Schwarzenegger Vetoes Series of Health-Related Bills
Gov. Arnold Schwarzenegger (R) on Wednesday vetoed a series of health-related bills, "sid[ing] with hospital and insurance interests" and showing that he would "take a hands-off approach to how these heavily regulated industries conduct business," the San Jose Mercury News reports (Marimow, San Jose Mercury News, 9/23). According to the Los Angeles Times, Schwarzenegger "angered Democrats" by rejecting "several of their most aggressive efforts to give patients more leverage in dealing with hospitals and insurers" (Rau/Vogel, Los Angeles Times, 9/23). Descriptions of the vetoed bills appear below.
SB 379, sponsored by Sen. Deborah Ortiz (D-Sacramento), would have set mandatory guidelines requiring hospitals to disclose charity care policies to the state and allowing state regulators to establish rules guiding hospital billing policies for the uninsured. The bill also would have prohibited hospital bills from being sent to collection agencies for 150 days following treatment, as well as prohibited families with annual incomes that do not exceed 400% of the federal poverty level from being billed at rates that exceed those paid by Medi-Cal, Medicare or workers' compensation. Under the bill, hospitals would have been barred from placing liens on patients' homes and using some other collection practices (California Healthline, 9/17).
Schwarzenegger in his veto message "expressed sympathy for patients" but indicated that he rejected the measure because he wanted to allow time for voluntary practices adopted by the industry this year to take effect, the Sacramento Bee reports (Rapaport, Sacramento Bee, 9/23). "It is my expectation that all hospitals in the state uphold their important commitment to the voluntary guidelines and that they are applied evenly, consistently and without hesitation," Schwarzenegger said.
Health Access California Executive Director Anthony Wright said, "The idea that the voluntary guidelines are working and that we don't need enforceable standards is completely belied by the actual facts."
Jan Emerson, a spokesperson for the California Healthcare Association, praised the veto, adding, "We are not going to slack off. We remain very committed to having every hospital in the state adopting and implementing these guidelines" (Silber, Contra Costa Times, 9/23).
AB 2532, sponsored by Assembly member Loni Hancock (D-El Cerrito), would have required hospitals to use lift teams or special devices to move patients. The bill was introduced in response to a recent study that found 52% of all nurses complain of chronic back pain potentially related to lifting and repositioning patients (California Healthline, 9/8).
Schwarzenegger in his veto message said he rejected the bill because it would add to other "well-intentioned mandates that have been placed upon California hospitals in recent years," such as nurse-to-patient ratios and seismic retrofit requirements (Sacramento Bee, 9/23). Schwarzenegger added that the legislation was "laudable" and encouraged hospitals to review their lift policies and incorporate new technologies and machinery into construction or renovations (Gledhill, San Francisco Chronicle, 9/23).
The California Nurses Association, which supported the measure, said the bill would have saved hospitals money by reducing workers' compensation costs and other related expenses (Sacramento Bee, 9/23).
SB 1555, sponsored by Sen. Jackie Speier (D-San Mateo), would have required all health insurers in the state to cover maternity care under individual plans, expanding upon a federal law that requires insurers to cover maternity care for group insurance policies. Statewide, 284,000 privately insured people do not have maternity coverage, according to a study by the University of California's Health Benefits Review Program (California Healthline, 9/13).
"In one of his longest veto messages," Schwarzenegger said the bill presented a "difficult choice," but he concluded that the legislation would increase health insurance costs and possibly force people to pay for unnecessary services, the Times reports (Los Angeles Times, 9/23). Schwarzenegger said he wanted to protect consumer choice because affordable health insurance options were "paramount to decreasing the number of uninsured Californians" (Sacramento Bee, 9/23).
Speier called the veto "a serious setback for women's health in California" (San Jose Mercury News, 9/23). She added that the veto "gives a thumbs-up to discrimination against women and allows insurers to drop maternity care from basic coverage, in order to sell lucrative low-cost policies to target populations" (Los Angeles Times, 9/23).
AB 2874, sponsored by Assembly member Manny Diaz (D-San Jose), would have required hospital operators to announce closings 180 business days in advance and give communities the chance to bring facilities under local control (California Healthline, 9/9). The bill would have established penalties for hospitals that did not comply with the notification requirements.
Schwarzenegger also vetoed SB 1540, sponsored by Sen. Bob Margett (R-Diamond Bar) (San Jose Mercury News, 9/23). The bill would have required hospitals 90 days before closing to notify all emergency medical services providers in their service area in addition to other entities hospitals currently are required to notify (Bill text, 8/26).
Emerson said the governor's veto shows he "recogniz[es] that the hospital industry is in a crisis and we need help." Emerson added, "Passing bills that serve to penalize hospitals does nothing to improve patient care or help hospitals stay open."
Beth Capell, a policy consultant for HAC, said, "You can see a pattern here of the governor saying kind words about the need to recognize the interests of consumers, but then his actions side with hospitals who overcharge, hospitals that close with very little notice and insurance companies that engage in predatory behavior by marketing health insurance that does not include maternity care" (San Jose Mercury News, 9/23).