HMO REFORM: Unlikely This Year, Democrats Say
"With less than two weeks to go before the 1998 Legislature adjourns," the Los Angeles Times reports that pro-HMO reform legislators agree that the "prospects of ... passing tough reforms ... appear dead for the year." State Assemblyman Martin Gallegos (D-Baldwin Park), chair of the Assembly Health Committee, said, "Sadly, for the consumers, we were not able to reach consensus on (HMO) consumer protection, so we'll have to try again in January with a new governor." Gallegos noted that Gov. Pete Wilson was expected to veto many of the proposals, including one that would give Californians the right to sue their health plans. But he said if the bills had at least advanced to the floors of both houses, "we would have had some very active debate that the public would have had an opportunity to hear."
A Modest Proposal
"More modest reforms still are moving through the Legislature," the Times reports. One of these measures (AB 332) would require the person making an HMO's coverage decisions to be medical doctor licensed in California. Another bill (SB 406) would "remove from Wilson the ability to appoint a state HMO overseer and instead give such authority to a five-member board appointed by the governor and the Legislature." And AB 1112, the so-called Pill Bill, would require HMOs and other health plans to cover prescription contraceptives. But many HMO reform advocates say modest measures aren't enough. State Senate Leader John Burton (D-San Francisco) continued to insist that the only "real reform" is giving patients the right to sue their HMOs. Referring to more modest reforms backed by the managed care industry, Burton said, "By and large, any reform that the HMOs would (support) is not necessarily going to be reform. If you are trying to reform an institution and they are buying into what you are doing, it ain't really much reform" (Vanzi/Ingram, 8/21). Click here to read this week's California Healthline coverage of the HMO reform debate in the state Legislature.