Gov. Brown Signs, Vetoes Three Health Care-Related Bills

On Thursday, Gov. Jerry Brown (D) took action on several health care-related bills, the Los Angeles Times reports (McGreevy/Mason, Los Angeles Times, 9/25).

Medi-Cal Estate Recovery Bill

Brown vetoed a bill (SB 1124) that would have limited the amount of assets the state can recoup from deceased Medi-Cal beneficiaries' estates, the San Jose Mercury News reports. Medi-Cal is California's Medicaid program (Seipel, San Jose Mercury News, 9/26).

In 1993, the federal government began requiring all states to recoup the long-term care costs of Medicaid beneficiaries ages 55 and older after they die.

SB 1124, by Sen. Ed Hernandez (D-West Covina), would have:

• Limited asset recovery of Medi-Cal beneficiaries ages 55 and older to long-term care in nursing homes;
• Prohibited asset recovery from the estates of surviving spouses of deceased Medi-Cal beneficiaries; and
• Required the state to provide beneficiaries with a list of Medi-Cal expenses subject to estate recovery.

However, the state Department of Finance estimated that the measure would eliminate $30 million in revenue that partly funds the Medi-Cal program (California Healthline, 8/14).

In a letter to the state Senate, Brown wrote, "Allowing more estate protection for the next generation may be a reasonable policy goal," adding, "The cost of this change, however, needs to be considered alongside other worthwhile policy changes in the budget process next year."

Anne-Louise Vernon, a new Medi-Cal enrollee, said, "It is shocking that Gov. Brown has chosen to single out low-income seniors by forcing them into an involuntary loan for their health insurance," adding, "This is unconscionable, and the governor's decision not to sign [the bill] is penny-wise, pound-foolish and frighteningly hardhearted" (San Jose Mercury News, 9/26).

No-Cost Contraception Bill

Meanwhile, Brown signed into law a bill (SB 1053), by state Sen. Holly Mitchell (D-Los Angeles), that will ensure access to no-cost contraception services for both men and women in the state (Los Angeles Times, 9/25).

The new law builds on the Affordable Care Act, which requires insurers to cover FDA-approved contraception without co-payments. In addition to ensuring no-cost contraception for women, the law requires no-cost coverage for vasectomies and other male contraceptive services.

In a release, Mitchell said that federal rules call for "reasonable medical management techniques" but lack clarity, resulting in inconsistent implementation.

The California Family Health Council and the National Health Law Program co-sponsored the measure. The bill was opposed by the:

• California Association of Health Plans;
• California Catholic Conference; and
• California Chamber of Commerce.

CAHP had argued that the measure would increase premiums and conflict with federal law, while the state Chamber of Commerce said it would impose an additional burden on employers (California Healthline, 5/7).

Inmate Sterilization Ban Bill

Brown also signed a bill (SB 1135) to prohibit prisons from forcing inmates to be sterilized as a method of birth control unless it is medically necessary, the AP/San Francisco Chronicle reports (AP/San Francisco Chronicle, 9/25).

The measure was introduced in response to an investigation by the Center for Investigative Reporting that found nearly 150 female inmates in the state were sterilized over a five-year period without proper approval (California Healthline, 5/28). A state audit released in June found that more than 25% of the 144 tubal ligations performed on inmates in fiscal years 2005-2006 and 2012-2013 did not include consent required by law (California Healthline, 6/20).

Sen. Hannah-Beth Jackson (D-Santa Barbara), the bill's author, said, "Pressuring a vulnerable population into making permanent reproductive choices without informed consent is unacceptable, and violates our most basic human rights" (Skinner, Reuters, 9/25).

The new law takes effect Jan. 1 (AP/San Francisco Chronicle, 9/25).