Latest California Healthline Stories
California Dental Care Crisis Could Get Worse With Budget
California has the second-lowest ranking for children’s oral health care in the nation, according to the National Survey of Children’s Health. Pre-schoolers have rotten teeth, oral infections and metal caps — and if proposed budget cuts go through, it could get worse.
Single Payer Bill Back in the Mix
The normally sedate audience at an Assembly health committee hearing broke into spontaneous applause last week as Senate member Mark Leno (D-San Francisco) stepped to the microphone. Leno was introducing SB 810, which would establish a single-payer health care system in California.
The burst of applause came from a busload of supporters in the hearing room. It has been a long, hard fight for single-payer advocates. Twice the idea has been approved by the state legislature, and twice it has been vetoed by the governor.
The single-payer system would bypass health insurance companies in California, handing the authority and responsibility of health care administration to the state. With passage of a national health care reform law, some expected the single-payer idea to wither on the vine. But at last week’s Assembly Health Committee hearing, it was alive and well.
Medi-Cal Waiver Gets Senate Committee Approval After Unusual Third Tier of Testimony
You know you’re in murky legislative territory when the format of a health committee meeting has to be changed to accommodate the complicated nature of the proposed bill.
In this case, it was AB 342 by John Perez (D-Los Angeles), which the Senate Health Committee eventually approved at its hearing last week. It is the companion Medi-Cal waiver bill to SB 208, which recently passed the Assembly Health Committee.
Usually, committees hear pro and con testimony, but for AB 342, Senate committee chair Elaine Alquist (D-Santa Clara) made a third category. “It’s a hybrid category just for this one bill,” Alquist said. “For those who are neither opposed nor support, but have concerns.”
Reform Bill Pushes Insurance Buttons
The California Legislature is working on many bills dealing with national health care reform — from major undertakings like setting up a health benefits exchange to more esoteric ones, like guaranteeing timely response to autism grievances.
Some generate hot debate, such as the give-and-take over proposed insurance changes during an Assembly Health Committee hearing this week.
At issue was SB 890 by Elaine Alquist (D-Santa Clara), which has three main provisions.
Law Would Mandate Maternity Coverage
The Senate Health Committee approved AB 1825 by Assembly member Hector De La Torre (D-South Gate) on Wednesday, which would force health insurance groups and plans to cover maternity services for women in California.
“It is similar to AB 98, which was vetoed by the governor last year,” Senate member Gloria Negrete McLeod (D-Chino) said. “It is four years till the (national health care) health exchange will open. Already we’ve seen a drop in coverage since 2007 from 22% to 19% coverage … and four more years will push many more women out of coverage.”
Maternity coverage particularly needs to be covered, Negrete McLeod said, because in many cases women don’t plan to become pregnant, and then find themselves scrambling to change their coverage to accommodate their now-preexisting condition.
Insurer Response Remains Key Story To Watch
The health industry’s focus is on HHS this week, as the department sprints to launch insurance portals and pools by key implementation deadlines. However, tensions between policymakers and private payers remain the long-term narrative to watch.
How Much Risk Will $761 Million Pay For?
The state legislature passed two bills yesterday that establish a temporary high-risk insurance pool. California currently has a high-risk pool system that handles 7,100 patients across the state. The new legislation would corral $761 million in federal funds over the next four years to create a significantly larger program.
High-risk pools are designed to insure those who can’t get health insurance. But that “uninsurable” bar is pretty low, according to legislative advocate Elizabeth Lansberg of the Western Center on Law & Poverty.
“Being uninsurable is not hard to achieve,” Lansberg said. “There are many people who just have high blood pressure or high cholesterol. But if you’re over 45 and have a pre-existing condition, it can be nearly impossible to get coverage.”
Big Week Ahead — and the Budget Looms
You’re going to see a lot of bills passed this week, at least through the committee phase of legislation. This is the final week, ending July 2, for laws to be approved out of committee, so legislators are likely looking at long, agenda-packed hearings.
For instance, the Senate Committee for Appropriations meets today (Monday), with a grand total of 96 items on its agenda. Good luck with that.
Also, July 1 is the beginning of the fiscal year, and that leads into the next deadline: passing a state budget.
Out-of-State Physician Reviews Questioned
It’s relatively common practice for utilization reviews — that is, a request for medical services reviewed to comply with treatment guidelines — to be conducted by out-of-state physicians.
A new law, SB 933 by Senate member Paul Fong (D-Cupertino), would end that practice.
On Wednesday, the Senate Labor and Industrial Relations Committee approved Fong’s bill. It is headed to the Senate floor for a vote … maybe. A policy review is under way to determine whether the bill should first go through the Appropriations Committee.
Despite Best Intentions, New Ratios Creating Problems
Requiring insurers to spend a certain amount on patient care was a widely acclaimed element of the health care overhaul. However, early efforts to set standards for medical-loss ratios are delayed, and resistance is growing. While some say industrywide MLR standards remain achievable, others are warning that it’s a “fool’s errand.”