Capitol Update: Senate Budget, Senate Appropriations

Today was a big day at the capitol, with budget subcommittees meeting to discuss proposals from the Governor’s May Revise, and the Senate Appropriations Committee meeting to decide which Senate bills will move on to the Senate Floor.

The Senate Appropriations Committee held a number of bills related to health, which means that those bills will not move forward and have the opportunity to be voted on this year–they will be “two year bills,” available to move next year. Most significantly, SB677 (Hernandez) which would have made conforming changes to the Medi-Cal program in accordance with the Affordable Care Act and expanding eligibility for the program, was held. For those curious, SB810 (Leno) which would move California toward a Single Payer health care system, was not heard, as supporters sought additional fiscal analysis.

Bills related to the implementation of ACA that moved forward include:

SB51 (Alquist) implementing the Medical Loss Ratio to ensure premium dollars go to health care rather than administration and profit, and that consumers receive rebates when the MLR is not met.

SB222 (Alquist) which allows local county-run health plans to form joint ventures to expand their networks to become regional public health insurance plan options.

SB615 (Calderon), which requires those selling insurance to have specific training, including on public programs. An earlier version originally alarmed community groups by requiring all navigators at the Exchange to be licensed brokers, but amendments removed those provisions, and with that, opposition from many consumer groups.

SB155 (Evans) requires health insurance plans in the individual market to cover maternity services.

SB703 (Hernandez) would establish a Basic Health Plan to provide care to individuals from 133%-200% of the federal poverty level, an option for states under the Affordable Care Act.

In budget news, the Senate Budget Subcommittee #3 on Health and Human Services looked at the proposals from the Governor’s May Revise related to the Department of Health Care Services.

The Subcommittee moved many of the Governor’s proposals forward after lengthy discussion of a number of controversial proposals, including the elimination of the Department of Mental Health, Department of Alcohol and Drugs, reduction of funding for transitioning seniors using the now eliminated Adult Day Health Care services, and the transition of 900,000 children from Healthy Families to Medi-Cal.

In the case of shifting Healthy Families children, the Senate Subcommittee voted to adopt placeholder trailer bill language, and booked the full budget reduction–the reduction that raised significant concerns about appropriate provider capacity, access for patients, and transition readiness and timing.

The Senate Subcommittee did reject a few of the Governor’s proposals, such as the idea to place Medi-Cal recipients on a “one-year lock-in” of their health plan. Advocates argued that this was a key consumer protection that was especially essential as seniors and people with disabilities were mandatorily enrolled in managed care.

The Subcommittee also rejected the Governor’s proposal to fully eliminate not Adult Day Health Centers (ADHC), restoring the $85 million from the March budget for a follow-up program currently called Keeping Adults Free from Institutionalization (KAFI).

The Assembly Budget Subcommittee on Health meets on these issues tomorrow. The Assembly Appropriations Committee will also reveal what bills they are releasing for floor votes.

Health Access California promotes quality, affordable health care for all Californians.
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