DISABILITY HEALTH COALITION BILL STATUS REPORT
(July 17, 2008)
The following is the most recent updated report on the status of bills that are being monitored by the Disability Health Coalition:
AB 851 (Brownley): Medi-Cal: Extension of the California Working Disabled Program
STATUS: This bill was scheduled for a hearing on June 30, 2008 by the Senate Appropriations Committee. The committee voted to refer the bill to the Senate Appropriations Committee Suspense File. All bills that are referred to the Suspense File remain on “pending” status until a later hearing date when the bills are reviewed collectively and are either voted off the Suspense File for a Senate Floor vote or “die” by remaining with the committee.
DISCUSSION: This bill removes the “sunset date” for the Medi-Cal California Working Disabled (CWD) Program, thereby extending the program indefinitely. The bill also expands the eligibility criteria for the CWD program.
The original program required the Department of Health Services to adopt a federal option under which employed persons with a disability who meet specified income and resource requirements and are temporarily unemployed can remain eligible for Medi-Cal health care benefits for up to 26 weeks. These individuals are required to pay a premium, which is equivalent to 5 percent of his or her personal or spousal countable income. The monthly premiums range from $20 to $250 per month. Approximately 3,000 persons were enrolled in the CWD program in 2007-08.
The author carried a substantially similar bill last year (AB 1113) that was vetoed by the Governor. This bill makes changes in the original legislation that are designed to meet the Governor’s concerns and secure his signature.
AB 1887 (Beall): Health Care Coverage: Mental Health Services
STATUS: This bill was scheduled for a hearing on July 14, 2008 by the Senate Appropriations Committee. The committee voted to refer the bill to the Senate Appropriations Committee Suspense File.
DISCUSSION: This bill would expand mental health care coverage requirements for health care service plan contracts and health insurance policies issued, amended, or renewed after January 1, 2009 to specifically include coverage for the diagnosis and treatment of mental illnesses for persons of all ages. It defines mental illness as mental disorders defined in the Diagnosis and Statistical Manual IV. It does not apply to health care benefit plans under the Cal PERS system, unless its board elects to purchase such a plan, coverage, or policy.
The supporters argue that the bill is necessary to end discrimination against patients with mental health and substance abuse disorders and ensure that coverage for these illnesses is equivalent to the coverage for other medical illnesses.
SB 840 (Kuehl) : Single Payer Universal Health Insurance
STATUS: This bill was scheduled for a hearing on July 16, 2008 by the Assembly Appropriations Committee. The committee voted to refer the bill to the Assembly Appropriations Committee Suspense File.
DISCUSSION: This bill would establish the California Healthcare System (CHS), the “single payer” system that would prohibit any other health care service plan or health insurance policy from being sold in California and, instead, would provide health coverage to all California residents under the single payer system. The state government-operated system would be administered by the California Healthcare Agency, an independent agency that would be under the control of a newly appointed Healthcare Commissioner. CHS would be required, among other things, to implement eligibility standards, adopt health benefits, establish formulas for health care expenditure budgets, paying claims, negotiating prescription drug prices, and resolving consumer disputes.
According to most fiscal analyses, the statewide annual costs would exceed $200 billion and would help generate these costs by ending the current system of health coverage and providing for other financing through taxes, redirecting current health program funding, and securing state waivers to aggregate federal and local health care funds.
The bill is sponsored by the California Nurses Association and is supported by a broad coalition of consumer groups, labor unions, and health care groups that believe that the single payer system with provide universal coverage, reduce overhead, and improve the quality of health care coverage.
It is opposed by health plans and health insurers who argue that while a single payer system appears attractive, evidence from other nations illustrates that to outcomes supporters are putting forth are not achievable. Business groups oppose the payroll tax provisions they argue will increase the costs of doing business without any corresponding improvements in the quality of care for workers. It is argued that nations that have single payer systems eventually realize that the system is unaffordable and that they must make reductions in the delivery and quality of care.
SB 1198 (Kuehl): Medi-Cal: Durable Medical Equipment
STATUS: This bill was scheduled for a hearing on July 9, 2008 by the Assembly Appropriations Committee. The committee voted to refer the bill to the Assembly Appropriations Committee Suspense File.
DISCUSSION: This bill requires group health plans and insurers to offer coverage for durable medical equipment (DME) in parity with other health benefits; and copayments, coinsurance, deductible, and maximum out-of-pocket costs. The bill is co-sponsored by the Disability Rights Education and Defense Fund and Protection and Advocacy, Inc.
The bill’s mandate means that health plans must offer the DME benefit in a package during employer purchasing negotiations. It would reduce costs currently incurred by individuals and families who otherwise are required to absorb these costs. It also closes the gap between annual or lifetime DME caps for DME costs that may exceed those caps.
Opponents argue that the bill would increase employer premiums for group coverage by $120 million and would limit the ability of insurers and employers to offer a wide range of affordable insurance products to their consumers.
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FINAL NOTE: DHC had been tracking SB 1332 (Negrete-McCloud), that would have established a Medi-Cal Managed Care Pilot Project to require seniors and persons with disabilities in specified counties in her Senate district who are not expressly excluded from enrollment to enroll in a Medi-Cal managed care health plan.
Although this bill was included in the DHC issue briefing flyer, it was not heard and was not passed by the Senate Appropriations Committee at its scheduled May 22, 2008 hearing.
