LEGISLATIVE ROUND-UP: Big Day for Health Care

      The Legislature yesterday moved on a slew of health care legislation, some modest, some more sweeping. Among its more significant actions, the Assembly approved AB 1380, sponsored by Assembly Speaker Antonio Villaraigosa (D-Los Angeles), on a vote of 46-30. The bill would, for the first time in 25 years, lift the $250,000 cap on damages for malpractice, and allow annual increases tied to inflation beginning next year. While Villaraigosa described the bill as "very modest," he expressed hope that it would be expanded in the Senate (Gladstone/Ingram, Los Angeles Times, 6/3). He initially sought an increase the cap to $475,000, "but he could not get the 41 votes he needed." He "said the California Medical Association so far has not acted in good faith," and called the group "unreasonable, recalcitrant, intransigent and arrogant." CMA officials "said they have no interest in negotiating an increase in potential lawsuits awards against their member doctors."

Medical Decisions
      The Assembly also passed, on a vote of 57-3, AB 58 sponsored by Assemblywoman Susan Davis (D-San Diego), which would require HMOs to have a licensed doctor make final medical decisions.

Right-to-Sue/External Appeals
      Both chambers of the Legislature passed "two landmark bills to let patients sue" HMOs for coverage denials. State Sen. Liz Figueroa's "closely watched" (D-Fremont) SB 21, supported by the Consumer Attorneys of California, would give employees of private companies the same right to sue as public employees, passed the state Senate 21-16. In the other chamber, Assemblywoman Carole Migden's (D-San Francisco) AB 55 "would also make HMO plans liable for patient harm due to failure to exercise ordinary care." It would also establish an independent review process for patients dissatisfied with a health plan's own appeals process. It passed 45-27 and goes next to the Senate. California Association of Health Plans spokesperson Cory Black said the organization strongly opposes liability, but supports independent review. "Health plan liability is the wrong solution to a very real problem that patients have about their health care," Black said (Hoge, Sacramento Bee, 6/3).

Medical Marijuana
      The state Senate, on a bipartisan 27-7 vote, passed SB 847 sponsored by Sen. John Vasconcellos (D-Santa Clara), which would establish a $3 million research program to determine the safety and effectiveness of marijuana as a pain medication (Los Angeles Times, 6/3).

Mental Health Parity
      The Senate also passed, 27-8, Sen. Richard Polanco's (D-Los Angeles) SB 468, which would require health plans "to cover treatment for mental illness in generally the same manner they cover other medical conditions." Supporters said the measure would lead to faster treatment of the mentally ill and would reduce burdens on families. Opponents, however, said it would raise the cost of health care, leading some employers to drop coverage (Sacramento Bee, 6/2). The measure goes on to the Assembly. Meanwhile, the Assembly passed a similar measure by Assemblywoman Helen Thomson (D-Davis), which would require health plans to cover "severe mental illness and, in the case of children, for serious emotional disturbances" (Los Angeles Times, 6/3). See story 4 on CalPERS' support of this measure.

The Bee Buzzes About Liability
      An editorial in today's Sacramento Bee asks: "Should health care dollars that now go to caring for patients be redirected to provide larger payouts for injured patients and bigger paydays for lawyers?" The editorial notes that the state's malpractice cap has effectively "discouraged the filing of dubious claims submitted for the purpose of winning a quick settlement." And while malpractice victims "suffer real pain ... there is pain and suffering on both sides of the [liability] equation," as nearly one-fourth of nonelderly state residents lack coverage. The Bee argues that liability reform is "inevitably a terrible zero-sum game. Higher awards for the past pain and suffering of malpractice victims, and bigger paychecks for their lawyers, would mean more uninsured Californians and more future pain and suffering among those who can't get care" (6/3).