Status Report: California 2008 Bills of Interest to Health Advocates

• SB 1440 (Kuehl) CAPPING ADMINISTRATION AND PROFIT: Would set a minimum medical loss ratio – requiring every insurer to spend at least 85 percent of premiums on patient care. Support, seek amendments. In Senate Appropriations.

Rescissions

o AB 1150 (Lieu) BONUSES: Would outlaw the industry practice of paying bonuses to insurance company employees when they rescind policies, for setting targets for rescinded policies and/or setting financial goals based on savings on health care claims. Support. In Sen. Appropriations.

o AB 1945 (De La Torre) INDEPENDENT REVIEW: Would require approval by Department of Managed Health Care or Department of Insurance for each individual rescission. Support. In Assembly Appropriations

o AB 2549 (Hayashi) TIME LIMIT: Would impose a six-month time limit in which insurers have to rescind individual health care policies once consumers’ applications are approved. Support. In Assembly Appropriations

Benefit Mandates

o AB 1887 (Beall) MENTAL HEALTH PARITY: Would require health plans to provide coverage for all diagnosable mental illnesses. HAC Support. In Assembly Appropriations

o AB1962 (De La Torre) MATERNITY COVERAGE: Would require all individual insurance policies to cover maternity services. Support. In Assembly Appropriations.

o SB 1198 (Kuehl) DURABLE MEDICAL EQUIPMENT: Would require group health plans and insurers to offer coverage for durable medical equipment, such as wheelchairs and shower seats. Support. In Senate Appropriations.

Improved Insurance Options

o AB 2 (Dymally) HIGH-RISK POOL: Would reform the Managed Risk Medical Insurance Program, which provides coverage for “un-insureables” who have “pre-existing conditions.’’ Efforts would make the high risk pool more affordable and available. Support. Inactive, Senate Floor

o SB 1622 (Simitian) PUBLIC INSURER: 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. In Senate Appropriations

Inadequate Insurance

o AB 2292 (Garrick) HEALTH SAVINGS ACCOUNTS: Would allow Californians who have Health Savings Accounts, linked to high deductible health plans, to qualify for state personal income tax deduction. Oppose. In Assembly Revenue &Taxation

o SB 972 (McClintock) UNREGULATED PLANS: Would create organizations of small businesses that could purchase unregulated and substandard health insurance products. Oppose. In Senate Insurance

HEALTH CARE PROVIDERS

Transparency

o AB 2967 (Lieber) TRANSPARENCY AND DISCLOSURE: Would require public reporting of cost and quality by doctors, hospitals HMOs and others in the health care industry. Support. In Assembly Appropriatons

o SB 1300 (Corbett) CONFIDENTIALITY CLAUSES: Would prohibit confidentiality clauses, which keep secret information on pricing and health care quality from consumers, in contracts between providers and insurers. Support. In Senate Appropriations

Doctor and Hospital Oversight

o AB 2146 (Feuer) ‘NEVER EVENTS’: Bans providers from billing patients or insurers when they have made an avoidable mistake, such as operating on the wrong person, prescribing the wrong drugs, or leaving foreign objects inside a surgery patient. Support. In Assembly Appropriations

o AB 2942 (Ma) COMMUNITY BENEFITS: Would standardize what non-profit hospitals report as “community benefits” to justify their non-profit status. Support. In Assm Appropriations

o SB 1633 (Kuehl) PREDATORY LENDING: 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. In Senate Appropriations

Hospital Transactions

o AB 2400 (Price) HOSPITAL CLOSURES: Would require public notice before closing a hospital. Support. In Assembly Appropriations

o AB 2697 (Huffman) BOUTIQUE HOSPITALS: 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 taking care of less affluent populations. Support. In Assembly Appropriations

o AB 2741 (Torrico) HEALTH IMPACT ANALYSIS: Would require for-profit hospital sales to undergo health impact analyses to gauge the transaction’s effects on the affected community, health care services, and the community’s public interest. Support. In Assembly Appropriations

o SB 1351(Corbett) OVERSIGHT: Would require Attorney General oversight into transactions involving district hospitals. Support. In Senate Appropriations

Balance Billing

o AB 1203 (Salas) EMERGENCY ROOM BILLS: 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. Support. In Senate Health

o AB 2220 (Jones) BINDING ARBITRATION: Requires providers and health plans to resolve contracting and payment disputes through binding arbitration. Watch. In Assembly Appropriations

o SB 981 (Perata) ER DOCTOR BILLS: 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. Support. In Assembly Health

UNDERSERVED COMMUNITIES

o AB 1472 (Leno) HEALTHY COMMUNITIES: Would establish the California Healthy Places Act, and require diverse state agencies and departments to work together assess and reduce health disparities in underserved communities. Support. In Senate Appropriations

o AB 2902 (Swanson) COMMUNITY HEALTH WORKERS: Would require the Office of Multicultural Health to encourage the use of community-based health care workers to help facilitate and coordinate better health outcomes in underserved communities. Support. In Assembly Appropriations

o AB 3027 (De Leon) LANGUAGE ACCESS: Would require health plans to translate materials into Medi-Cal threshold languages. Support. In Assembly Appropriations

o SB 1332 (Negrete-McLeod) MANDATORY MEDI-CAL MANAGED CARE: Would require seniors and persons with disabilities in Riverside-San Bernardino Counties to enroll in Medi-Cal managed care. Oppose. In Senate Appropriations

COVERAGE EXPANSIONS

Children’s Coverage

o AB 1 (Laird/Dymally) and SB 32 (Steinberg) UNIVERSAL CHILDREN’S COVERAGE: Would expand children’s coverage, including the Healthy Families program, to all children in families up to 300% of poverty ($49,800 for a family of 3). Support. On Senate and Assembly Floors, respectively)

o SB 1168 (Runner) DEPENDENT CARE: 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. In Senate Appropriations

o SB 1593 (Alquist) BRIDGING COVERAGE: Would clarify that children currently covered by county health initiatives would be first in line to receive Medi-Cal and Healthy Families coverage once those programs are expanded. Support. In Senate Appropriations

Working People with Disabilities

o AB 851 (Brownley) MEDI-CAL FOR WORKING DISABLED: Increases eligibility for those working with disabilities to buy Medi-Cal coverage through the Medi-Cal California Working Disabled Program. Also extends the program, which will sunset 9/1/08.

Universal Coverage

o SB 840 (Kuehl) SINGLE PAYER: Would establish a single-payer health care system in California that would enable all residents to have health coverage. Support. In Assembly Appropriations

Health Access California is a statewide health care consumer advocacy coalition of over 200 groups. This article has also been published on the Health Access Weblog.