Committees Talk Health, Move Budget
In passing the May revision out of the Assembly and Senate budget committees, a raft of legislators raised questions about the funding of health care programs, both present and future.
“This has been an arduous process, I must say,” Assembly member Holly Mitchell (D-Los Angeles) said. “We have had to make some tough decisions — with almost half of the March actions, half of those March cuts coming out of health and human services. These are services that Californians rely on.”
The current budget revision includes more cuts to health-related programs, including the shift of 870,000 children from the Healthy Families program to Medi-Cal managed care.
Adult Day Health Care on Track?
Adult day health care is like the Polly Purebred of the California budget process — always in calamity, always one sinister flick of the mustache away from disaster.
Well, for the moment anyway, it looks like ADHC actually might be untied and lifted off the budget train tracks.
“We’re going to focus all our attention now on the governor,” Lydia Missaelides of the California Association of Adult Day Services said. “So he understands what’s at stake here.”
Basic Care, Medical Home, Home Care Act All Clear First Hurdle
A number of health care-related bills just met the deadline for passage out of house of origin. In a way, it’s a litmus test for whether or not bills have the political capital to become law, and quite a few health proposals made the initial cut.
The bills recently passed by the Assembly now head to the state Senate, and vice versa. Beyond the high-profile AB 52 by Mike Feuer (D-Los Angeles) to regulate health insurance rate hikes, there were several health-related bills that moved on:
Health Reform Legislation Regularly Assailed
Last week’s deadline to get legislation through the Assembly and Senate saw a number of big-ticket health care proposals make their way through the Legislature — including one bill to regulate rate hikes by health insurers, and another to launch a new kind of basic health care insurance program in California.
Many of the health-related proposals — especially ones that had anything to do with meeting federal guidelines for implementation of the federal health reform law in 2014 — met with resistance, skepticism and sometimes derision.
Assembly Sends Health Insurance Regulation Bill on to Senate
Assembly Republicans really didn’t want to hear about AB 52 yesterday.
First there was a motion to block the bill to regulate health insurance rate increases because bill language had been amended the day before. The Assembly voted to reject that objection by waiving the one-day waiting period.
Then Assembly member Curt Hagman (R-Chino Hills) balked at hearing the bill a little earlier in the agenda. “I know we lost the motion to bring this up [in the first place],” he said, “but this is also out of order at this point.”
Should Insurance Companies’ Rates Be Regulated?
To get a picture of how much political heat AB 52 generates, you only have to look at its last committee hearing.
The bill, which would allow California’s Department of Insurance to review and limit the size of health insurers’ rate hikes, is expected to hit the Assembly floor for a vote today.
Last Friday, AB 52, by Assembly member Mike Feuer (D-Los Angeles) was up for a do-pass in the Assembly Committee on Appropriations. Those affairs are generally quick, without much fanfare — because so many bills go through Appropriations, the actual voting on all of the do-pass bills is rapid-fire.
Health Officials, Public Hospitals at Odds Over Fee
The state says it’s just shifting money around, and that everyone benefits from new federal financing tools known as CPEs — certified public expenditures.
Under the recent federal Medicaid waiver, California can get up to $400 million in federal funds for state-only programs, according to Toby Douglas, director of the California Department of Health Care Services. These are programs licensed or certified by the state providing care and services to a designated population, such as adult day health care or developmental disability care. Public hospitals provide some state-only services, and submit these certified public expenditures, or CPEs, to get federal matching funds.
“But we don’t have enough state-only expenditures, and public hospitals have expenditures beyond what they can get from the waiver,” Douglas said. “We can roll over that money … they get more federal funds, and we get to use their excess certified public expenditures to reach the $400 million mark.
‘Budget Dust’ Councils May Get Second Life
Three health care advisory committees were on the May revise chopping block, but now an Assembly subcommittee has voted to keep them.
When Assembly member Allan Mansoor (R-Costa Mesa) found out that one of the commissions up for elimination — the California Commission on Emergency Medical Services — was composed entirely of volunteers who are experts in their field, and that the state pays only for travel expenses for a grand total of $9,000 a year, he wondered aloud about the urgent need to disband it.
“If we’re going to review a commission,” Mansoor said, “let’s find one with a few more zeroes after it, maybe we want to find a more expensive commission to eliminate.”
Careful Steps in Dismantling Mental Health Agency
It’s a big move, eliminating an entire department of important state services.
Over and over yesterday, in two separate health and human services budget subcommittee hearings, officials insisted that eliminating the California Department of Mental Health was not a diminishment of services, but rather a reorganization.
“There are ways we can create better efficiencies, better ways of integrating behavioral and physical health,” Toby Douglas of the Department of Health Care Services said. “It will happen gradually, it will happen over the next year. We want to work with the Department of Mental Health, to make mental health an essential component of health care delivery.”
Wet Protest, Dry Policy in Capitol
Diana Dooley summed it up nicely.
“First of all, I wanted to thank you all for the heavy lifting you did in March,” the secretary of California’s Health and Human Services Agency said yesterday in addressing members of a budget subcommittee on health and human services.
“These were difficult proposals to make, and difficult ones to respond to,” she said.
“And, regrettably, it’s not enough.”