David Gorn

Insurers, Advocates Face Off Over Rate Regulation

Assembly member Mike Feuer (D-Los Angeles) said the issue boils down to this:

“In the United States, health care costs went up 3.4% last year. At the same time in California, health care premiums went up by as much as 39%,” Feuer said. “Medical costs are going up, no question. But premium costs are going up much more quickly, and that’s the gap we’re trying to bridge here.”

That’s the point of AB 52, heard yesterday in the Assembly Committee on Health. The bill was co-authored by Feuer and Jared Huffman (D-San Rafael) to give the state’s insurance commission the power to review premium rate hikes by health insurers, and to limit them if they’re deemed excessive.

Series of Proposals for Community Health Improvement

When it comes to improving the health of a large pool of Californians, small steps can yield big cumulative results. That’s the idea behind a series of proposed laws that are coming before committees in the next two weeks — and part of an overarching plan to get health considerations included in land-use and other policies on the Capitol’s daily agenda, according to Ellen Wu of the California Pan-Ethnic Health Network.

“The state can pass laws and [convene] task forces,” she said, “that can change all of our policies so that they incorporate health.” For instance, she said, when you’re planning some kind of development, make sure multi-lane roads don’t run alongside schools or hospitals.

A few of the bills on tap:

Four Rallies for Children’s Health Across California

Enough is enough, according to Kelly Hardy, director of health policy at Children Now.

First there was the $12 billion in state budget cuts that will hit the Medi-Cal, First Five and Healthy Families programs. More recently, a federal proposal would trim $480 billion nationally from Medicare and Medicaid.

And now state legislators are back at the drawing-and-quartering board, mulling an all-cuts budget that could slash another $15.4 billion.

Dealing With a Taboo Problem in Asian Community

Asian American girls have the highest rates of depressive symptoms of any racial/ethnic or gender group, according to a study released last month by the National Alliance for Mental Illness. Asian Americans are at a high risk for many other mental health issues — including higher rates of suicide deaths among young women and older women in the Asian community.

California has the largest Asian American population in the nation, by far. A conference is being convened today in Los Angeles to address the issue.

“The quality of mental health care provided to ethnic minority groups is inadequate,” conference keynote speaker Stanley Sue said. “There is a paucity of research, especially rigorous research such as clinical trials, on treatment outcomes for ethnic minority groups.”

Dooley Named Interim Chair of Exchange Board

About 150 people crammed an auditorium in Sacramento to be part of history: The California Health Benefits Exchange board met for the first time — the initial big step toward implementing the first reform-prompted insurance exchange in the nation.

“If we succeed, we will set the health care reform agenda for the rest of the nation,” board member Susan Kennedy said. “If we fail, we will precipitate the downfall of it nationally. And we are fully committed to seeing it succeed.”

The first day of the board was a busy one.

Authorization Delays Targeted by Senate Bill

The Senate Committee on Health approved a bill last week that would cap administrative delay at 48 hours for prescription authorization.

The reasoning is simple behind SB 866 by Ed Hernandez (D-West Covina), according to  Liz Helms, chair of the California Chronic Care Coalition.

“In representing more than 16 million people with chronic conditions in California, you can imagine how many medications that these people are taking,” Helms said, “and what a barrage of prior authorizations that face them when they’re trying to get their medication in a timely manner.”

Senior Care Facility at Issue

Planners of a new congregate care facility in Santa Barbara who want to build an 18-bed facility needed a waiver from the state to go beyond the area’s 12-bed limit. The state denied the waiver.

Now comes SB 177 by Tony Strickland (R-Moorpark), which would reclassify the area so the new facility can have 18 beds rather than its current 12-bed allowance.

“This is a bill that lowers the population threshold from 500,000 to 400,000 that triggers the 12-bed limit,” Strickland said.

Research Geared to Real-World Results

Francis Collins is on the cusp of something big. Several somethings big.

Collins, director of the National Institutes of Health, told journalists about a number of possible breakthroughs in clinical and policy breakthroughs during the Association of Health Care Journalists annual conference in Philadelphia.

“This is a golden era in terms of understanding disease,” Collins said. “But there is still a daunting gap between fundamental knowledge and application of that knowledge.”

New Senior Home Worker Law: Protection or Intrusion?

A vast workforce in California has gone unregulated and unmonitored — and that could be a danger to the seniors they are supposed to help.

That’s the gist of a new law passed this week by the Senate Committee on Health. SB 411 by Curren Price (D-Inglewood), the Home Care Service Act of 2011, would require background checks and elementary care instruction for all workers who help out in seniors’ homes.

“Without background checks or training, anyone can be a home health worker,” Price said. “And that could leave some seniors vulnerable to fraud and abuse.”

Trying To Bridge Gap Between Direct Hiring, Access

It’s a bill that keeps coming up — by the same author three years in a row, and in three different forms in the previous legislative session. But this time around, Assembly member Sandré Swanson (D-Alameda) swears it will be different.

And for one day, at least, it was.

Swanson’s bill, AB 1360, on Monday passed out of the Assembly Committee on Business, Professions and Consumer Protection on a 5-3 vote. It now heads to the health committee. It’s a bill that attempts to address the shortage of physicians in underserved and rural areas by allowing some hospitals in those districts to hire them directly. The idea is medical facilities would be better able to attract physicians — particularly primary care doctors — if they were allowed to negotiate directly with them.