Latest California Healthline Stories
Dooley Hopeful, Realistic on Health Care Changes
California’s recently appointed secretary of Health and Human Services, Diana Dooley, sat down with us this week to talk about the present and future of health care in California. The full story and interview will appear Thursday in California Healthline’s Feature section.
Dooley knows this is a pivotal time in California’s history in terms of health care policy. As the first in the nation to start a health benefits exchange as mandated under the health reform law, California is poised not only to revamp its own complicated and arcane health care system, but also possibly to influence the way the rest of the nation approaches health reform.
But how all of that will play out over the next three or four years is not the only thing on the new secretary’s plate.
Proposal Sends Shiver Through Health Agencies
The budget proposed by the governor yesterday, which includes deep cuts to health care programs in California, is unlikely to be passed in its current form, political experts said.
Legislators have made it clear that they most likely will wait for incoming Governor Jerry Brown to take office in January before taking on the latest budget shortfall. And legislative leaders have expressed support for health and human service programs: from contributing an amicus brief last week to a lawsuit that would reverse cuts in mental health programs, to lobbying for repeal of Schwarzenegger’s line-item vetoes last month of many human services programs.
But whether or not any of the proposed budget cuts happen, the latest budget reduction plan is a huge red flag to health care advocates.
How California’s Health Care Landscape Is Shifting
At a panel discussion in Sacramento yesterday, the line of the day belonged to Louise McCarthy, head of governmental affairs for the Community Clinic Association of Los Angeles County.
The phrase “elephant in the room” kept coming up throughout the discussion, and usually it referred to some health care money owed and not being paid by the state.
“It’s not an elephant in the room we’re dealing with,” McCarthy said. “It’s more of a pachyderm party right now.”
Dealing with Continual, Constant Cuts
“Well, I have to tell you, I’m looking forward to getting paid again.”
That’s the summary reaction to passage of the state budget from Dave Jones, CEO of Mountain Valleys Health Centers up north in rural Lassen County.
“We are all relieved to have a budget,” he said.
Decision Time in Governor’s Office
This is the week. After months of debates and votes by the state Assembly and Senate, hundreds of bills were passed and sent on to the governor for his signature.
And those bills are still waiting for a signature. In part, that’s due to the absence of a state budget. But now, the governor has just four more days to sign or veto the pile of bills in front of him. The deadline is Thursday, Sept. 30.
There are several dozen health care bills pending, including many that reinforce or help implement the national health reform law. The governor is expected to sign most of them — but that doesn’t mean there hasn’t been a behind-the-scenes battle raging over some of them.
How Budget Morass Could Spring One Bill From Limbo
The Assembly and Senate both passed a bill on the last day of the legislative session, but it ended up being put on hold after Republicans closed ranks and refused to approve it on concurrence.
According to the state’s Chief Clerk, E. Dotson Wilson, it is currently the only bill that could get a re-vote when the Legislature gathers to decide on the budget. AB 1542 by Dave Jones (D-Sacramento) would encourage establishment of patient-centered medical homes.
“Because it has an urgency clause, it is eligible to be taken up again when the legislature votes on the budget,” Wilson said. “There is a window there.”
Legislature Approves Health Care Bills
The days are dwindling down to a precious few. By next Tuesday, the state legislature must approve or reject all the bills on its docket.
That means it has three more days to vote.
Many bills have passed this week, but several high-profile bills are still hanging, and expected to be heard and voted on today.
Medi-Cal Crunch Looms for Community Clinics
The budget is about seven weeks late now. Without a budget, the state can’t keep writing Medi-Cal checks to health care providers. And that budget crunch begins today, when the last Medi-Cal checks go out to community clinics throughout California.
Without that $43 million every two weeks, those clinics will be in big trouble, according to Carmela Castellano-Garcia, president and CEO of the California Primary Care Association (CPCA).
“That means clinics are not going to receive 50% to 80% of their revenue, so they’ll be in a challenging financial situation,” Castellano-Garcia said. “This budget stalemate is going to have significant impact on them.”
Committees Move Health Bills Forward
It is sausage-making time in Sacramento.
It’s the time where intense behind-the-scenes lobbying is going on over the many dozens of bills being held in suspense in the Assembly and Senate appropriations committees.
These are bills that require a certain amount of funding, so they can’t all go on to a floor vote in the state legislature. As one staffer put it, critical decisions have to be made here, because the state has more bills than money.
Anthony Wright — executive director of Health Access and a veteran observer of the California Legislature — acknowledges that health care politics in Sacramento have changed a bit because of national health care reform, but he’s quick to add this is not a time for health advocates to sit back on their heels.
“It can always get worse,” Wright said, adding, “And without new revenues, it will get worse.”
Wright said Democrats are on the right track by identifying new sources of money in their budget proposal announced this week.