many of their members are uninsured, underinsured, and otherwise exactly the folks that need to be part of the deliberations on health reform.
I am proud to have ACORN on the Health Access California board, as one of twenty-five member consumer and constituency organizations that direct our public policy agenda. In recent years, ACORN had increased their attention on health care issues, responding to their members. We have worked with them on the issue of prescription drug prices, medical debt, and particularly around hospital overcharging issues, with local campaigns around inappropriate billing practices of specific hospitals. They have been a key ally for coverage expansions and health care reform in the last few years, both at the state and federal level.
What next year look like? I don't know. We're still reeling from this year's bad news, on bills and budget. And a lot will depend on the elections, at both the state and federal level. Even after a bad year, there's reasons for optimism.
Health Access will be having our 20th Anniversary Celebration on November 20th at the Sacramento Convention Center, and in addition to a reception, we'll have an afternoon symposium about the politics and prospects for health reforms in 2009-10. Put it in your calendars!
As someone who has been involved in organizing with senior citizen groups for over a decade, I have learned to recognize that some of my best allies will not be with us forever. But it doesn't make it any better.
Joan B. Lee, a leader in the Gray Panthers locally, statewide, and nationally, passed away Saturday night. She will be missed, not just as an advocate for seniors, people with disabilities, health care, and progressive ideals, but as someone who was known in the corridors of power in Sacramento, and had an impact.
She was an important ambassador between different groups: between different anti-war groups with different tactics here in Sacramento; between seniors and people with disabilities; between senior groups and Latino organizations; and between activists with different strategies around health reform.
We worked with her a lot on many issues, from fighting budget cuts to supporting the universal single-payer health care bill, SB840. We partnered with her and other groups on Medicare Part D, and I remember her actively distributing glossy postcards printed by the national Gray Panthers with a slogan I think she came up with: "PHRMA got the donut, we got the hole."
She was an active member of the OuRx coalition that was successful in a groundbreaking prescription drug discount program, and other key legislation. She was an active members of the Olmstead Advisory Committee, and always looked to bring in the perspective not just seniors but people with disabilities.
It was a pleasure to present in front of the Sacramento Gray Panthers group, which she helped convened monthly at the Hart Senior Center. She also was prominent statewide, as part of the Gray Panthers Affiliation of California Networks
UPDATE: A memorial service is scheduled for Friday, August 15, at 11 am, at the Unitarian Universalist Society of Sacramento, 2425 Sierra Boulevard, Sacramento, CA 95825. Refreshments will be served.
* Condolences can be sent to her family, including her husband Arnie, at their home in Sacramento, at 5313 Fernwood Way, Sacramento, CA 95841.
* Condolences to the Sacramento Gray Panthers can be sent to PO Box 19438, Sacramento, CA 95819