CALIFORNIA: GOVERNOR VETOES MANAGED CARE BILLS
Following through on his promise to veto all bills thatThis is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.
attempt to overhaul the managed care industry, Gov. Pete Wilson
(R) vetoed Friday eight HMO-related health care bills (Smith,
Sacramento Bee, 10/11). Wilson also "vetoed a popular measure --
supported by right-wing conservatives and liberal Democrats
alike -- that would have allowed low-income AIDS patients to
return to work without losing their Medi-Cal benefits" (Salladay,
San Francisco Examiner, 10/14).
THE VETOED BILLS
Sacramento Bee reports that the managed care measures
rejected would have: "granted cancer patients an immediate,
independent medical review if an HMO denied an autologous bone
marrow treatment", prevented a managed care company from "denying
critically ill patients treatment without first providing an
examination", "required HMOs to disclose the process used to deny
or grant health care services", required coverage of
complications of mastectomies" as well as allowed doctors to
determine a patient's length of stay after a mastectomy,
"required HMOs to cover certain procedures for diagnosing
prostate cancer" and "required HMOs to cover medication,
equipment, supplies and education for diabetes patients"
COLD AS ICE?
One of the bills vetoed, AB 760, would have entitled a woman
with breast cancer to a prompt, independent review following the
denial of a physician-recommended treatment by her insurance
company. Kathleen Connell, state controller and sponsor of the
measure, said, "Clearly the governor doesn't care that 5,000
California women will die of breast cancer this year and that
this bill would have saved some of those lives. His political
decision to rob them of this treatment combined with his failure
to recognize breast cancer as a leading killer of women is
nothing short of cold-hearted" (Connell release, 10/10).
Wilson also rejected a bill, proposed by Assemblywoman
Carole Migden (D), that would have resolved a "Catch-22 situation
common with AIDS patients on Medi-Cal" (San Francisco Examiner,
10/14). According to Migden, "[a]s many patients take advantage
of new protease-inhibitor drugs, their health improves and they
often want to return to work. But returning to work means losing
Medi-Cal, the state-federal health insurance for the poor." The
San Francisco Examiner reports that Migden's bill would have
"exempted up to $2,500 a month in income for disabled people,
including those with HIV and AIDS, from the Medi-Cal income
requirements." The extension would have allowed people to return
to work while receiving financial assistance to pay for the
expensive drugs, which can cost up to $1,800 a month (10/14).
San Francisco Chronicle reports that the bill "would have allowed
people with AIDS and other disabilities to retain Medi-Cal
coverage until they obtained private health insurance coverage"
(Gunnison, 10/14). Wilson vetoed the measure because he said he
believed it created an "entitlement program supported only by the
state general fund." Wilson also said the bill contained
"significant ambiguities." Migden said, "We are bitterly
disappointed. This was a humane and appropriate measure to
address a unique social and medical problem." Migden said she
will introduce a bill next year that addresses the Wilson's
concerns (San Francisco Examiner, 10/14).