Your schedule in conferences...

Friday, February 19, 2010

Two upcoming conferences of note for advocates for health and human services:

The California Working Families Policy Summit 2010, on February 25th, will feature Keynote Speaker Secretary of Labor Hilda L. Solis, a former California Congresswoman and state legislator. It will also include a taped message from First Lady Michelle Obama.

It is free, although there is a charge for the luncheon. You can register for the conference online at http://www.ccrwf.org/ or download the agenda and mailing or faxing it with payment if it applies. The early registration deadline is Friday, February 19 and registration closes on Friday, February 22.

The California Budget Project 2010 Conference, "The 3 Rs: Recession, Recovery, Reform: What's in Store for California?" on March 25th, features the health policy-obsessed Washington Post reporter, commentator and blogger Ezra Klein, a native Californian.

Sign up by February 20 to attend CBP's one-day public policy conference at the early bird price of $90. Sign up online or by faxing or mailing the form in our conference brochure.


While we have presented at past versions of these conferences, we aren't this year, but we encourage your attendance regardless... We are simply posting these because they provide good, solid information, and they are are worth your time.

Labels: Budget, Sacramento

posted by Anthony Wright | Permalink | 6:16 AM


 

Assemblymembers on Guv's budget: "Not the wisest thing"

Friday, February 12, 2010

Gov. Arnold Schwarzenegger’s self-described “draconian” budget proposals began sounding a little less inevitable by the end of Thursday’s lengthy Assembly Budget Subcommittee hearing at the Capitol.

A strong showing of citizen-advocates opposed many of the cuts, emphasizing the benefits of threatened health programs ranging from one that provides infected jail inmates with HIV and AIDS drugs to the widely accessed Adult Day Health Care program.

Members of the subcommittee chaired by Assemblyman Jerry Hill (D) noted that if the governor’s proposals were to be adopted, the costs for alternatives would be higher in the long run.

Cases in point:
* The Office of AIDS program buying discounted HIV-AIDS drugs for county jail inmates prevents costly and hazardous outbreaks of disease. The governor would cut the entire $9.5 million portion of the program for counties – and then would also transfer more prison inmates to county jails, which cannot afford the drugs.

* The governor would eliminate vision coverage for kids whose families buy discounted health insurance through the Healthy Families SCHIP program. Lawmakers noted that this move would cost the state uncounted federal dollars by preventing better classroom performance by children who need glasses.

* A proposal to eliminate Adult Day Health Care drew one of the largest crowds of opponents, who testified that the option of long-term housing was unaffordable. Another option, for household members to quit their jobs to care for the participants 24-7 would cost California productive workers and income taxes.

* Administration spokesmen argued that Family Planning Services funded by a 9-to-1 federal match needed to be eliminated because “coming up with 10-cents on the dollar in this environment” was difficult. Legislators questioned that assessment, and suggested the Administration go find even more programs with a $9 federal match for every $1 spent by the state.

Assemblyman Jim Beall Jr. (D) noted that moving ahead with health program cuts would be short-sighted because of the likelihood of federal health reform creating opportunities to restructure delivery of health care in California.

In particular, Beall said, new federal rules about mental health care getting parity with physical health care should pave innovative paths for blending delivery of care.

The final segment of the 6-hour hearing, interrupted by the second Assembly floor vote on Sen. Abel Maldonado’s nomination for lieutenant governor, was dedicated to the last item on the agenda: a proposed shift of at least $1 billion from Proposition 63 Mental Health Services Act dollars to the general fund.

The item brought out perhaps the largest turnout of the day, with advocates from Long Beach to Sonoma lining up to tell stories of how the MHSA saved money, and lives. After a Sacramento woman tallied the cost – over $2 million -- of her mentally ill mother’s numerous hospitalizations, she made the point that early intervention through MHSA-style programs would have led to far less costly, and tragic, outcomes.

Of the proposal to shift MHSA dollars to the general fund, Assemblyman Wesley Chesbro (D) said “The impact of this will be severe if it’s allowed to go forward.”

Following the entire presentation, Hill said, “We fully understand the governor’s request,” regarding the mental health funds. “This is probably not the wisest thing to do.”

Labels: Budget, MediCal, Sacramento, SCHIPHealthyFamilies

posted by Cynthia Craft | Permalink | 4:34 PM


 

A big budget turnout...

Wednesday, January 27, 2010

More on the budget hearing from Jessica Rothhaar, who directs our budget organizing for Health Access California:

The hearing room was overflowing with Californians from around the state. The big turnout conveyed the severe impact of the cuts absolutely clear.

Senators Ducheny, Leno and Lowenthal also repeatedly expressed disbelief that the LAO was recommending adoption of the Governor’s cuts without accounting for the additional costs of consequences they admitted would happen, such as additional ER admissions, uncompensated care, homelessness, HIV/AIDS infection rates, etc. or the political impossibility of others, such as the taking of Prop. 10 and Prop. 63 money to backfill other programs. On the flip side, Senator Ducheny did ask several times whether less drastic cuts might be possible to several of the programs under discussion, such as to Healthy Families vision coverage.

Among the groups speaking against the cuts at yesterday's hearing included: AIDS Healthcare Foundation; Alliance of Californians for Community Empowerment (ACCE); AltaMed; Alzheimers Association; The ARC; Asian Pacific American Legal Center (LA); Bayview Adult Day Health Care; CA Alliance of Retired Americans; CA Association of Adult Day Services; CA Association of Family Health Centers; CA Association of Health Plans; CA Association for Health Services at Home; CA Association of Public Hospitals and Health Systems; CA Commission on the Status of Women; CA Disability Community Action Network; CA Hospital Associationl CA Immigrant Policy Center; CA Medical Association; CA Primary Care Association; Casa Pacifico ADHC; Children Now and the 100% Campaign; Children’s Specialty Care Coalition; County Health Directors Association of CA; County Mental Health Directors Association of CA; County Welfare Directors Association of CA (CWDA); Developmental Disabilities Council of Alameda County; Easter Seals; Elderday ADHC; Futures Explored; Graceful Senescence ADHC; Hemophilia Council of CA; Loma Linda University Medical Center; National Alliance for the Mentally Ill; Oral Health Access Council; Para Los Ninos; Placer Independent Resource Services; Planned Parenthood Affiliates of CA; Resources for Independent Living; Sacramento CARES; San Diego Council of Community Clinics; San Francisco AIDS Foundation; United Association of California Care Providers (UACC); and Western Center on Law and Poverty.

There was particularly awesome turnout and testimony organized by the California Association of Adult Day Services, which had members there from just about every district represented on the Budget Committee, including San Diego, San Bernardino, Santa Cruz, San Francisco, Contra Costa and Los Angeles. Let's keep it up!

Labels: Budget, Sacramento

posted by Anthony Wright | Permalink | 3:31 PM


 

Blunt language about a blunt budget...

Tuesday, January 26, 2010

There was no escaping the sharp wit and quick tongue of Sen. Denise Moreno Ducheny (D), chair of the Senate Committee on Budget and Fiscal Review, on Tuesday as the panel heard its first airing of the rationale behind the governor's budget proposals to drastically slash taxpayer-funded health services -- for the second year in a row.

Again and again, Ducheny offered succinct retorts that, in effect, signaled to the admininstration that Gov. Arnold Schwarzenegger's ideas amounted to little more than glasses-half-empty. In nearly every area of cuts described, Ducheny demanded more data before moving forward on the governor's punishing health-care cuts for California's most vulnerable populations at a time when the prolonged recession continues to drag down the state's economy.

More than once, Ducheny and other senators questioned why revenue-raising options were not considered as alternatives to decimating services to taxpaying, lower-income citizens. "Most of these programs were started in the first place with the theory that they would save us Medi-Cal dollars in the long run," Ducheny said, demanding more concrete figures from the administration's Department of Finance as it outlined proposed cuts in adult day health care, Healthy Families coverage for children, mental health programs, HIV-AIDS drug assistance and more.

"It's a pig in a poke, is what it is," Ducheny said, chiding the finance department and the Legislative Analyst's Office representatives for not presenting more details to support the claim of potential savings. "It's a bit of an irony that, if we're the seventh-richest state in the union, why the people who put us there couldn't help us more, by paying a [higher] Vehicle License Fee, for example."

Said Sen. Mark Leno (D-San Francisco): "When the governor talked about 'Sophie's Choices,' he didn't suggest revisiting the tax breaks for revenues. He didn't say that was one of 'Sophie's Choices.'"

Still, time and again, both the LAO and DOF representatives fell short in their explanations of how the puzzle pieces of the governor's proposed budget cuts fit together in a way that made sense in helping Californians weather the tsunami of a persistent recession.

Those offering testimony against the governor's cuts raised the discussion to a blunt level not frequently heard in such a formal setting. They spoke of the elderly and the frail expiring before being able to find a bed in a long-term nursing home. They spoke of children being left behind to fail in classrooms; they spoke of more and more people becoming homeless, hopeless, ailing and unjustly relegated to being second-class citizens. Phrases like "fiscally foolish," "morally reprehensible" and "appalling and horrific" replaced the more polite, mutually beneficial language that advocates typically offer up in legislative hearings.

Regarding the proposal that Healthy Families vision care benefits be dropped for children whose low-income parents pay 150% more in premiums than they did a year ago, Ducheny said, "How are the children going to 'Race to the Top' if they can't read?"

Senator Roderick Wright, a Democrat from Los Angeles, provoked the most heated discussion in dismissing what he called "the euphemisms regarding 'reduction of services.'"

Should the governor's proposals be adopted, Wright said, "We are voting to let people die. If we don't face the consequences of these cuts, if we don't face the fact that we are discussing life or death for some folks. . .we are doing a disservice to the public."

Labels: Budget, Sacramento, Schwarzenegger

posted by Cynthia Craft | Permalink | 9:40 PM


 

Tuesday morning quarterbacking...

Monday, April 13, 2009

The National Coalition on Health Care is coming to town with a forum tomorrow, Tuesday, April 14, from 8:30 a.m. to 1:00 p.m., at the CALPERS building, Lincoln Plaza North, 400 Q Street, here in Sacramento. You can click here to register.

The National Coalition on Health Care is one of those nonpartisan coalitions that include business and labor, providers and patient advocates, and so the conversation should be interesting. There's some common goals and objectives, but we know there's real differences one you get into the details...

Speakers will include (in alphabetical order):
· John Arensmeyer, Founder and CEO, Small Business Majority
· Barbara Blake, State Secretary, United Nurses Associations of California
· Denny Delk, Member of the National Board, American Federation of Television and Radio Artists
· Ted Epperly, M.D., President, American Academy of Family Physicians
· Stephenie Foster, Senior Vice President for Government Relations, American Legacy Foundation
· Gregory A. Franklin, Assistant Executive Officer, Health Benefits Branch, California Public Employees' Retirement System
· Mark Goldberg, Executive Vice President, National Coalition on Health Care
· Leif Haase, Director, California Program, New America Foundation
· Scott Hauge, President, Small Business California
· Elizabeth Imholz, Special Projects Director, Consumers Union of U.S., Inc.
· Edward Levine, M.D., Partner, McKinsey & Co., Global Healthcare Practice
· Paul Markovich, Chief Operating Officer, Blue Shield of California
· Joel E. Miller, Senior Vice President for Operations, National Coalition on Health Care
· Kathy Rallings, Regional Uniserv Staff, California Teachers Association
· Jim Schlotz, Regional Uniserv Staff, California Teachers Association
· Herb Schultz, Senior Health Policy Advisor, Office of Governor Schwarzenegger
· Richard Allen Williams, M.D., Clinical Professor of Medicine, UCLA School of Medicine, and President and CEO, The Minority Health Institute, Inc.
· Anthony Wright, Executive Director, Health Access California
· Lucien Wulsin, Jr., Executive Director, Insure the Uninsured Project

The other point of interest is the mix of national and state voices, so it should be interesting to hear the back-and-forth between the California experience and the conversation of the moment at the national level.

Labels: Sacramento, YearOfReform

posted by Anthony Wright | Permalink | 6:28 PM


 

Back and forth...

Thursday, March 05, 2009

Just back from DC, where the momentum for health reform is palpable. Just in the last week, there was a presidential speech with a strong commitment to act, a budget with committed dollars, and key appointments to fill out the team.

Today, Thursday afternoon (Eastern time), there's a White House Forum on health reform to be broadcast on CSPAN.

Also today, there's oral arguments in the lawsuit regarding the false and misleading language in the Prop 1A title, summary, and analysis. We'll need a longer effort to detail the budget cap proposals' impact on health care, and defend core programs.

Only a few years ago, it used to be Washington seemed to be a quagmire, where health advocates were simply preventing the worst, whereas California was pointing the way with active movement. Now, we are on offense in DC, and defense in Sacramento. How quickly things change.

Labels: Obama, Sacramento, YearOfReform

posted by Anthony Wright | Permalink | 1:07 AM


 

Back in health care world...

Tuesday, February 17, 2009

Even with the honoring of Capt. Sully, the pilot who managed to land a plan in a river despite having no engines working, the main event in the Capitol is clearly the budget. Every speaker at the honoring event invoked the budget. Back on health care policy issues, two things this afternoon:

There's an Assembly Health Committee, chaired by Assemblyman Dave Jones, on the "transparent reporting of quality data and outcomes." It's a huge, important topic, that's the key to health reform, in the effort for better patient safety, quality improvement, and cost containment. One of our board members, Betsy Imholz from Consumers Union, is testifying, with several of our allies (and opponents) in the transparency fight. It's also good to see the new Assembly Health Committee in action, with the new members getting grounded in some of these technical issues.

There's also a briefing and celebration of the signing of SCHIP, with a briefing entitled, "How Will California Seize Opportunities Provided By SCHIP Reauthorization and Other Federal Initiatives?" The briefing and reception is from 3-5pm, at the Sheraton Grand Sacramento Hotel at 1230 J Street here in Sacramento.

Lots going on, indeed.

Labels: Budget, Sacramento, SCHIPHealthyFamilies, Transparency

posted by Anthony Wright | Permalink | 2:50 PM


 

State of the Schwarzenegger

Thursday, January 15, 2009

Earlier this week, there was lots of rumors about Governor Arnold Schwarzenegger's State of the State. There was considerable buzz that the Governor would mention new efforts around health care, beyond the continued focus on the ongoing budget saga. It was unclear whether the Governor would seek to offer health proposals that seek to build bridges with the Democrats in the legislature, or more of the health cuts and vetoes that we have seen in the past year.

But the Governor today said he wasn't going to give a standard State of the State, while the budget and cash crunch loomed. He suggested he had big plans and proposed legislation, ready on his desk, on many issues, including health care... but that they will wait until after the budget deal. So no new news today on health policy.

On the budget, the Governor appropriately described the magnitude of the crisis and asked everybody to give, but he didn't recognize how much some have given while others have not.

The Governor needed to acknowledge the $16 billion in cuts already made to health, education and other vital services. In health care, cuts have been made to have a quarter-million children lose coverage, and yet we continue to have a Republican blockade on raising any taxes or revenues to prevent even worse cuts.

We need to remember that despite the Governor's recognition that we need to increase some revenues, his budget proposes to deny coverage to a half-million parents, and to deny specific benefits like dental, optometry, podiatry and psychology to millions more. The cuts the Governor proposes would not only harm the health system we all rely on, but also hinder efforts to stimulate our state's economy. California would lose hundreds of millions of dollars in federal matching funds, doubling--and in some cases tripling--the negative impact of these cuts not just in the health system, but the economy as a whole.

The speech seemed to reflect that a budget deal may be near--enough so that any other speech might risk blowing up negotiations. We hope any budget deal considers both the health and economic impacts of these cuts, and raises the taxes and revenues to prevent those cuts, and make sure we can meet the increased needs in California.

Labels: Budget, Sacramento, Schwarzenegger

posted by Anthony Wright | Permalink | 11:32 PM


 

Assembly chairs...

Wednesday, January 14, 2009

Assembly Speaker Karen Bass just announced chairs of committees, both policy committees (which we largely knew) and budget subcommittees (which we didn't). We are still awaiting the membership rosters, to see how hard it will be to pass legislation this year.

The biggest news is that first-term Assemblymember Jerry Hill (D-San Mateo), Chair will chair Budget Subcommittee #1 for Health and Human Services. He was a former San Mateo County Supervisor, which did some innovative work on expanding health coverage and providing health services, and so should come with real-world knowledge about the impacts of the health and human services cuts that he will be reviewing.

Here's the chairs and vice-chairs of other committees of interest to health consumer advocates:

Health:
Assm. Dave Jones, D-Sacramento, chair
Assm. Nathan Fletcher, R-San Diego, vice chair

Accountability and Administrative Review:
Assm. Hector De La Torre, D-South Gate, chair
Assm. Audra Strickland, R-Thousand Oaks, vice chair

Appropriations:
Assm. Kevin De León, D-Los Angeles, chair
Assm. Jim Nielsen, R-Gerber, vice chair

Budget:
Assm. Noreen Evans, D-Santa Rosa, chair
Assm. Roger Niello, R-Fair Oaks, vice chair


Revenue and Taxation:
Assm. Charles Calderon, D-Montebello, Chair
Assm. Chuck DeVore, R-Irvine, Vice Chair

Rules:
Assm. Ted Lieu, D-Torrance, Chair
Assm. Sam Blakeslee, R-San Luis Obispo, Vice Chair

Labels: Bass, Budget, Sacramento

posted by Anthony Wright | Permalink | 6:25 PM


 

Senate Committee Assignments...

Tuesday, January 13, 2009

Senate President Pro Tem Darrell Steinberg has announced the new committee assignments for the next session. Here's the committees of interest for health advocates:

HEALTH COMMITTEE:
Sen. Alquist (Chair - D)
Sen. Strickland (Vice Chair - R)
Sen. Cedillo (D)
Sen. Negrete McLeod (D)
Sen. Wolk (D)
Sen. Pavley (D)
Sen. DeSaulnier (D)
Sen. Leno (D)
Sen. Cox (R)
Sen. Maldonado (R)
Sen. Aanestad (R)

There are 11 members of Senate Health Committee: There are 7 Democratic Senators, and any legislation need 6 votes to pass out of the committee.


APPROPRIATIONS COMMITTEE:
Sen. Kehoe (Chair -D)
Sen. Cox (Vice Chair -R)
Sen. Yee (D)
Sen. DeSaulnier (D)
Sen. Corbett (D)
Sen. Leno (D)
Sen. Oropeza (D)
Sen. Hancock (D)
Sen. Wolk (D)
Sen. Runner (R)
Sen. Wyland (R)
Sen. Walters (R)
Sen. Denham (R)


BUDGET & FISCAL REVIEW
(All Senators will be members of the full Budget Committee. However, there will be only three voting members on each of five Subcommittees.)

SUBCOMMITTEE #3 ON HEALTH & HUMAN SERVICES, LABOR & VETERANS' AFFAIRS
Sen. Leno (Chair - D)
Sen. Alquist (D)
Hollingsworth (R)

Labels: Sacramento, Steinberg

posted by Anthony Wright | Permalink | 4:33 PM


 

Happy holidays...

Thursday, December 25, 2008

As a health consumer advocate, it seems the most appropriate holiday this season is Festivus, with its annual airing of greivances.

Where would you start? Health reform stalling at the beginning of the year? Many worthy bills dying in the legislature or by the Governor's veto pen, not for policy reasons, or even the standard tug-of-war between interests, but seemingly for petty personality politics?

Any recap of the year starts and ends with the budget crisis--the ugly cuts made (including paperwork burdens for the purpose of having kids drop off coverage), as well as the many threatened; the disastrous September budget that makes the situation worse, with corporate tax giveaways and an unfunded "rainy day" fund that--if not defeated on a future ballot--will siphon money from health and education, and other vital services. We have a "year in review" piece ready to publish, but given that budget negotiations are continuing, we may have more bad news to add to it before the year is out.

In a "bah humbug" mood about the budget, George Skelton in the LA Times has a holiday column that simply takes apart the arguments by those that refuse any discussion of new taxes to prevent devastating cuts. There's no time of year where it's good to deny health care to our fellow Californians, whether they be children, the poor, or others. Hopefully the decisions made in the holiday season start the new year in a positive way.

Labels: Budget, Sacramento

posted by Anthony Wright | Permalink | 7:45 PM


 

A Bleak Budget

Wednesday, December 10, 2008

HEALTH ACCESS UPDATE
Monday, December 8th, 2008


LAWMAKERS MEET IN RARE JOINT SESSION ON BLEAK FISCAL FUTURE
* Lawmakers warned that they need to act now
* State fiscal officers say current situation is the worst they’ve seen in decades
* Parties spar over the economic impact of cuts versus taxes

REMINDER: Health Access/CPEHN Holiday Party in Oakland: THURS, DEC 11th
* You're invited! Max's 500 12th St, Oakland. 4-7pm. RSVP to jessicar@health-access.org

What's new on the Health Access WeBlog: CPR for CPR, Live Blogging from the Joint Convention, Bankruptcy Debt and Medical Debt, Tough Cookies, New Senate Budget Committees and Chairs, Health Care as Economic Stimulus, Obama and Daschle Asks for Advice; Insurance for Insurance?


SACRAMENTO--All 120 legislators – from those who’ve been here 8 days to those who’ve been here 8 years – gathered in a rare “joint convention’’ in the Assembly Chambers on Monday to get the full fiscal debrief from the state’s fiscal luminaries – the Treasurer and the Controller, the Legislative Analyst’s Office, and the Governor's Department of Finance.

The purpose of the gathering was part Budget 101 for the newbies and a wake-up call, of sorts, even for those who have been at it for a while. The numbers expressed were not new to those who have been watching the budget implosion since it was signed in late September: That California will face a nearly $30 billion deficit if lawmakers do not do something in the next five weeks.

What was striking was the urgency with which all the top fiscal officers spoke. Treasurer Bill Lockyer, whose career in Sacramento spans four decades (1973) intoned that lawmakers need to “adopt an honest and balanced budget very soon. No gimmicks. No phony accounting. Stop plying on the tooth fairy.’’

What makes this year’s deficit so much worse than usual, said Legislative Analyst Mac Taylor, is the fact that the state has already turned over every rock and no longer has money – or tricks – remaining up its sleeve to balance the budget. Additionally, tricks and borrowing that were employed in previous years will be coming due, exacerbating the problem.

The scenario is so scary, said State Controller John Chiang, that the state will not be able to pay its bills beginning in March. While that timeline has been widely known – what was striking about Monday’s testimony is the juxtaposition of numbers.

The state’s general fund is about $103 billion. Typically, California has about $18 billion it can pass around from fund to fund (internal borrowing), like borrowing $100 from a savings account until payday, then repaying that loan.

The problem, Chiang said, is that the state has borrowed so much that that internal borrowing capacity will dwindle to $882 million (that’s 5% of what it usually is). In March, California will have totally maxed out all of that capacity, leaving it $1.9 billion in the red.

Assembly Speaker Karen Bass, speaking to reporters before the joint session, said the reason for the extraordinary meeting was that she wanted all members to hear the same thing at the same time. “I think some of my colleagues, on both sides, are in denial,'’ she said

The Governor last week called lawmakers into a extraordinary fiscal session, which gives them just 45 days to enact midyear cuts and revenues he has re-submitted.

In health care, the Governor's proposed cuts include:
* denying Medi-Cal coverage to nearly a half-million low-income parents;
* eliminating dental, vision, podiatry, and several other Medi-Cal benefits for 2.5 million parents, seniors, and people for disabilities; and
* reducing funding for public hospitals.

MORE COAXING NEEDS TO HAPPEN FOR REVENUES

Even after the fiscal Armageddon layed out by the state’s financial officers, lawmakers – new and old – made statements and asked leading questions that largely fell along party lines.
As an alternative to taxes and revenues, Republicans invoked the California Performance Review reports, which Gov. Arnold Schwarzenegger commissioned when he first took office to "blow up the boxes." Few of the ideas were implemented.

Last year’s Assembly Budget Vice Chair Roger Niello, a Republican, asked what could be done about the fast-growing social service programs, for instance.

Mike Genest, the Director of Finance and former chief of the Senate Republican Budget office, acknowledged that social service programs grow at a pace that far outstrips the state’s income growth. For instance, while state revenues grow at about 5 percent, Department of Developmental Services grew at 15 percent, Department of Mental Services grew at 12 percent, and In-home supportive services grew at 13 percent.

But, Genest said, “It’s difficult to sit and suggest cuts in in-home supportive services when you’ve seen the workers bathing people, changing their medical devices or taking people to the store. We do not take cuts lightly because this is very serious business and the reason they are growing is because the need is growing.’’

One of the newest lawmakers, Republican Assemblymember Danny Gilmore from Hanford explained that unemployment in his southern Central Valley district was higher than the nation and rest of the state. “How important is job creation. Is it essential to putting (the budget) in balance?” he asked, leadingly.

In fact, job creation is one of the strategies that Treasurer Bill Lockyer and Gov. Arnold Schwarzenegger have spoken about. To create that, the state would have to be able to sell its infrastructure bonds for school building, rail projects and other important projects. California, though, would not be *able* to sell its bonds unless the legislature acted on some kind of midterm package, Lockyer said.

Republicans asked about the impact of increasing taxes on the economy. Democrats asked about the impacts of cuts on the economy.

Fiscal experts said both would hurt the economy, but at this point, the state has little choice. Lockyer suggested trying to increase the state’s match for Medi-Cal. (In fact, a Health Access report earlier in the year, available on our website, detailed the particularly negative impact of health care cuts.)

But all conceded that lawmakers were going to have to do what they did not want to do.

WHAT’S NEXT

The Assembly has announced two budget sessions in the two weeks leading up to Christmas. The first, on Thursday, would be about Education. Next week’s would be about Transportation.

The Senate has a new Budget Committee that includes all Senators, and new subcommittees (and new chairs) that will meet this Wednesday. Senator Alex Padilla chairs the new subcommittee on Health and Human Services.

Health Access will continue to monitor budget news as it becomes available. For information, contact the author of this report, Hanh Kim Quach at hquach@health-access.org.

Labels: Budget, Sacramento, Updates

posted by Anthony Wright | Permalink | 4:51 AM


 

The Budget Committee of the Whole

Friday, December 05, 2008

So while Senate President Pro Tem Steinberg makes good on his promise (threat?) to have *every* member of the Senate sit on the budget committee, and on one budget subcommittee, here's the breakdown, announced today.

For Budget Subcommittee No. 3 on Health and Human Services:
Sen. Alex Padilla (D) will chair.
Other members include:
Sen. Mark Leno (D)
Sen. Gilbert Cedillo (D)
Sen. Elaine Alquist (D)
Sen. Leland Yee (D)
Sen. Dave Cox (R)
Sen. Bob Huff (R)
Sen. Sam Aanestad (R)

The other subcommittee of note for health advocates is Budget Subcommittee No. 5 on Revenues and the Economy, chaired by the Chair of the full Senate Budget Committee, Sen. Denise Ducheny, Chair (D).
Other members include:
Sen. Lou Correa (D)
Sen. Ron Calderon (D)
Sen. Ellen Corbett (D)
Sen. Lois Wolk (D)
Sen. Robert Dutton (R)
Sen. Jeff Denham (R)
Sen. Tony Strickland (R)

These committees are expected to meet on Wednesday. No word yet on the official makeup of the Assembly Budget Subcommittees.

Labels: Budget, Sacramento, Steinberg

posted by Anthony Wright | Permalink | 10:52 PM


 

Our Holiday Party, and more...

Thursday, December 04, 2008

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, jessicar@health-access.org

* Positions Available: No. California Organizer; Statewide Online Organizer
Job descriptions on website; Resumes and cover letters to jobs@health-access.org


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:

* Victory on Balance Billing: Court Upholds DMHC Decision to Stop Unfair Billing of Patients
* Alquist to Chair Senate Health; Jones to Chair Assembly Health
* Excerpts from New Sen. Pres. Steinberg's Swearing-In on Health Care & Budget
* The Challenge of Children's Coverage: Why Kids May Lose Coverage...
* Orzag at OMB: The Crucial Role of the Crafters and Evaluators of Reform
* The New Team on Health Reform: In the Obama Admin, the House, the Senate
* The Budget Choices: A Final Vote for the Lame-Duck Legislature
* The Insurer's Health Reform Plan: Guaranteed Issue, But What Else?
* Leadership Changes at Medi-Cal: Maxwell-Jolly, Douglas To Replace Shewry, Rosenstein
* Chairman Henry Waxman and the Improved Prospects for Federal Health Reform
* Health Access' 20th Anniversary: Previews and Reviews, The Best and Worst of Times
* California Congressional Delegation Steps Up on Health Reform

We'll continue to post up-to-the-minute information about health and budget issues, both at the state and federal levels, in the legislature and at the agencies and administration.

Labels: HealthAccessCommunity, Sacramento, Updates

posted by Anthony Wright | Permalink | 12:47 AM


 

No applause warranted...

Friday, September 19, 2008

The California State Senate passed the supplementary aspects of the budget just now. The Assembly is expected to follow suit shortly.

At the end, Senator Romero announced that "the desk is clear" and Senator Perata concluded, "We're finished." No speech or final comment, because what is there to say? There was an awkward pause, and some Senators started clapping, as if waiting for the curtain to come down.

No applause. Not for this.

Labels: Budget, Sacramento

posted by Anthony Wright | Permalink | 4:42 PM


 

Veto! but for the wrong reasons...

Tuesday, September 16, 2008

The Governor just announced that he will veto the budget bills, when they come to him.

Should he veto it? The proposed budget not only fails to fix the ongoing budget crisis, but places health and other vital services at even more risk in future years. Let's be clear: This doesn't just defer the issue for another next year: it makes severe, harmful cuts this year, and makes the budget problem much worse in future years. The budget steals revenues from future years to patch together this year's problem, but now that's money that won't be there in those future years. And it's not like there will be less demand for health and education.

The Governor would be right to veto this budget for not raising the revenues needed to prevent cuts to health, education and other vital services.

Instead, the Governor seeks to make a bad budget worse, by placing another funding priority to compete with existing services, without any new resources. A rainy day fund is not a bad thing, but if the Governor wants one, he should raise the revenues to fund one. The Governor's budget proposals would lead to more, not less, cuts to vital services.

The Legislature needs to get back to work... but not with what the Governor has proposed.

Labels: Budget, MediCal, Sacramento

posted by Anthony Wright | Permalink | 3:34 PM


 

Sign or Veto? We'll see...

Wednesday, September 03, 2008

HEALTH ACCESS ALERT
Thursday, September 4th, 2008


LEGISLATIVE UPDATE: HEALTH BILLS HEADING TO GOVERNOR'S DESK
* Bills pass on high-risk pool, benefit mandates, rescission review, and single-payer
* Some bills stall, including standards for individual insurance, transparency
* ACTION ALERT: Get letters of support into Governor’s Office ASAP

Click for What's New on the Health Access WeBlog: More on Budget Negotiations, A Late Budget Record; The Republican Budget, Revealed; The Last Days of Legislative Session; Medi-Cal at the DNC; "Voila, Problem Solved!"; More on MRMIP, and Much More...


The Legislature ground to a slow halt on Sunday, August 31st, the constitutionally imposed deadline for all bills in the 2007-08 legislative session to pass.

Now, Gov. Arnold Schwarzenegger has 30 days to sign the bills – midnight September 30th. Complicating matters this year, however, is the fact that the governor has vowed he would veto all bills until a state budget has passed. The state budget is a record 63 days late with no signs of compromise. It’s unclear whether the governor will actually follow through on that promise, given that the Governor made an exception last month to sign the high speed rail initiative (which he sponsored) to get it on the ballot.

LETTERS NEEDED

Health advocates however, should still submit letters to the governor’s office urging him to sign bills. Letters should be sent to:

Gov. Arnold Schwarzenegger
State Capitol, Governor’s Office
Sacramento, CA 95814

HEALTH CONSUMER BILL UPDATE

Following is a list of how bill that were still alive at the end of the legislative session fared:

BILLS HEADED TO THE GOVERNOR

Insurer Oversight:
* CAPPING ADMINISTRATION AND PROFIT: SB 1440 (Kuehl) would set a minimum medical loss ratio – requiring every insurer to spend at least 85 percent of premiums on patient care.
* INDEPENDENT REVIEW: AB 1945 (De La Torre) would establish an independent DMHC/DOI review process if an insurer wants to rescind coverage, and raises the standard in existing law so that coverage can only be rescinded if a consumer willfully misrepresents his health history.
* BROKER ACCOUNTABILITY AND FAMILY COVERAGE AFTER RESCISSION: AB 2569 (De Leon) would require brokers who take applications to attest, under penalty of perjury, that the information is complete and accurate to the best of their knowledge. Also ensures that family members whose coverage depends on that of the rescinded person may be offered another individual policy.

Benefit Mandates:
* MENTAL HEALTH PARITY: AB 1887 (Beall) Would require health plans to provide coverage for all diagnosable mental illnesses.
* MATERNITY COVERAGE: AB1962 (De La Torre) would require all individual insurance policies to cover maternity services.
* DURABLE MEDICAL EQUIPMENT: SB 1198 (Kuehl) would require group health plans andinsurers to offer coverage for durable medical equipment, such as wheelchairs and shower seats.

Improved Insurance Options:
* HIGH-RISK POOL: AB 2 (Dymally) would reform the Managed Risk Medical InsuranceProgram, which provides coverage for “un-insureables” who have “pre-existing conditions.’’ Efforts would make the high risk pool more affordable and available.
* USE OF INSURER PENALTIES: SB 1379 (Ducheny) would use the fines levied on insurers for improper rescissions to subsidize MRMIP and repay loans for physicians working in underserved areas
* PUBLIC INSURER: SB 973 (Simitian) would create a statewide public insurer, connecting existing regional, county-based health care plans, to compete with private health careplans and provide consumers more affordable coverage choices.

Consumer Protections:
* DENTAL PREDATORY LENDING: SB 1633 (Kuehl) Would prohibit dentists’ offices from offering high-interest loans to patients while they are under the influence of anesthesia. Would also prohibit dental offices from charging lines of credit before services have been rendered.
* UNFAIR BUSINESS PRACTICES: AB 2842 (Berg) would protect Californians from insurance agents trying to sell them private Medicare plans through cold calls and bait-and-switch tactics.

Hospital Transactions:
* HOSPITAL CLOSURES: AB 2400 (Price) would require public notice before closing a hospital. * BOUTIQUE HOSPITALS: AB 2697 (Huffman) would require so-called “boutique hospitals’’ to assess their impact on a community’s health system annually, specifically whether they siphon doctors, workers, providers from hospitals caring for less affluent populations.

Balance Billing:
* EMERGENCY ROOM BILLS: AB 1203 (Salas) would prevent emergency departments – which do not have a contract with a patient’s insurance company -- from directly billing the patient, requiring the hospital to seek payment directly from insurers.
* ER DOCTOR BILLS: SB 981 (Perata) would prevent emergency physicians – who do not have a contract with a patient’s insurance company -- from directly billing the patient, requiring providers to seek reimbursement directly from insurers.

Coverage Expansions:
* DEPENDENT CARE: SB 1168 (Runner) would allow adult dependent children, who are still covered under their parents’ health plan, to stay on that coverage even if the child takes a medically necessary leave of absence from school.
* UNIVERSAL COVERAGE SINGLE PAYER: SB 840 (Kuehl) would establish a single-payer health care system in California that would enable all residents to have health coverage.


BILLS THAT WILL NOT ADVANCE THIS YEAR
* INSURANCE MARKET STANDARDS: SB 1522 (Steinberg) would sort health insurance policies into five coverage categories, ranging from “comprehensive’’ to “catastrophic.’’ Organization of plans into these categories would enable consumers to better track premium, benefits and cost-sharing, and assist consumers in making apples-to-apples comparisons between plans. Would weed out “junk’’ insurance by developing minimum benefit standards.
* TRANSPARENCY AND DISCLOSURE OF COST AND QUALITY DATA: AB 2967 (Lieber) Would require public reporting of cost and quality by hospitals, HMOs and others in the health care industry. Was substantially amended against the author’s wishes at the end of the year, and was ultimately opposed by health advocates.
* CONFIDENTIALITY CLAUSES: SB 1300 (Corbett) would prohibit confidentiality clauses, which keep secret information on pricing and health care quality from consumers, in contracts between providers and insurers.

If you have questions, contact the author of this report, Hanh Kim Quach, at hquach@health-access.org. For the most up-to-date bill lists, please visit
http://www.health-access.org/advocating/docs/2008Bill%20List%209%2002%2008.pdf

Labels: Legislation, Sacramento

posted by Anthony Wright | Permalink | 10:30 PM


 

Like Michael Phelps. Except not.

Tuesday, September 02, 2008

We have now gone longer than we ever have in California history in not passing a budget...it's a record!, write Matthew Yi of the San Francisco Chronicle, and Evan Halper at the Los Angeles Times.

Can we say "we told you so?" on Proposition 56, which stopped salaries to legislators for every day the budget is late, and reduced the 66% threshold to pass a budget to 55%? On the repeal of the car tax, which dug us deeper into this multi-billion hole?

We have to stay focused on being very clear about the consequences of the cuts in the budget the Republicans are crafting, and support the revenues needed to prevent such cuts.

More to come on the budget battles...

Labels: Budget, Sacramento

posted by Anthony Wright | Permalink | 1:00 AM


 

As the dust settles...

Monday, September 01, 2008

So the legislative session ends, even if the budget battle continues. Lots of disappointments this year on health care, including the failure of bills that would have required greater transparency for insurers--SB1522(Steinberg)--and providers--AB2967(Lieber), SB1300(Corbett). There's more to write about those and other bills in the days ahead.

Many health bills did pass. Here's a few, with fuller descriptions of these bills are on the Health Access website at:
http://www.health-access.org/advocating/2008_bills.html

AB2(Dymally) to improve the high-risk pool;
AB1945(De La Torre) to have independent review of recissions;
SB1440(Kuehl) to requirement that 85% of premiums go to patient care, rather than administration or profit;
SB981(Perata) and AB1203(Salas) to restrict balance billing;
SB840(Kuehl) to establish a universal single-payer health system;

There's others, and we'll have a full report early in the week.

Labels: Legislation, Sacramento

posted by Anthony Wright | Permalink | 1:31 PM


 

Even better than the "mensch" award I saw him get...

Thursday, August 21, 2008

Senator Darrell Steinberg was officially sworn in to be Senate President Pro Tem today, in a touching ceremony on the Senate floor this afternoon. With the current Senate President Pro Tem Don Perata making the motion, and the current Republican leader Dave Cogdill seconding the motion, it was approved unanimously by voice vote.


He also gave a speech that seemed to counter the cynicism about public service and government these days, which seems especially ripe right now because of the budget standoff. He talked about the advances made in some areas, whether infrastructure, stem cell research, or mental health, and suggested that progress could be made in other areas as well. As Shane Goldmacher at the Sacramento Bee reports:

Labels: Sacramento, Steinberg, YearOfReform

posted by Anthony Wright | Permalink | 11:50 PM


 

Final floor votes...

Tuesday, August 19, 2008

HEALTH ACCESS UPDATE
Wednesday, August 20th, 2008


HEALTH LEGISLATION UP FOR FINAL VOTES

* Handful of consumer bills on the line, including single-payer, insurance standards, medical loss ratios, recission review, coverage for those with "pre-existing conditions."
* Budget remains unresolved: negotiations continue on cuts, revenues, and caps.

Click for What's New on the Health Access WeBlog: More on Budget Negotiations; The Return of Harry & Louise; How to Improve the Economy; The Insurance Companies "Listening Tour"; HSAs; The Folly of a Spending Cap; The Consumers Union Cover America Tour RV Comes to Sacramento; New Studies; NJ Prohibits Hospital Overcharging; Premiums Going Up; The DNC Platform on Health Reform; Preparing for Denver; ER Overcrowding and Timely Access to Care; Ups and Downs of the Budget Fights; MegaLife and Mega Problems


The 2007-08 Legislative Session is fast coming to a close. Bills are up for final floor votes in the next several days--the last chance for health care advocates to weigh in with legislators about pending legislation is now.

While midnight August 31st is the deadline for bills to pass, legislative leaders have, at times, indicated they wanted to end session sooner – as early as this Friday, August 22nd. It is unclear whether either house will actually complete their legislative work at the end of this week, given that a state budget still has not passed. While both have national party conventions to attend over the next two weeks, the budget may keep the legislators in town through the 31st, and perhaps later. Adding to the uncertainty, Gov. Arnold Schwarzenegger has vowed to veto any and all bills that land on his desk if a state budget is not passed.

Regardless of the exact last day of session, legislation will be considered in the next several days that will have a major impact on health care consumers, from those trying to compare and purchase insurance, to those denied for "pre-existing conditions."

Health Access continues to track a number of health consumer-related bills. Several bills work to ensure that consumer have more confidence that there coverage will be there for them when they need it. More information is available on the Health Access website, at:
http://www.health-access.org/advocating/2008_bills.html

Here's a selected list of pending legislation that Health Access California, the statewide health care consumer advocacy coalition, supports:

ON ASSEMBLY FLOOR

* INSURANCE MARKET STANDARDS: SB 1522 (Steinberg) Would provide standards for health insurance policies in the individual market. This would weed out "junk" insurance and sort policies into five coverage categories, ranging from “comprehensive’’ to “catastrophic," to enable consumers to better track premium, benefits and cost-sharing. Benchmark policies would assist consumers in making apples-to-apples comparisons between plans. SUPPORT/SPONSOR
* SINGLE PAYER: SB 840 (Kuehl) Would establish the framework for a universal, single-payer health care system in California that would enable all residents to have health coverage. SUPPORT
* HOSPITAL DISTRICT ASSET TRANSFERS: SB 1351 (Corbett) Would require Attorney General oversight into transactions involving district hospitals. SUPPORT
* INSURANCE COMPANY FINES: SB 1379 (Ducheny) Would use millions in fines levied on insurance companies for improperly rescinding coverage to fund two programs: high-risk pool for those rejected by insurance companies because of "pre-existing conditions"--which has a waiting list of nearly 1,000 Californians and financial aid program for physicians who serve in underserved areas. SUPPORT
* PREDATORY DENTAL PRACTICES: SB 1633 (Kuehl) Would prohibit dentists’ offices from offering high-interest loans to patients while they are under the influence of anesthesia. Would also prohibit dental offices from charging lines of credit before services have been rendered. SUPPORT
* UNFAIR BUSINESS PRACTICES: AB 2842 (Berg) Would protect Californians from insurance agents trying to sell them private Medicare plans through cold calls and bait-and-switch tactics. SUPPORT
* HOSPITAL CLOSURES: AB 2400 (Price) Would require public notice before closing a hospital. SUPPORT

ON SENATE FLOOR

* HIGH-RISK POOL: AB 2 (Dymally) Would reform the Managed Risk Medical Insurance Program, which provides coverage for “un-insureables” who have “pre-existing conditions.’’ Would institute reforms and generate revenues through fees to make the high risk pool more affordable and available. SUPPORT
* BALANCE BILLING IN EMERGENCY ROOMS: AB 1203 (Salas) Would prohibit balance billing by doctors and hospitals for care received after an emergency patient is stable enough to be transferred to a contracting hospital or released. SUPPORT
* MENTAL HEALTH PARITY: AB 1887 (Beall) Would require health plans to provide coverage for all diagnosable mental illnesses. SUPPORT
* LIMITING RESCISSIONS: AB 1945 (De La Torre) Would create an independent DMHC/DOI review if an insurer wants to rescind coverage, and raises the standard in existing law so that coverage can only be rescinded if a consumer willfully misrepresents his health history. SUPPORT
* BROKER ACCOUNTABILITY AND FAMILY COVERAGE AFTER RESCISSION: AB 2569 (De Leon) Would require brokers who take applications to attest that the information is complete and accurate to the best of their knowledge. Also ensures that family members whose coverage depends on that of the rescinded person may be offered another individual policy. SUPPORT
* PUBLIC INSURER: SB 973 (Simitian) Would create a statewide public insurer, connecting existing regional, county-based health care plans, to compete with private health care plans and provide consumers more affordable coverage choices. SUPPORT
* DURABLE MEDICAL EQUIPMENT: SB 1198 (Kuehl) Would require group health plans and insurers to offer coverage for durable medical equipment, such as wheelchairs and shower seats. SUPPORT
* CONFIDENTIALITY CLAUSES: SB 1300 (Corbett) Would prohibit confidentiality clauses, which keep secret information on pricing and health care quality from consumers, in contracts between providers and insurers. SUPPORT
* CAPPING ADMINISTRATION AND PROFIT: SB 1440 (Kuehl) Would set a minimum medical loss ratio – requiring every insurer to spend at least 85 percent of premiums on patient care. SUPPORT
* FREQUENT ER USE: SB 1738 (Steinberg) Would continue pilot program in six counties that has provided frequent emergency room users with more cost-effective preventive care and disease maintenance through clinics and other resources. SUPPORT

HEADING TO GOVERNOR’S DESK

* MATERNITY COVERAGE: AB 1962 (De La Torre) Would require all individual insurance policies to cover maternity services. SUPPORT
* BOUTIQUE HOSPITALS: AB 2697 (Huffman) Would require so-called “boutique hospitals’’ to asses their impact on a community’s health system annually, specifically whether they siphon doctors, workers, providers from hospitals caring for less affluent populations. SUPPORT
* DEPENDENT CARE: SB 1168 (Runner) Would allow adult dependent children, who are still covered under their parents’ health plan, to stay on that coverage even if the child takes a medically necessary leave of absence from school. SUPPORT

For more information, contact the author of this report, Hanh Kim Quach, policy coordinator at Health Access California, at hquach@health-access.org.

Labels: Insurers, Legislation, Sacramento

posted by Anthony Wright | Permalink | 6:03 PM


 

Single-payer in committee...

Wednesday, July 16, 2008

After a long pause, SB840(Kuehl) was heard in Assembly Appropriations Committee today, it's first committee hearing since late year, where the bill went through much of the legislative process already. Rather than have the bill simply go to the Governor's desk for a certain veto, Senator Kuehl wanted to keep the bill alive and continue the organizing in support of the bill, and the concept.

Now in the second year of a two-year session, it is continuing down the legislative path. The bill attracted an unusually large number of backers--including Health Access California--for an Appropriations Committee, which is really focused on the financing of bills rather than the policy, and where authors often provide abbreviated testimony or even waive presentations altogether. It was predictable opposed by many the insurer and employer groups.

As expected, the bill was placed on suspense, with a final determination about if it will be released for a floor vote in a few weeks. The bill does not include financing: a companion bill with financing was stalled in the first policy committee last year, and would need to be updated anyway. Rather, the bill puts forward the concept, and would set in motion a process to determine the financing.

The reason for moving the bill is to keep the commitment to health reform alive, to keep SB840 in the policy discussion, and to advance the elements of single-payer--from group purchasing to public program coverage to progressive financing--in the health debate in the state and nation. Let's keep the mometum...

Labels: Kuehl, Sacramento, SB840

posted by Anthony Wright | Permalink | 11:20 PM


 

Live-blogging the conference committee...

Sunday, June 15, 2008

HEALTH ACCESS UPDATE
Saturday, June 14th, 2008


BUDGET CONFERENCE COMMITTEE DEBATES HEALTH ITEMS
* Budget Conference Committee attempts to reconcile Assembly, Senate decisions
* Drug discount program, QSRs, and provider rates debated; Most items left open.
* These and other cuts dependent on final budget resolution and revenues

Click Here for What's New on the Health Access WeBlog: Healthy Blogging; Consumers Union's Cover America Tour; the LA Times on This Year's Health Reform; Hospitals Auctioning Medical Debt; C-Section as a Pre-Existing Condition; Speaker Bass on the Budget; Jones to be Health Chair; the Health Divide Between Obama and McCain; the Individual Market; High Deductible Plans; the Field Poll on Health Cuts; Health Access is Hiring; Budget Resources; the Biggest Threat to Health Reform: the Budget Cuts; New Families USA Report Grading California's Consumer Protections; Taking Consumer Representation Seriously; and Full Real-Time Budget Conference Committee Reports!


Budget season is in full swing as the bi-cameral Budget Conference Committee began meeting this past Thursday.

The conference committee is made up of six members -- three from the Assembly and three from the Senate. The Senate conferees are Senators Denise Ducheny (the chair), Bob Dutton, and Mike Machado. The Assembly conferees are Assemblymen John Laird (the vice-chair), Mark Leno and Roger Niello. Together, their task is to pore through a 439-page agenda contains all the differences between the Senate and Assembly version of the budget and reconcile them.

Health programs sit right in the middle of that agenda and came up Saturday afternoon. Health Access tracked discussions on the health budget on our blog in real time at:
www.health-access.org/blogger.html.

For people tracking this issue, here's a scorecard of all the proposed cuts, including those accepted, rejected, and those where there is disargeement between the two houses:
http://www.health-access.org/preserving/Docs/BudgetScorecard%20061408.pdf

Some of the most severe cuts, like direct cuts to Medi-Cal eligibility for working parents, were rejected by both the Assembly and Senate majorities and those are not "in conference." However, the legislators again repeated today that those cuts are still pending, unless the budget includes revenues to offset those cuts.

The conference committee focused on items where the Assembly and the Senate took different actions. That includes:
* the start of the California Discount Prescription Drug Program, where the Senate voted to defund the program and delay the start of it for a year, and the Assembly (along with the Governor) allowing the program to get underway, to start negotiating with drug companies.
* the question of imposing additional paperwork burdens for children on Medi-Cal, through quartely status reports. the Assembly voted against the proposal; the Senate put forward a modified proposal to have children's families renew their coverage every six months, rather than on an annual basis.
* the biggest dollar amounts considered were whether to restore the 10% provider rate cut made this February for doctors, hospitals and others who care for patients with Medi-Cal coverage.

Most items heard today, including these three areas, remained open while lawmakers directed staff to work out compromises or gather more information about the programs. Before leaving the items "open," lawmakers debated quarterly status reporting for children and adults, and the 10% rate cut for providers, as well as the frustration that many of these cuts mean losing federal matching dollars as well.

"We can talk about all we want to about restoring cuts, or we can defer the consideration of cuts, but until we can put focus as to where we are going to go with revenues, we are creating a false document,'' said Sen. Mike Machado, urging lawmakers to look realistically at the state's fiscal problems. "I think it's very difficult to talk about this if we're not going to talk about the revenue side. We're creating a budget in a vacuum.''

One cut that was made was to accept the Governor's proposed reduction to hospitals who do not contract with Medi-Cal.

The committee ended Saturday afternoon on an up note, with some federal funds identified that could be applied to California Children's Services, which pays for medical care for children with chronic illnesses and disabilities. The committee approved a compromise measure between the two houses on this issue.

Again, no decisions are final until a final budget is passed and signed into law.

Health Access will continue to track the Budget Conference Committee, which will resume Monday, June 16th at noon to continue discussion of health-related items, including to clinics and the Healthy Families program.

In the meantime, Health Access keeps a scorecard of items of interest to health advocates. For more information, contact Hanh Kim Quach, the author of this report, at hquach@health-access.org.

Labels: Budget, MediCal, Sacramento, Updates

posted by Anthony Wright | Permalink | 12:25 PM


 

Our big day is tomorrow!

Friday, June 13, 2008

The latest news is that the Budget Conference Committee will begin on health issues tomorrow morning -- that's right, Saturday -- around 10 a.m.

See you then....

UPDATE: They stopped tonight on page 170 -- California Integrated Waste Management Board. We begin on page 208. The committee plans to meet from 10-1 Saturday (men do not need to wear ties.) They will break on Sunday for Father's Day and resume Monday, tentatively, from noon to 3.

Labels: Budget, Sacramento

posted by Hanh Kim Quach | Permalink | 6:09 PM


 

Conference Committee

For those of you following, the Legislative Budget Conference committee began yesterday and has been meeting all day today. They resume again at 4:30 p.m. with Department of Fish and Game. On the agenda, they are about 70 pages away from Department of Health Care Services issues. (So far they've gone through 133 pages in 1.5 days to give you an idea of the pace)

It's unclear if they will get to our issues tonight, or if they will address them tomorrow.

We'll keep you updated.

Labels: Budget, Sacramento

posted by Hanh Kim Quach | Permalink | 4:07 PM


 

Jones to be chair of Health Committee...

Thursday, June 05, 2008

Speaker Bass has announced that Assemblyman Dave Jones (D-Sacramento) will be the new chair of Assembly Health Committee. Here's health-specific excerpts from the report by Shane Goldmacher at the Sacramento Bee Capitol Alert:


Jones, a Sacramento Democrat, is currently chairman of the Assembly Judiciary Committee. The new chairmanship is considered higher on the Capitol pecking order, as many influential bills pass through the health panel, particularly as Gov. Arnold Schwarzenegger has said reforming the state's health system remains a top priority.

The current chairman, Assemblyman Mervyn Dymally, D-Compton, is termed out this year...

None of the changes are effective immediately. The new chairs will take over the committees in December.

Here's a recap of... the committee chair and leadership moves Bass has made since her selection as speaker:
Majority leader: Alberto Torrico
Assistant speaker pro tem: Lori Saldaña
Appropriations: Kevin De Leon
Budget: Noreen Evans
Rules: Ted Lieu
Health: Dave Jones

Labels: Bass, Legislation, Sacramento

posted by Anthony Wright | Permalink | 5:52 PM


 

The stars aligning again...

Wednesday, April 30, 2008

All week, we've seen signs that while health reform stalled, the need and the urgency--and the opportunity--has not.

* We have had a Field Poll showing broad support for the proposed California legislation that did stall, and even the broad provisions that any major reform is going to need to do.

* A Kaiser Family Foundation poll showed health as a major election issue this year, outpacing many other pocketbook issues--and the startling factoid, picked up by Ricardo Alonso-Zaldivar of the LA Times, that 7% of Americans said they made a decision about marriage based on the need for health coverage.

* A Robert Wood Johnson study, as reported by Lisa Girion in the Los Angeles Times, that laid out the bare facts about the rise in health care costs and the decrease in the number of jobs that now come with health benefits. Yes, the worry that the polls found is based on real trends-- people are appropriately more concerned about the status quo than the needed reforms.

* The playing field is set, the public is there, and so are many of the politicians. Governor Schwarzenegger made a strong commitment to revisit health care reform in the remaining years in his term.

The editorial board of the San Jose Mercury News may have cracked even the cynics, with their opinion piece today:

By all appearances, Gov. Arnold Schwarzenegger's plan for health care reform died an ugly death on the floor of the Legislature in January.

But as Billy Crystal's Miracle Max cracked in "The Princess Bride": "There's a big difference between mostly dead and all dead. Mostly dead is slightly alive."

Besides a great movie reference, the Mercury News also provided another key element to a new possibility: the need to get legislation passsed this year, to set the stage for 2009. We appreciate their spotlight on the Health Access California-sponsored SB1522 (Steinberg), and there are other key bills that can provide real help for people and patients as soon as possible, and lay the foundation for further reform.

It's not too late to resurrect the governor's plan. And even though it might take a miracle to reform health care in California, it's worth a shot in 2009.

That doesn't mean the subject can be ignored this year. The Legislature has work to do now to set the stage.

Next year Karen Bass will be Assembly speaker, Darrell Steinberg will lead the Senate and someone other than George Bush will be in the White House. If public support for reform remains strong, the stars will be aligned for the governor to make another run at passing his comprehensive package.

According to a Field Poll released Monday, a whopping 72 percent of voters said they generally favor Schwarzenegger's plan. And the need for reform continues to grow. Some 6.6 million Californians, 19 percent, are uninsured, and that number is certain to increase as the economy worsens. A Kaiser Family Foundation poll released Monday showed that every 1 percent jump in U.S. unemployment would cause the number of uninsured to rise by 1.1 million nationwide.

Two bills before the Legislature may give an early indication of the prospects for reform in 2009.

The first, Steinberg's SB 1522, would set up what consumer advocates call an apples-to-apples comparison for individuals seeking private insurance coverage. It's sure to draw intense interest from insurance companies, and it will test the governor's willingness to collaborate across party lines.

The second, Sen. Sheila Kuehl's SB 1440, would require insurance companies to spend a minimum of 85 percent of premium dollars on health care expenses. That's a concept from the earlier reform package that insurance companies hoped was more than "mostly dead."

Calling Miracle Max.

With all this momentum, I don't think we need a miracle to get comprehensive health reform in 2009-10, just our work and commitment. It would help to have some movement, as the editorial points out, by putting some of the legislative building blocks in place.

Labels: InTheNews, Sacramento, Schwarzenegger, YearOfReform

posted by Anthony Wright | Permalink | 9:44 PM


 

Budget hearings and benefits...

Monday, April 28, 2008

Lots of budget hearings for health advocates today.

The Senate Budget Subcommittee on Health, chaired by Senator Alquist, met this morning. It heard several proposed cuts. It did *not* take action on a proposal to delay the state's prescription drug discount program, and similarly held open other proposals to cut community clinics, and various other efforts to get care for children and vulnerable patients.

The Assembly Budget Subcommittee on Health, chaired by Assemblywoman Berg, is meeting this afternoon. The big topic is the elimination of Medi-Cal "optional" benefits, especially dental coverage.

My colleague Hanh will have a full report later.

Also: Stan Rosenstein was also finally confirmed by the Senate today for his position today at the Department of Health Care Services.

Labels: Budget, Sacramento

posted by Anthony Wright | Permalink | 4:04 PM


 

Health Care Musical Chairs in the Administration

Thursday, April 24, 2008

Big changes on health care in the Governor’s office: Ana Matasantos, legislative deputy extraordinaire and health reform maven, has moved on up – to be deputy director of Department of Finance. A big job given our BIG deficit, and we’re lucky to have someone who comes from and understands the health and public program world occupying that spot.

Filling the legislative position in the Governor's office will be Jennifer Kent, formerly of Department of Health Care Services, and most recently at Health and Human Services Agency. Jennifer was instrumental in drafting and negotiating the transparency/price and quality disclosure language in ABx1 1 (Nunez), which has since been dropped into AB 2967 (Lieber). Jennifer can be reached at Jennifer.Kent@gov.ca.gov.

The legislative position in the Governor’s office was formerly held by Richard “Fig” Figueroa, in a prior Administration, who is now staffing the Governor’s cabinet on health and human services.

Congrats to all.

Labels: HealthAccessCommunity, Sacramento, Schwarzenegger

posted by Hanh Kim Quach | Permalink | 2:34 PM


 

More on rescissions

Friday, April 18, 2008

I wanted to follow up on Anthony's post with some more details about what Gov. Schwarzenegger's administration has laid out as his goals, this year, to tackle the rescission problem.

A quick recap: The state ordered the immediate reinstatement of health coverage for 26 enrollees who had their health policies retroactively cancelled in the past four years by Kaiser, Blue Cross or Blue Shield. Thousands more policies of consumers insured by the three named insurers, Health Net and Pacificare, could also be reinstated after review by an independent arbiter. These retroactive cancellations typically occured after a consumer started using lots of expensive health services -- triggering a second and very, very close look at their application by insurers.

As the system is now, said Daniel Zingale, one of the governor's health policy advisors, "If you use it, you lose it,'' of health coverage. To change this, the governor is supporting the following guidelines and principles to protect consumers:

1) A clear application process, which could help prevent mistakes and omissions
2) If there is no evidence of "willful misrepresentation,'' a policy cannot be rescinded
3) Plans must give adequate notice to consumers about the fact that they are investigating their applications. There would also be an established appeals process for consumers.
4) A prohibition on bonuses, quotas and other incentives for insurance company employees to rescind.

Of course, Zingale pointed out -- and we wholeheartedly agree -- this would all be moot had we passed ABx1 1. With health reform, we would have:

• Guaranteed issue: everyone receives coverage, regardless of pre-existing conditions,
• Guaranteed that everyone was paying into the system so insurers didn't go nuts about NOT being able exclude the really sick and expensive people,
• And guaranteed affordable health coverage and/or subsidies to purchase health coverage for 4 million Californians.

In the absence of that, though, this is a great place to focus reforms that would begin to help consumers feel more secure about the coverage they have.

Labels: BlueCross, Insurers, InTheNews, Rescissions, Sacramento

posted by Hanh Kim Quach | Permalink | 1:18 PM


 

The Big Five on the Budget changes...

Assemblywoman Karen Bass will take the reins of the Assembly and assume the Speakership in mid-May, right at the time the budget negotiations get going with the unveiling of the Governor's May Revise. Those Big Five meetings will also include Sen. Dave Cogdill, representing the Senate Republicans, who takes over this week. Marty Omoto at the California Disability Community Action Network has the update at the California Progress Report.

Labels: Budget, Sacramento

posted by Anthony Wright | Permalink | 10:25 AM


 

Upcoming hearings...

Monday, March 31, 2008

While the Capitol is closed today in recognition of Cesar Chavez, the action starts up again tomorrow, in full forse. Some upcoming hearings of note here in Sacramento:

* Assembly Health Committee will meet tomorrow, Tuesday, April 1st--yes, April Fool's Day. What's not a joke is the drug companies' opposition to AB2821 (Feuer), to limit the "gifts" given by drug companies to doctors. And a spirited discussion on AB1945 (De La Torre), on rescissions. Should be an interesting hearing.

* Next Monday, April 7th, the Senate Budget Subcommittee on Health and Human Services will hold a hearing at 10:30 am on some of the proposed cuts to Medi-Cal, like Quarterly Status Reports.

* An important reform of the individual insurance market, AB1522(Steinberg), sponsored by Health Access California, is up in Senate Health Committee on Wednesday, April 9th. The committee starts at 1:30pm. There are other bills of note as well on the docket.

Labels: Drugs, Legislation, MediCal, Sacramento

posted by Anthony Wright | Permalink | 12:13 PM


 

The DMHC Oversight Hearing...

Thursday, March 27, 2008

HEALTH ACCESS UPDATE
Friday, March 28th, 2008


SENATE PANEL QUESTIONS HMO REGULATOR
* Lawmakers question Department of Managed Healthcare’s oversight of health insurers
* Inquiry into regulations for timely access, discount plans, rescissions, language access and mental health parity
* Sen. Kuehl sees "pattern" of siding with industry against consumers
* Laws passed more than five years ago still not implemented


Click Here for What's New on the Health Access WeBlog: Health Care Consumers Views; GAO Individual Market Investigation; More Debriefings on California Health Reform; A Health Reform Backlash Against San Francisco Restaurants?; Health Budget Cuts Nationally; Shooting for 60 Votes; 1,000 Posts!; Web Wonkery; McCain's Misstep: Do We Go to the Doctor Frequently?; The Hot Hearing for the Week; Mayor Newsom Suing Sacramento Over Medi-Cal Rates; So-Called Consumer Directed Health Plans; Overseeing the DMHC


SACRAMENTO--At a special hearing of the Senate Health Committee on Thursday, Department of Managed Health Care Director Cindy Ehnes was questioned for over nearly seven hours about her department’s handling of five separate regulations and whether it had met its charge as a consumer protection agency in implementing and enforcing laws to help patients. “This hearing is meant to provide a level of oversight to ensure that legislation that is passed gets implemented in a way that is consistent with the way it was intended,’’ said Sen. Sheila Kuehl, chair of the Senate Health Committee.

At issue were three laws, passed in the late 1990s and earlier this decade, which still have not been put into practice: Timely access to health care, access to health care that is both culturally and linguistically sensitive and mental health parity. Additionally, Ehnes was interrogated about the Department’s rationale for regulations regarding retroactive cancellations of health policies and so-called "discount health cards".

For more detailed information on all these issues, you can visit the Health Access website and blog. As well, the Senator posted a detailed agenda and background papers on her website, at:
www.sen.ca.gov/kuehl


TIMELY ACCESS TO CARE

Background: First on the list was the issue of timely access to care, which were intended to prescribe specific time-elapsed standards for how long it should take patients to get into to see a physicians. The law was passed in 2002, and after many years of hiccups, regulations were on the path to implementation in 2007. The regulations spelled out exactly how quickly patients should be able to get in to see a doctor in certain situations. (I.E. Urgent primary care needs: 24 hours; Routine primary care needs: 10 days; Urgent specialty care: 72 hours; Routine specialty care: 14 days)

But in December, the Department yanked that version, stripped out all specific requirements, and left it up to health plans to determine their own standards, as had been the practice in the years before the law was passed. Health Access California and Western Center for Law and Poverty testified that the law did not meet the legislature's intent in having the Department set clear, prescriptive standards. Last month, the Office of Administrative Law rejected the regulations, saying the department had not allowed enough time for public comment given the dramatic changes in the regulations. To read Health Access' writings on this, click here.
The difference between the August and December versions of the regulations was so stark that Sen. Sam Aanestad, R-Grass Valley, asked, “It looks like the department just punted. What was the amazing turnabout?’’

Department’s take: Ehnes said she felt that the August regulations – 26 pages – were too complicated and would force plans to micromanage physicians they contract with. She said the department focused on the clinical triage via phone, where patients could call in and get a professional to tell them what they needed to do. Health Access’ Beth Capell later said this telephonic triage was available during limited times -- weekdays during work hours.

Legislative comment: “Regulations are supposed to go further than the statute. Sometimes they are going to be very complicated. I would encourage a little more complication,’’ Kuehl said. She urged that the Department set prescriptive, time-elapsed standards when developing new regulations in the new year. Aanestad indicated he thought the Department was "almost there" with previous version of the regulations that had set standards.

DISCOUNT HEALTH CARDS

Background: Discount health cards aren’t health plans, but cards that consumers pay a monthly premium, for access to a list of physicians that will purportedly provide them discounts. The problem is, often, physicians don’t know they’ve been put on a list, and consumers don’t know what the base price off which they receive a discount, making the discounts meaningless. These plans are often marketed toward lower-income or limited-English consumers who believe they are actually buying health coverage, and these plans rely on this confusion to thrive.

The plans have been deemed illegal by the state Attorney General; but there has been confusion about if they should be allowed or licensed and regulated, and even what agency should do the regulating. The DMHC has started a process of developing regulations to license these discount cards, working with the industry. Health Access testified that while the value of these products was questionable, any regulations must at a minimum ensure real discounts to a real network of providers with real notice of what consumers are and are not getting for their money.

Department’s take: The department has investigated 53 discount health plans and ordered cease and desist orders against 7. Ehnes said developing regulations and licensing such products was not meant to be an endorsement, but to try to better understand the products.

Legislative comment: Kuehl asked the department, as it continued its work, to strongly consider whether these products offer any real economic value to consumers.


RESCISSIONS

Background: In the past couple of years, the startling practice of retroactive cancellation of policies by insurers has arrested the public’s attention. Consumers, who have been paying monthly premiums and believed they are insured, receive high-dollar treatments for cancer, heart disease and the like. These expensive treatments often trigger insurance companies to review the enrollees’ initial application and rescind policies, claiming enrollees did not properly disclose pre-existing health conditions. Policies are cancelled, retroactively, as if consumers were never insured. Consumers are then sometimes left with thousands –if not hundreds of thousands of dollars -- in debt for treatments they believed were covered. The courts have determined this practice is illegal unless consumers willfully misrepresent their health status.

Department’s take: Ehnes said the DMHC has been aggressive in investigating plan behavior since the practice came to light. The department, along with the Department of Insurance are developing regulations so that plans do not have the ability to rescind without reason and that consumers can’t misinterpret applications.

Legislative comment: Kuehl’s primary concern was how consumers could obtain coverage after they’ve been cancelled. These cancellations occur on the individual market where consumers are often denied coverage due to pre-existing conditions. Once consumers’ coverage is cancelled, it would be impossible for them to obtain coverage through any carrier.Aanestad believed the department was not properly protecting consumers and making that the focus. “The first priority is to reinstate coverage for consumers. The second priority is to make headlines and change the industry, but it doesn’t sound like that’s really happening.’’


CULTURAL AND LINGUISTIC ACCESS

Background: In 2003, the legislature passed a law, SB853(Escutia), that required health plans to ensure that the consumers who did not speak English as a first language had proper medical interpretation services. Up until then, consumers brought in their children to translate, did not get care, or got the wrong care because they were unable to communicate with their doctors. This is particularly important in California where 55 percent of the population reports not speaking English well. The California Pan-Ethnic Health Network, Latino Issues Forum, and other groups were concerned that the notice about these new rights were left to the industry to determine, without consumer input. Plans have complained it is costing them millions to translate materials.

Department’s take: Ehnes said she was committed to this issue and was attempting to evaluate all aspects, including whether the regulations go beyond the law and whether it will cost too much.

Legislative comment: Kuehl said when the legislature passes something, that’s the rule. “We don’t care what it costs everybody. Cost is important…but that’s not the top consideration. …We really mean it about providing real access to language minorities,’’ said Kuehl, who was also critical about the department’s process in listening to all stakeholders and allowing enough time to comment on regulations. “Please push the envelope on this one, because I know you want to.’’


MENTAL HEALTH PARITY

In 1999, the Legislature passed mental health parity, providing consumers with access to mental health benefits equal to coverage in other health services. But to this day, consumers are still finding it difficult to obtain mental health services they need on the same level as other health services. Timely access to providers remains a problem as well as plans’ treatment and financial obligation toward mental health. The Senators urged the department to be more aggressive about following up on surveys and studies that found consumers lacking access to mental health.

PARTING NOTES

Ehnes said the department would continue to work on these – along with other issues – under the department’s jurisdiction. Kuehl reiterated that the hearing was intended to ensure that laws were actually implemented and not allowed to wither once passed. She also continued to encourage the department to have more open and collaborative process.

For more information, contact Elizabeth Abbott, director of administrative advocacy at Health Access California, at eabbott@health-access.org. Interested organizations can also contact the author of this report, Hanh Kim Quach, policy coordinator at Health Access, at hquach@health-access.org.

Labels: DMHC, Kuehl, LanguageAccess, Sacramento, TimelyAccess, Updates

posted by Anthony Wright | Permalink | 10:12 PM


 

Oversight about oversight...

Victoria Colliver at the San Francisco Chronicle has a preview of today's Senate Health Committee hearing--which is expected to be at least five hours of grilling on a range of meaty issues.

The Senate Health Committee, chaired by Senator Sheila Kuehl, will hold a hearing today on "Consumer Protection under the California Department of Managed Health Care: Adequacy of Implementation and Enforcement," reviewing the DMHC's oversight in five key areas: timely access, language access, so-called discount health plans, retroactive denials of coverage; and mental health.

In all these issues, they strike to the core of whether the coverage is meaningful, and whether the consumer is getting value for what they paid for. And on all these topics, there are pending decisions regarding regulations or implementation issues at the DMHC.

It won't be a surprise to readers of this blog that health and consumer advocates will press for stronger standards and more aggressive oversight for the health insurance industry--and for good reason.

Consumers are increasingly concerned that their coverage won't be there for them when they need it--that they won't be able to get in to see a doctor or specialist, to get a translator if necessary, or even that their coverage will be retroactively rescinded.

In light of these HMO practices, the Department needs to be more--not less--aggressive in protecting patients and investigating the insurance industry.

Yet, the tendency by the Schwarzenegger Administration is to leave the decisions up to the insurers. Recent regulations would let insurers decide their own standards on timely access; to determine their own method of notifying patients about their rights to an interpreter. On new regulations of discount cards, the Department were shaped by the industry they were purporting to regulate-an industry that offers a product of dubious value to consumers.

The regulations to ensure timely access to care has been a particular subject of controversy--and focus for Health Access. For years, the Department of Managed Health Care has had numerous drafts of regulations to implement a 2002 law to establish and enforce standards to ensure access to care within clear timeframes. Yet the most recent draft let the insurers set their own standards. Senator Kuehl recently wrote a letter indicating this conflicted with the intent of the Legislature is passing the bill.

We hope this hearing provides much-needed legislative push to the Department to resolve these issues quickly, and the political cover to prioritize protecting patients, regardless of industry opposition. Consumers want and need more assurances that their coverage will provide the protection that they paid for.

If nothing else, the hearing brings additional *public* scrutiny to these issues--which is important, given the stakes for the average health consumer, but rare, given that DMHC regulations usually get attention from the industry and a handful of consumer advocates.

We have an ongoing interest--Health Access California, the statewide health care consumer advocacy coalition, was the sponsor of the HMO Patient's Bill of Rights in the late 1990s that created the Department of Managed Health Care, to be a stand-alone department with a specific focus on consumer protection. Our group continues to advocate on behalf of consumers at the DMHC on a range of issues. More recently, Health Access was the sponsor of AB2179(Cohn) in 2002, which required the Department to establish and enforce standards for timely access to care; and a strong supporter of SB853(Escutia) to require language access to care.

So we'll be continuing to do our own oversight, over the insurers--and their regulators.

We'll have a report on the hearing later in the day.

Labels: DMHC, Kuehl, Sacramento

posted by Anthony Wright | Permalink | 1:36 AM


 

Back in session... and the hot hearing for the week...

Tuesday, March 25, 2008

The legislators came back to Sacramento this week after spring break... and it's getting frantic, quick. Bills (see the Health Access bill list) introduced this year only have a few weeks to pass their first policy committee.

While the budget and policy committees continue their regular work, the most interesting and high-profile hearing this week will probably be the Senate Health Committee, chaired by Senator Sheila Kuehl, hold a special Thursday session.

The hearing is entitled "Consumer Protection under the California Department of Managed Health Care: Adequacy of Implementation and Enforcement," is expected to take several hours and maybe more.

The issues to be discussed at this informational hearing are meaty, as it asks for reports on the DMHC's implementation of regulatons in many areas of strong interest to consumer advocates, including timely access, so-called "discount health plans," rescissions, language access, and mental health parity.

We're posted some about the pending regulations to ensure patients have timely access to care. A month ago, Senator Kuehl urged the Department to withdraw their proposed regulations, stating that they were not in line with the legislature's intent when passed AB2179. The author, Assemblywoman Rebecca Cohn, has been termed out, but Health Access California was a sponsor, and Senator Kuehl was a member of the Legislature that voted for it.

But it's clear that this hearing is about more than just timely access--or even about the other key issues. It's about being clear that the DMHC should be focused on consumer protection as its core mission--it's the reason that the DMHC was created in the first place. There's too many important issues for anything else to get in the way.

Labels: DMHC, Kuehl, Sacramento, TimelyAccess

posted by Anthony Wright | Permalink | 3:55 PM


 

Congratulations...

Thursday, February 28, 2008

to the Speaker-elect of the California Assembly, Karen Bass.

She has familiarity with health care issues, serving on the Assembly Health Committee and being part of Speaker Nunez's leadership team on health reform in the past year. Prior to her election to the Assembly, she founded and created the well-regarded Community Coalition, and so is steeped in her experience in community organizing, and in needs of the neighborhoods of Los Angeles, for health care and otherwise.

Assemblyman Mark Ridley-Thomas and others have their assessments and reactions.

Labels: Sacramento

posted by Anthony Wright | Permalink | 9:11 PM


 

Legislative leadership...

Friday, February 08, 2008

From all the reports on the various political blogs, it seems that both Speaker Fabian Nunez and Senate President Pro Tem Don Perata will hold their leadership posts for the remainder of the legislative year.

In terms of afterwards, there's lots of possibilities for the race to replace the Assembly Speaker, but there will be a first vote on March 11th.

Congratulations to Senator Darrell Steinberg on being the next choice of Senate President Pro Tem. Folks in health advocacy are very familiar with him for his authorship of the universal children's coverage bill; his leading advocacy on mental health issues, and his leadership on budget and appropriations committees, of which health care issues always loom large.

Labels: Sacramento

posted by Anthony Wright | Permalink | 12:10 AM


 

Revisiting rescissions...

 

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Speaker Perez in his own words on health budget cu...

 

The *big* impact of budget cuts...

 

Fired up...

 

The Backstory on Anthem BlueCross' Bad Behavior

 

Unfair and unbalanced...

 

Wright on Wright on Health...

 

A Stark choice...

 

The President's final argument...