HMO REFORM: Interest Groups Wrestle to Influence Davis’ Policy
As Gov. Gray Davis looks to come through on his campaign promise to overhaul the state's regulation of managed care, industry lobbyists and consumer advocates jockey for position. While Davis has asserted that the hallmark of his administration will be his ability to "find consensus," some contend that in the health care arena too much compromise might undercut consumer protection. "The devil really is in the details. You might get consensus on very broad points, but you really have to be prepared for heavy battle on the details, which can make or break the whole thing," explained Elizabeth Imholz, western region director for Consumers Union. Although Davis was vague in his initial goals, others have taken up firm positions. The California Medical Association has geared up to fight capitation agreements, some are urging Davis to move HMO oversight from the Department of Corporations, and still others are calling for the governor to mandate independent review panels. But "the thorniest dispute," reports the Orange County Register, will be managed care liability. While Davis has "never spoken in detail about the issue," he has intimated that he would be "open to changing" the contentious law prohibiting HMO members from taking legal action against their health plans.
Staking the Middle Ground
HHS Secretary Grantland Johnson and Business, Transportation and Housing Secretary Maria Contreras-Sweet are expected to issue recommendations in March for state oversight of the industry, followed by Davis' own plans in late March or early April. Until then, interest groups are hashing it out, with "lobbyists for employer and managed care groups" insisting that "Davis will listen to their arguments." California Association of Health Plans Executive Director Walter Zelman noted that many bills vetoed by Wilson last year could gain the industry's support "if they were pared back a bit." He said, "Sometimes, it's the last 10 or 20% of a bill that's worrisome to us," but noted that consensus would prove to be evasive unless Davis could "get some of the advocates of reform to scale back their demands." For his part, Jamie Court of Consumers for Quality Care "said his group will not participate in any compromises with the industry." He said, "Any bill that the industry supports doesn't extend a genuine right to the patient" (Weintraub, 2/20). The Orange County Register Saturday outlined the positions of each side in the HMO reform debate, click here to read.