MANAGED CARE REFORM: Senate Okays Direct OB/GYN Access Bill

      On "a lopsided bipartisan vote" of 30-3, the 40-member state Senate passed a bill yesterday that allows "female HMO members to choose obstetricians or gynecologists as their primary care physicians." State Sen. Bruce McPherson (R), who sponsored the bill, said, "This is basic care, not specialty care for women. It's analogous to children receiving care from pediatricians." While many large HMOs in California already offer women direct access to OB/GYNs, the measure would make it illegal for any California HMO to require women to first receive a referral from a primary care physician to see an OB/GYN. "This is cost-effective because instead of making two visits, a woman may only have to see one physician," said McPherson. The San Francisco Chronicle reports Gov. Pete Wilson (R) "is expected to sign the bill" (Lucas, 3/20). The bill (AB 12) now goes to the state Assembly which is expected to send it to Wilson "in the next week or so," the Los Angeles Times reports. Wilson spokesperson Lisa Kalustian said the governor "favors the concept" of the bill, "but stopped short of saying he would sign it."

The Spin
      The Los Angeles Times reports that the state Senate's approval of Assemblywoman Susan Davis' (D) measure marks "the first significant action this session to reform California's multibillion-dollar managed health care industry" (Ingram, 3/20). "Politically, managed care is the sleeper issue of the 1998 elections," with many politicians "attempting to capitalize on the frustration" many consumers feel with HMOs, the San Francisco Chronicle reports (3/20). But the managed care "reform drive was brought to a temporary halt last summer when Wilson vowed to veto more than 80 managed care bill he considered 'uncoordinated, reactive (and) piecemeal' solutions to complex problems," the Times reports. Wilson said he vetoed the Davis bill last year, but did so "because it violated his warning to the lawmakers, not because of the measure's merits" (3/20).

Not Good Enough
      The California Association of Health Plans wanted to amend the bill with a measure allowing "health plans to impose a higher copayment for direct access to OB/GYNs if those plans were already charging a higher copayment for direct access to other specialists," according to association spokesperson Jeff Bean. Despite the failure of such an amendment, he said his group would not ask for a veto of the bill (San Francisco Chronicle, 3/20). The Los Angeles Times reports that consumers for Quality Care said it supports Davis' bill. The consumers group, however "is concerned that the governor will accept relatively limited reform bills ... but will reject more far-reaching proposals," such as allowing patients to sue their HMOs for medical malpractice, according to director Jamie Court (3/20).