2003-10-18 -- California Healthcare Legislative Update

HEALTH ACCESS UPDATE Tuesday, November 18th, 2003

HEALTH CARE AT CROSSROADS

* Appointments from the Gubernatorial Transition: Health Care Hints

* Continued Work Needed to Expand Health Coverage: Nov 6th Advocates
Mtg to Implement SB 2

* Medicare Debate Set for Showdown: Will Privatization Pass?

GOVERNOR'S APPOINTMENTS: HINTS OF A HEALTH AGENDA

Since Governor-elect Arnold Schwarzenegger rarely mentioned health
care in his campaign, and he has no public record on the subject, very
little is known about his positions on the key health policy issues of
the day.

His appointments have been scrutinized to figure out how he will deal
with health care issues. His transition team of more than 60 people,
while notable for the wide breadth of experience and diversity, was
sorely lacking in major leaders from the health world, either from
industry, academia, or advocacy circles.

However, his two most important important appointments--transition
finance director and chief of staff--raise serious concerns.

         TRANSITION FINANCE DIRECTOR: Donna Arduin

Schwarzenegger asked Donna Arduin, on loan from Florida Governor Jeb
Bush's finance staff, to conduct an overall   audit of California's
budget and make recommendations. According to Florida advocates, Ms.
Arduin is known for advocating major cuts to health and social
services.

* Under her direction, Florida has made cuts that have been rejected
here in California, including lowering the eligibility for adults on
Medicaid from 100% to 88% of the federal poverty level, and
eliminating Medicaid coverage for adults for such benefits as dental
care, vision care, and hearing aids.

* Other cuts made in Florida by Ms. Arduin have not even been proposed
here in California. Florida has capped enrollment in their Child
Health Insurance Program (called KidCare), which has so far denied
coverage 60,000 children who are now on a waiting list; increased
co-payments on prescription drugs, medical transportation, and
non-emergency use of the emergency room; and increased premiums on
families in KidCare. She also proposed to eliminate medically needy
program in Medicaid, but this last suggestion was rejected.

         CHIEF OF STAFF: Patricia Clarey

Last week, the Governor-elect announced that HMO senior executive
Patricia Clarey would be named as his chief of staff. Clarey worked in
the first President Bush's Administration and then as deputy chief of
staff in Governor Wilson's Administration. She then went off to
Transamerica Insurance before becoming vice president for governmental
affairs at Health Net, one of the large California HMOs.

Her appointment, combined with the dominance of the Wilson team that
opposed HMO reform, raises serious questions about the future of HMO
reform and the Patients Bill of Rights, including the continued
enforcement of these important consumer protections.


HEALTH EXPANSIONS: DEFENSE AND OFFENSE: SB 2 (Burton)

With the signing of SB 2 (Burton), to extend health coverage to over
one million uninsured workers and their families, advocates for the
uninsured have significant work to do in order to make the promise a
reality. Here's some work to defend, implement, and expand SB 2.

* DEFEND: The Chamber of Commerce and a few other business
organizations are beginning a petition drive to get a ballot
referendum to repeal SB 2. They are paying $2 a signature to collect
the more than 373,816 signatures needed to qualify the referendum for
the ballot, either on the March or November 2004.

Most voters get their health coverage through their employer, and
polls have shown that voters are strongly supportive of the concept of
SB 2, even after opposition arguments are read. Especially with the
increased coverage of health care labor disputes in Southern
California, voters may very well want the protections in SB 2 to
preserve the coverage they have. However, the campaign to repeal SB 2
is likely to rely on misinformation and scare tactics, as the name of
the campaign--Californians Against Government Run
Healthcare--suggests. More information on this effort will follow.

* IMPLEMENT: The bill has a two-year implementation process that
includes multiple agencies. Last Wednesday, the Managed Risk Medical
Insurance Board (MRMIB) started its deliberations on how to implement
SB 2, including putting out a list of issues for consideration
regarding implementation that they are seeking comment on. They will
finalize the list of issues at their next meeting.

Advocates for the uninsured are invited to a planning meeting on SB 2
implementation on Thursday, NOVEMBER 6th, 2003, at 2:00PM in
SACRAMENTO. This "Faces of the Uninsured" convening will be a strategy
session to plan and figure out all the ongoing work that will be
needed to make the promise a reality, including the policy work of
implementation at six agencies, especially given the new
administration. Location to be announced. Please RSVP to Anthony
Wright, Health Access, at awright@health-access.org. Transportation
subsidies are available for those organizations who need them.

* EXPAND: Even as SB 2 is defended and implemented, the work toward
universal coverage needs to continue. SB 921 (Kuehl), to establish a
universal health care system, is currently awaiting a hearing in the
Assembly Health Committee with a probable hearing date in March.
Continued advocacy is needed to expand the organizations in support of
universal health care, and to urge Assembly legislators to support
this proposal.



 ADVOCATES MOBILIZE AGAINST MEDICARE BILL

The U.S. Congress continues to debate the particulars of a Medicare
prescription drug bill, now pending in conference committee. Over 40
Democratic and Republican Senators have expressed serious concerns
about the details of the final product, over a number of key issues.
Health Access California has opposed both H.R. 1 and S. 1. Both bills
provide little relief to many seniors, and actually would cost
hundreds of thousands of seniors more than they pay today for
prescription drugs. More disturbingly, the bills--particularly the
House legislation--would lead to the privatization of Medicare.
Several other issues and problems have been raised by senior and
consumer advocates with the content of the bill.

It is likely that the Congress will make a decision and vote on a
proposal in the next two weeks. Health advocates should contact
Senator Barbara Boxer and Senator Diane Feinstein to urge them to
OPPOSE any proposal that does not provide real relief to seniors, and
that leads toward the privatization of Medicare.

For more information, see the following websites:

Campaign for America's Future:
http://www.ourfuture.org/issues_and_campaigns/medicare/index.cfm

Alliance for Retired Americans:
http://www.retiredamericans.org/rxbill/overview.htm

Families USA:
http://www.familiesusa.org/site/PageServer?pagename=Medicare_Index

Anthony E. Wright
Health Access
1127 11th St., #234,
Sacramento, CA 95814
Ph: 916-442-2308,
Fx: 916-497-0921
awright@health-access.org