Bills Live and Die in Suspense: Update on Appropriations Votes on Health Bills in the California Legislature

• WORKING DISABLED: AB 851 (Brownley): 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. SUPPORT

• NO PAY FOR ‘NEVER EVENTS’: AB 2146 (Feuer): 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

• RESCISSION TIME LIMIT: AB 2549 (Hayashi): Would impose an 18-month time limit in which insurers have to rescind individual health care policies once consumers’ applications are approved. SUPPORT

• HEALTH IMPACT ANALYSIS: AB 2741 (Torrico) Would require for-profit hospital sales to undergo health impact analyses, just as in non-profit hospitals sales, to gauge the transaction’s effects on the affected community, health care services, and the community’s public interest. SUPPORT

• PUBLIC DISCLOSURE: AB 2910 (Huffman) Would require public disclosure and oversight of waivers of the Knox-Keene act. Over the last 30 years, more than a dozen major waivers have been granted with no public input and no public oversight. SUPPORT

• COMMUNITY BENEFITS: AB 2942 (Ma): Would standardize what non-profit hospitals report as “community benefits” to justify their non-profit status. Also requires for profit hospitals to report community benefits. SUPPORT

SENATE BILLS HEARD IN ASSEMBLY APPROPRIATIONS

PASSED: HEADING TO ASSEMBLY FLOOR VOTES

• SINGLE PAYER: SB 840 (Kuehl). Would establish the framework for a single-payer health care system in California that would enable all residents to have health coverage; financing would be worked out by a commission. SUPPORT

• BALANCE BILLING BY EMERGENCY PHYSICIANS: 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. 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

• HOSPITAL DISTRICT ASSET TRANSFERS: SB 1351 (Corbett): Would require Attorney General oversight into transactions involving district hospitals.
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

• INSURANCE MARKET STANDARDS: SB 1522 (Steinberg): Would set standards for individual health insurance; organization of plans into these categories would enable consumers to better track premium, benefits and cost-sharing, and required "benchmark" plans would assist consumers in making apples-to-apples comparisons between insurers. Would weed out “junk’’ insurance by developing minimum benefit standards to include doctor, hospital, and preventative care, and set a cap on out-of-pocket costs. SUPPORT

HELD IN COMMITTEE

• MEDICAL NECESSITY: SB 1525 (Kuehl): Requires health plans to explain how they determine medical necessity. Also requires health plans to report their rates of denial of care or modifications to care because of medical necessity. SUPPORT.

Hanh Kim Quach is the Health Care Policy Coordinator for Health Access California. Before joining the organization, she worked as a journalist for nearly 9 years covering issues in California. 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.