GOV. DAVIS: Legislature Gears Up to Tackle HMO Reform
Bracing for an avalanche of 70 health reform bills likely to cross his desk in the "frenzied final four weeks" of this year's legislative session, Gov. Gray Davis is set to meet today with key leaders to cobble together one bill in an effort to avoid a "hodgepodge package," the San Francisco Chronicle reports. "We hope we can fashion a comprehensive package that will be signed this year," Davis said of his scheduled meeting with state Senate President Pro Tem John Burton (D-San Francisco) and Assembly Speaker Antonio Villaraigosa (D-Los Angeles). "Wherever we can, we will work with the governor on issues," Villaraigosa said, adding, "But there will be times that we disagree." The Chronicle reports that "strained relations" between the governor and Democratic leaders over the past few months may play out in this "final showdown" (Gledhill, 8/16). Although Burton predicts a "very fruitful" conclusion to the session, he warned, "When it gets down to HMO reform and some other stuff, I just think the Legislature will have a different point of view. The governor will have to determine what he will do." However, Assembly Health Committee Chair Martin Gallegos (D-baldwin Park), a member of Davis' task force charged with culling through the HMO bills, said, "I think you are going to see reform consistent with the governor's moderate, centrist, incremental approach." The reforms are "things we never would have gotten under Gov. Wilson," Gallegos said, pointing to bills that would allow enrollees to sue their plans for damages stemming from delay or denial of services, a new state regulatory organization, an independent review board and mandated mental health benefits (Ingram, Los Angeles Times, 8/16).
High on Democrats' priority list, the San Jose Mercury News reports, is state Sen. Liz Figueroa's (D-Fremont) SB 21, which would allow employees of private employers to sue their health plans. While Gallegos said he thought Davis would sign Figueroa's bill, details such as whether damages will be capped have yet to be worked out. For his part, Davis said last week, "A patient's first interest is not to file a lawsuit; it is to get treated and get well. Lawsuits have a role to discourage outrageous behavior and to cause companies to behave in an appropriate fashion. However, we have to keep our eye on the ball." Jamie Court of Consumers for Quality Care cited the right-to-sue provision as the most important reform, saying, "You can pass a law saying HMOs must provide everything a doctor wants, but unless you have a law to enforce it, it doesn't do any good." Union of American Physicians and Dentists Executive Director Gary Robinson agreed, saying, "Liability for HMOs is the linchpin. HMOs now, through a variety of mechanisms, are forcing doctors to make decisions that reduce the amount of care they provide, but then doctors have all of the liability." The San Jose Mercury News reports that at today's meeting, Davis plans to avoid those bills "requiring HMOs to cover specific medications and services, because their costs are still being evaluated." Gallegos said lawmakers are also planning to address during the next four weeks "the issue of fiscal solvency for medical groups on the verge of bankruptcy" (Jordan, San Jose Mercury News, 8/16).