SACRAMENTO ROUNDUP: A Look Back At Assembly Action On Health Care
With the recent completion of the state Legislature's 1998 session, California Healthline is offering readers a look at the outcome of just some of the major health-related proposals. Today's installment focuses entirely on legislation that originated in the Assembly. The next installment, which will appear on Tuesday, will wrap-up major health-related bills introduced in the state Senate. A final installment in next Wednesday's issue will look exclusively at managed care legislation. Gov. Pete Wilson has until the end of this month to sign bills that made it to his desk, and many of the bills outlined below are still pending a final decision from the governor.
- AB 34: Health Care Service Plan Benefits: Breast Cancer -- Howard Wayne (D-San Diego). AB 34 would require health plans to provide coverage for diagnosis, screening and treatment of breast cancer. The bill was sent to the governor Aug. 31. As of Sept. 10, he had not signed it.
- AB 332: Health Plan Medical Directors -- Liz Figueroa (D-Fremont). AB 332 would require HMO medical directors to have a valid license to practice medicine before they can overturn a doctor's decision. It would also prevent a physician's original decision from being overturned unless an HMO reviewer physically examines the patient. "AB 332 is a great bill because it's such a simple idea -- a doctor's decision should only be overturned by another doctor," Figueroa said. The bill passed the Assembly by a vote of 49-14. It now awaits a decision by Wilson. [NOTE: A similar bill, SB 557 (Tim Leslie, R-Tahoe City), was introduced in the Senate.]
- AB 341: Health Care Coverage/Second Opinions -- Michael Sweeney (D-Hayward). AB 341 would mandate that an HMO pay for the second medical opinion of another doctor in the plan, or by an outside doctor if an expert could not be found within the plan. The bill passed the Senate 22-15 and 60-13 without debate in the Assembly. The HMO industry opposes the measure. Wilson spokesperson Sean Walsh said the governor has not yet decided whether to sign or veto the bill.
- AB 695: Unlicensed Health Care Workers -- Sheila Kuehl (D-Encino). AB 695 would prohibit an unlicensed person from performing certain duties that a registered nurse should perform, such as administering medication, giving shots, performing certain lab tests and other patient procedures. AB 695 cleared the Assembly in January but died in the Senate Appropriations Committee shortly before the legislative session ended in August. Click here to read California Healthline coverage of the unlicensed health care worker trend.
- AB 789: Health Care Workers -- Tony Cardenas (D-Panorama City). AB 789 would authorize the DHS to request and maintain employment information on certified nurses assistants and certified home health aides. It would also require the DHS to inform employers if these workers had a criminal background. The measure unanimously passed the Assembly floor, as well as the Senate, and was referred to the governor. The bill is sponsored by the California Association of Health Facilities and supported by the Little Hoover Commission. As of Sept. 10, Wilson had not signed the bill.
- AB 984: Emergency Response System/Health Care Coverage -- Susan Davis (D-San Diego). AB 984 would revise the definition of "basic health services" to include emergency response and ambulance transport services, and would mandate that health plans include services as part of their insurance coverage. The bill was sent to the governor in August. As of Sept. 10, he had not signed it.
- AB 1100: Health Care Coverage/Mental Illness -- Helen Thomson (D-Davis). AB 1100 would require health plans and insurers, with the exception of Medi-Cal plans, to cover six biologically based mental illnesses on par with physical ailments. The bill was sent to Gov. Wilson on Aug. 28. The California Chamber of Commerce and managed care industry oppose the bill, arguing it would drive up premiums. Martyn Hopper, state director of the National Federation of Independent Businesses, said, "This is a well-meaning attempt at ensuring coverage for mental illness, but it will actually result in less workers having health insurance," as the additional coverage will drive up premiums. Laurie Flynn, executive director of the National Alliance for the Mentally Ill, called on Wilson to join 19 other states that have enacted similar policies. She said, "Gov. Wilson has a unique opportunity to offer a lifeline to thousands of California families dealing with the challenges of ... mental illness. ... This is solid public policy that many other Republican governors have embraced." A Wilson spokesperson said it is "a bad bill" and "bad public policy." As of Sept. 10, the governor had not signed the bill. Click here for California Healthline coverage of the legislation.
- AB 1112: Contraceptive Coverage -- Robert Hertzberg (D-Los Angeles). AB 1112 would require health insurers that cover prescription drugs to extend coverage to FDA-approved birth control pills. The measure would include an exception for "religious charities" opposed to birth control but would require "insurance companies to fully disclose the exemption to employees" and offer them a voucher. Planned Parenthood of California supports the bill; the California Catholic Conference said the exemption meets its concerns. Wilson vetoed the bill earlier this year before it included the religious exemption and indicated that he may do so again, on account of a new provision which allows women in families earning up to $66,000 to access the state-funded contraception program if their business will not provide the coverage on religious grounds. The bill is currently awaiting Wilson's signature. Click here to read coverage of Catholic opposition to the bill.
- AB 1208: Occupational Safety and Health: Safe Needles -- Carole Midgen (D-San Francisco). AB 1208 would require the California Occupational Safety and Health Administration to define safe needle devices and require employers to use them to help prevent accidental needle jabs that transmit contagious diseases like AIDS and hepatitis. The California Healthcare Association opposes the bill on the grounds that the issue needs further study. The bill was sent to Wilson at the end of the session. The governor is on record as opposing the measure. Click needle sticks to read past CHL coverage of this issue.
- AB 1397: Medi-Cal/Maternity Benefits and Services/County Patients -- Martin Gallegos (D-Baldwin Park). AB 1397 would prohibit physicians from withholding pain relief from women in labor and declare it unethical to do so based on a patient's financial resources. Gallegos proposed the bill after reports surfaced of poor women being denied epidurals at Northridge Hospital in Los Angeles County. The bill passed 68-9 in the Assembly and 22-14 in the Senate. Wilson had not signed the bill as of Sept. 10. Click here to read past CHL coverage of the measure.
- AB 1557: HMO Liability -- Martin Gallegos (D-Baldwin Park). AB 1557 would require health plans to have a written policy on second medical opinions. It was amended to prevent HMOs from forcing patients into involuntary, binding arbitration systems. The measure passed unanimously in the Assembly and was defeated in the Senate Appropriations Committee, largely due to the fact that HMO civil liability provisions were tacked on to the bill (see CHL 8/20).
- AB 1621: Health Care Coverage: Reconstructive Surgery -- Liz Figueroa (D-Fremont). AB 1621 would mandate insurance coverage for needed reconstructive surgery, defined as "surgery performed on abnormal structures of the body caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease" in order to "give a patient a normal appearance." The bill would also require Medi-Cal to cover medically necessary reconstructive surgery. AB 1621 is currently awaiting Gov. Wilson's signature.
- AB 1663: HIV Reporting/Unique Identifier Method -- Carole Migden (D-San Francisco). AB 1663 would require doctors or laboratories who test patients for HIV to pass on positive results to county health officials via an alphanumeric code, who would then forward the information to the state. The names would remain with the testing agency, and a civil fine could be imposed should they be released. AB 1663 has been sent to the governor. As of Sept. 10, he had not signed the bill. For more information on the bill, click here.
- AB 1667: AB 1667 is one of the many bills that would provide HMO enrollees with an independent medical review should they be denied treatment and seek an appeal. The bill passed the Assembly 75-2, but could not get out of the Senate Appropriations Committee because lawmakers attempted to link it to AB 2436, which would allow patients to sue their HMOs.
- AB 1816: Medi-Cal: List of Drugs -- Gary Miller (R-Diamond Bar). AB 1816 would open up Medi-Cal's formulary to any new asthma drug approved by the Food and Drug Administration. Miller said the bill is in response to the 80% increase in the number of children treated for asthma in the last 20 years. But the state DHS said the measure "is as much for the benefit of several pharmaceutical companies as it is for children." The bill passed the Assembly 74-1 May 27, but never cleared the Senate before adjournment. Click here to read California Healthline coverage of the bill.
- AB 1924: Emergency/Urgent Care -- Dion Aroner (D-Berkeley). AB 1924 would require hospitals to submit certain information annually to the DHS and the county health departments to determine if a region has adequate emergency and urgent care. It passed the Assembly but never made it out of the Senate prior to adjournment. Click here to read a related story from the CHL archive.
- AB 2056: Clinical Laboratory Tests -- Richard Floyd (D-Carson). AB 2056 would authorize any person to request, and any licensed clinical laboratory or public health laboratory to perform certain specified lab tests. It would require the test results to be given only to the person who is being tested. The measure was sent to Gov. Wilson at the end of the session. As of Sept. 10, he had not signed it.
- AB 2171: Healthy Families Program -- Antonio Villaraigosa (D-Los Angeles). AB 2171 is intended to reassure legal resident aliens about their eligibility for Healthy Families coverage. If passed, state funds would be used to supplement the five year period that legal aliens are entitled to receive public benefits. A Villaraigosa spokesperson said the bill would not directly boost the number of Latinos applying for Healthy Families, but that the "public policy statement it makes will help this group substantially." The bill is currently awaiting Gov. Wilson's signature. Click here to read an original CHL story about Healthy Families' outreach to the Latino community.
- AB 2282: Obstetrical Care -- Martha Escutia (D-Huntington Park). AB 2282 would direct the DHS "to improve the content and timeliness of obstetric data" by requiring county hospitals to track maternal and fetal injuries in a database. State health officials would have oversight of the database to correct any improper medical actions. The American College of Obstetricians and Gynecologists, the California Healthcare Association, the National Organization for Women, the Service Employees International Union and Planned Parenthood Affiliates of California support this bill. However, state health officials oppose it because they believe creating a database would be too expensive and question the reliability of hospital information. Wilson is reportedly considering a veto. Click here to read California Healthline's coverage of the maternity ward bill.
- AB 2305: Health Care: Pain Medication -- George Runner (R-Antelope Valley). AB 2305 would require HMOs to provide access to pain management medications deemed appropriate. The bill is on Wilson's desk. As of Sept. 10, the governor had not signed it. Click here to read coverage of Runner's op-ed on end-of-life care.
- AB 2436: Health Care Liability: Liz Figueroa (D-Fremont). AB 2436 would allow patients to recover damages from health plans that "exercised influence or control which result in the failure to exercise ordinary care." Consumers for Quality Care and other patient advocate groups support the measure, as does the California Trial Lawyers Association. Many HMO and industry groups oppose it, contending it would raise the price of premiums. The measure passed the Assembly May 29, but was defeated in the Senate Appropriations Committee Aug. 19 after Assembly Speaker Villaraigosa attempted to link the bill to Johnston's independent appeals process bill (SB 1653). Click here to read coverage of the controversial measure.
- AB 2693: Controlled Substances: Prescriptions -- Carole Migden (D-San Francisco). AB 2693 would end the triplicate prescription form required for many narcotic pain relievers. State Rep. George Runner (R-Antelope Valley), co-author of the bill, said doctors must be armed "with the ability to provide every possible pain management therapy" so that terminally ill patients in agonizing pain won't have to turn to physician-assisted suicide. The measure passed unanimously in both houses of the Legislature, and currently awaits a signature from Gov. Wilson. As of Sept. 10, he had not signed it. Click here to read coverage of Runner's Los Angeles Times op-ed on the bill.
- AB 2762: Medi-Cal Coverage Of HIV-Infected Persons -- Dion Aroner (D-Berkeley). AB 2762 would extend Medi-Cal coverage to HIV-positive Californians. Upon passing the Assembly 59-11 May 26, it was referred to the Senate Health and Human Services Committee and then to the Appropriations Committee. No further action occurred during the session. Click here to read California Healthline coverage of an editorial advocating passage of Aroner's measure.