Tag Archives: Tobacco

Legislative Recap on Health: #Health4All; Out-of-Pocket Costs; Medi-Cal, Etc.

The Senate and Assembly adjourned Thursday, one day ahead of the June 5th deadline to pass all bills out of the first legislative chamber. The good news is that most key bills of interest to health care consumers have passed out of the house of origin, while one bill, opposed by public health groups, was defeated. Bills moving forward deal with limits and protections against unfair out-of-pocket costs; efforts at improving Medi-Cal; and most notably a significant expansion of access to coverage for all regardless of immigration status.

These bills now head to the second half of the legislative process. For details on each bill, see our weekly bill matrix:

http://www.health-access.org/i…

Below the fold, full reports on:

* SB 4 To Take Historic Steps to #Health4All & Cover the Remaining Uninsured

* Patient Protection Bills To Limit Out-of-Pocket Costs

* Additional legislation on transparency, Medi-Cal, tobacco control, and more

SB4, THE FRAMEWORK FOR #HEALTH4ALL REGARDLESS OF IMMIGRATION STATUS

The most-watched health bill was SB4, the first bill to pass a state legislative body that would explicitly expand coverage regardless of immigration status. The California Senate passed SB4 on a historic and bipartisan vote, 28-11, with all Democratic senators and 2 Republican senators voting in support. This bill, which continues California’s path to #Health4All, moves on to the Assembly Health Committee for consideration.

With last week’s amendments in the Senate Appropriations Committee, SB 4 would:

* Expand Medi-Cal eligibility to all children regardless of immigration status, as an entitlement;

* Expand coverage for undocumented adults as budget allocations will allow (to be decided each year in the budget, and that enrollment will be capped if funding runs out).

* By way of a Section 1332 waiver (a formal request to the federal government), SB 4 would allow all Californians to purchase coverage through Covered California using their own money.

Senator Ricardo Lara, author of SB 4, called the vote “historic” and one that Senators will remember long after their term is over. “We are talking about our friends, our families, our neighbors. Illness doesn’t care about our immigration status,” said Lara, describing the bill as still “realistic, balanced, and fiscally prudent.”

Several Senators rose to speak during the floor debate. From the opposing side, GOP Senators Jeff Stone, Janet Nguyen, and Bob Huff raised concerns about cost, arguing that expanding Medi-Cal was a “false promise” until the program addresses access issues. Several Democratic Senators responded to that argument, including Senator Richard Pan who stated, “We certainly need to make fixes to Medi-Cal, but certainly being on Medi-Cal is better than being uninsured.” Senator Isadore Hall derided “excuses,” Senator Ben Hueso wanted focus on the issue at hand: “We have a solution on the table, and we should move it forward.” Senator Hernandez rebutted concerns about cost: “The most inefficient way to provide health care is through the emergency room-we all pay for it.”

The most noteworthy speech was by GOP Senator Andy Vidak announcing his support for the bill while also raising the need to address Medi-Cal access issues and federal immigration reform. He and another Central Valley Republican, Senator Anthony Cannella, were the two GOP Senators to vote for the bill. Senator Nguyen abstained, with the rest of the caucus voting no.

This issue is currently pending in Budget Conference Committee as a $40 million item in the Senate’s budget proposal. The next week or two will make a big difference in whether enrollment under SB4 would start in the budget year 2015-16.

BILLS LIMITING OUT-OF-POCKET COSTS

Four Health Access-sponsored consumer protection bills to prevent unfair out-of-pocket costs passed out of their “house of origin” this week and are heading to the second half and second legislative chamber in the weeks ahead. The remaining sponsored bill, AB 248 (Hernandez) on large employer junk insurance is further along in the process, having passed out of the Assembly several weeks ago.

* Requiring Accurate Provider Directories: SB 137 (Hernandez) would set standards for provider directories and establish more oversight on accuracy so people know whether their doctor and hospital are in network when they shop for coverage, change coverage, or try to use their coverage. SB 137 passed out of the Senate with bipartisan support. The final vote was 33-0.

* Preventing Surprise Bills: AB 533 (Bonta), which would protect patients from “surprise” bills from out-of-network doctors when they did the right thing by going to an in-network hospital, imaging center, or other facility, passed out of the Assembly with a vote of 74-1.

* Limiting Prescription Drug Cost Sharing: AB 339 (Gordon), which would prevent discrimination against consumers with health conditions by setting standards for cost sharing on prescription drugs passed out of the Assembly with a vote of 48-29.

* Capping Individual Out-of-Pocket Costs: AB 1305 (Bonta) on limitations on cost sharing in family coverage passed out of the Assembly with a vote of 78-0. This bill ensures that the ACA individual out-of-pocket maximum (now $6,600) will apply to individual patients-even if they are in a family plan (which has an overall family out-of-pocket max of $13,200).

* Prohibit Subminimum Coverage: AB 248 (Hernandez), which would prohibit sale of subminimum coverage by insurers to large employers passed out of the Assembly several weeks ago with a vote of 51-27 and will next be heard in Senate Health.

TRANSPARENCY

SB546 (Leno) would advance transparency in our health system by extending rate review to large group health coverage. This bill, which requires justification of above-average rate increases, passed out of the Senate with a vote of 23-16.

Other transparency bills faltered earlier this year, including SB 26 (Hernandez), which sought to create a health care cost and quality database, was held in Senate Appropriations Committee amid questions on how to finance it. Earlier in the process, AB 463 by Assemblyman Chiu to facilitate more disclosure on prescription drug costs was stalled in Assembly Health Committee. These efforts will likely be revisited in future years.

MEDI-CAL

Several bills designed to improve the Medi-Cal program, which now covers almost 12 million Californians, advanced out of their house of origin.

* SB 33 (Hernandez), which would limit estate recovery in Medi-Cal to the federally required minimum of long-term care services and eliminate recovery from the estate of a surviving spouse of a deceased beneficiary, passed out of the Senate with a vote of 33-0.

* AB 1231 (Wood), which would facilitate practical access to Medi-Cal specialty care through coverage of nonmedical transportation, also passed out with a vote of 76-0.

* AB 635 (Atkins), which would require the Department of Health Care Services to seek federal funding to establish a program to provide and reimburse for certified medical interpretation services to Medi-Cal beneficiaries with limited English proficiency, passed out of the Senate with a vote of 72-2.

* AB 366 (Bonta), which would require the Department of Health Care Services (DHCS) to report to the Legislature on Medi-Cal access passed out of the Assembly with a vote of 77-0.  Originally introduced as a measure to restore Medi-Cal provider reimbursement rates and bring them up to Medicare levels in future years, this bill came out of the Appropriations Committee’s suspense hearing significantly scaled back in scope. A companion measure SB 243 (Hernandez) was held in Appropriations during the suspense hearing and is not moving forward.

TOBACCO CONTROL

A handful of bills aimed at the negative health impacts of tobacco use passed, including SB 151 (Hernandez) to raise the smoking age from 18 to 21. SB 140 (Leno), which would revise the definition of tobacco products to include e-cigarettes, thus subjecting such products to the same regulations as other tobacco products, passed out of the Senate with a vote of 25-12.  Public health groups, including the Heart Association, Lung Association, and Health Access supported that measure and opposed the related bill SB 24 (Hill), which did not classify e-cigarettes as tobacco. Research suggests that e-cigarettes have much the same negative effect as cigarettes. SB 24 (Hill) failed passage.  

OTHER KEY CONSUMER BILLS

A full matrix of the latest on all active bills supported by Health Access and other health and consumer advocates is available online (here). That list includes ACA implementation legislation like SB 43 (Hernandez), which would extend the sunset date on essential health benefits standards from 2016 to 2018 and incorporate recent changes in federal guidance regarding habilitative care (services that help you keep, learn, or improve skills and functioning for daily living); AB 1117 (Garcia) would help bring more resources to Medi-Cal to improve immunization rates for 2-year-olds and AB 1299 (Ridley-Thomas) seeks to improve the delivery of mental health services for foster youth.

WHAT’S NEXT?

Now that these bills have passed the critical house of origin deadline, they will next be heard in the “other house,” meaning if the bill was introduced in the Assembly, it will be heard in the Senate, and if the bill was introduced in the Senate, it will be heard in the Assembly. Committee hearings will resume on June 8th. Policy committees have until July 17th to meet and report bills out of committee.

This blog entry is cross-posted at http://blog.health-access.org. It was written by Sawait Hezchias-Seyoum, Health Care Policy Advocate, Health Access. Stay tuned for tools and talking points to bring these bills to the finish line.  

San Francisco Fights Tobacco Companies

Tomorrow, San Francisco’s City Attorney’s office goes up against the legal powerhouse that is the team of lawyers that Phillip Morris brings to bear in pretty much any suit.  To summarize, the City banned the sale of tobacco products in pharmacies.  Phillip Morris was pretty pissed about that.  Not having any legal claim that makes sense to the random joe off the street, they went with the jack of all trades: The First Amendment.

Yes, you read that right, Big Tobacco thinks that we here in SF are stifling their freedom of speech by not allowing them to sell their poisonous products in outlets that are supposed to be geared towards health. Unsurprisingly, the lower court smacked down that argument. Big Tobacco appealed, and they are now going before 9th Circuit Judge Alex Kozinski (as well as Judges Reinhardt and Hug), always an entertainer in his own right.

“Consumers ought to have a reasonable expectation that drugstores will serve their health needs, not enable their deadliest habits,” said City Attorney Dennis Herrera.  “San Francisco’s elected officials have a legitimate right to protect the public health, and there is nothing about the City’s ban on tobacco sales in pharmacies that impinges on the tobacco industry’s First Amendment rights.”

The hearing is at 9:30 tomorrow morning.

Is Your Legislator Taking Money From Big Tobacco?

Over 40,000 Californians die every year from tobacco smoking, nearly one-fifth of all of the deaths that occur in the state.  That’s 17 times the 2,500 California homicides.  That’s ten times the 4,100 Californians who will die of breast cancer this year.  Despite decreases in smoking rates, tobacco use remains the state’s leading public health emergency.

What, therefore, can you say about an elected official who takes campaign contributions from the industry that needs, for its survival, that that public health emergency continue unabated and thus needs a favorable regulatory climate in Sacramento?

A new report from the American Lung Association of California details the bribes donations that Big Tobacco gave to legislators and candidates during 2005-6.

Big Tobacco gave $130,700 to 2005-6 Senators, $24,900 (19.1%) to Democrats and 105,800 (81.9%) to Republicans.

Big Tobacco gave $366,823 to 2005-6 Assemblymembers, $75,200 (20.5%) to Democrats, and $291,623 (79.5%) to Republicans.

Big Tobacco gave $98,500 to incoming 07-08 freshmen legislators, $50,100 (50.9%) to Democrats and $48,400 (49.1%) to Republicans.

Big Tobacco spent $2,160,864 on lobbying during the 2005-6 Term.  Philip Morris spent $884,694, RJ Reynolds spent $598,507, US Smokeless Tobacco spent $391,137, Lorillard spent $187,202, and the California Distributors Association spent $99,324. 

You can look at the report for the details, but I have compiled the data into lists sorted by party and whether the legislator or candidate took Big Tobacco money during 2005-6.  Please contact your legislator to let them know that you either appreciate that they did not take Big Tobacco’s money or to urge them to cease doing so.

Senate Democrats who took no Big Tobacco money during 2005-6:

Alarcon, Richard (no longer in Senate)
Alquist, Elaine
Bowen, Debra (no longer in Senate)
Cedillo, Gilbert
Chesbro, Wesley (no longer in Senate)
Corbett, Ellen (new in 07-08)
Dunn, Joseph (no longer in Senate)
Escutia, Martha (no longer in Senate)
Figueroa, Liz (no longer in Senate)
Kehoe, Christine
Kuehl, Sheila
Lowenthal, Alan
Ortiz, Deborah (no longer in Senate)
Padilla, Alex (new in 07-08)
Perata, Don
Romero, Gloria
Scott, Jack
Simitian, Joe
Soto, Nell (no longer in Senate)
Speier, Jackie (no longer in Senate)
Steinberg, Darrell (new in 07-08)
Torlakson, Tom
Wiggins, Patricia (new in 07-08)

Senate Republicans who took no Big Tobacco money during 2005-6:

NONE

Senate Democrats who took Big Tobacco money during 2005-6:

Correa, Lou ($4,300) – new in 07-08
Ducheny, Denise Moreno ($4,300)
Florez, Dean ($8,600)
Machado, Michael ($1,000)
Migden, Carole ($4,300)
Murray, Kevin ($3,400) (no longer in senate)
Vincent, Edward ($3,300)

Senate Republicans who took Big Tobacco money during 2005-6:

Aanestad, Sam ($6,600)
Ackerman, Richard ($9,300)
Ashburn, Roy ($7,050)
Battin, Jim ($8,300)
Cox, Dave ($8,600)
Denham, Jeffrey ($4,300)
Dutton, Robert ($9,100)
Harman, Tom ($9,600)
Hollingsworth, Dennis ($5,300)
Maldonado, Abel ($3,300)
Margett, Bob ($3,300)
McClintock, Tom ($11,550)
Morrow, Bill ($2,600) (no longer in Senate)
Poochigian, Charles ($8,100) (no longer in Senate)
Runner, George ($8,800)

Assembly Democrats who took no Big Tobacco money during 2005-6:

Arambula, Juan
Bass, Karen
Beall Jr., Jim (new in 07-08)
Berg, Patty
Bermúdez, Rudy (no longer in Assembly)
Brownley, Julia (new in 07-08)
Chan, Wilma (no longer in Assembly)
Chavez, Ed (no longer in Assembly)
Chu, Judy (no longer in Assembly)
De La Torre, Hector
de Leon, Kevin (new in 07-08)
DeSaulnier, Mark (new in 07-08)
Dymally, Mervyn
Eng, Mike (new in 07-08)
Evans, Noreen
Feuer, Mike (new in 07-08)
Frommer, Dario (no longer in Assembly)
Goldberg, Jackie (no longer in Assembly)
Hancock, Loni
Hayashi, Mary (new in 07-08)
Hernandez, Edward (new in 07-08)
Huffman, Jared (new in 07-08)
Jones, Dave
Karnette, Betty
Klehs, Johan (no longer in Assembly)
Koretz, Paul (no longer in Assembly)
Krekorian, Paul (new in 07-08)
Laird, John
Leno, Mark
Levine, Lloyd
Lieber, Sally
Lieu, Ted
Liu, Carol (no longer in Assembly)
Matthews, Barbara (no longer in Assembly)
Montañez, Cindy (no longer in Assembly)
Mullin, Gene
Nation, Joe (no longer in Assembly)
Nava, Pedro
Oropeza, Jenny (no longer in Assembly)
Pavley, Fran (no longer in Assembly)
Portantino, Anthony (new in 07-08)
Ridley-Thomas, Mark (no longer in Assembly)
Ruskin, Ira
Saldaña, Lori
Salinas, Simon
Salas, Mary (new in 07-08)
Solorio, Jose (new in 07-08)
Vargas, Juan
Wolk, Lois

Assembly Republicans who took no Big Tobacco money during 2005-6:

Nakanishi, Alan
Richman, Keith (no longer in Assembly)

Assembly Democrats who took Big Tobacco money during 2005-6:

Baca Jr., Joe ($8,700) (no longer in Assembly)
Caballero, Anna ($3,300) – new in 07-08
Calderon, Charles ($14,400) – new in 07-08
Calderon, Ronald ($15,100) (no longer in Assembly)
Canciamilla, Joseph ($3,300) (no longer in Assembly)
Carter, Wilmer ($3,300) – new in 07-08
Cohn, Rebecca ($500) (no longer in Assembly)
Coto, Joe ($6,600)
Davis, Mike ($3,300) – new in 07-08
Galgiani, Cathleen ($3,300) – new in 07-08
Horton, Jerome ($10,900) (no longer in Assembly)
Karnette, Betty ($1,000)
Ma, Fiona ($3,300) – new in 07-08
Mendoza, Tony ($1,000) – new in 07-08
Negrete McLeod, Gloria ($8,600)
Núñez, Fabian ($3,300)
Parra, Nicole ($7,600)
Price, Curren ($6,300) – new in 07-08
Richardson, Laura ($3,300) – new in 07-08 (on her way to Congress)
Swanson, Sandre ($4,300) – new in 07-08
Torrico, Alberto ($2,000)
Umberg, Tom ($3,300) (no longer in Assembly)
Yee, Leland ($4,300) (no longer in Assembly)

Assembly Republicans who took Big Tobacco money during 2005-6:

Adams, Anthony ($3,300) – new in 07-08
Anderson, Joel ($5,300) – new in 07-08
Aghazarian, Greg ($9,100)
Benoit, John ($11,600)
Berryhill, Tom ($6,600) – new in 07-08
Blakeslee, Sam ($6,600)
Bogh, Russ ($13,118) (no longer in Assembly)
Cogdill, David ($14,800) (no longer in Assembly)
Cook, Paul ($3,300) – new in 07-08
Daucher, Lynn ($7,700) (no longer in Assembly)
DeVore, Chuck ($8,900)
Duvall, Michael ($4,300) – new in 07-08
Emmerson, Bill ($8,100)
Fuller, Jean ($4,300) – new in 07-08
Garcia, Bonnie ($17,028)
Gaines, Ted ($4,800) – new in 07-08
Garrick, Martin ($3,300) – new in 07-08
Haynes, Ray ($5,300) (no longer in Assembly)
Horton, Shirley ($11,350)
Houston, Guy ($12,600)
Huff, Bob ($7,600)
Jeffries, Kevin ($3,300) – new in 07-08
Keene, Rick ($12,850)
La Malfa, Doug ($13,350)
La Suer, Jay ($3,300) (no longer in Assembly)
Leslie, Tim ($1,500) (no longer in Assembly)
Maze, Bill ($8,100)
McCarthy, Kevin ($9,778) (no longer in Assembly)
Mountjoy, Dennis ($5,800) (no longer in Assembly)
Niello, Roger ($5,300)
Plescia, George ($20,699)
Runner, Sharon ($9,800)
Silva, Jim ($3,300) – new in 07-08
Smyth, Cameron ($6,600) – new in 07-08
Spitzer, Todd ($10,100)
Strickland, Audra ($14,350)
Tran, Van ($7,600)
Villines, Mike ($13,600)
Walters, Mimi ($8,600)
Wyland, Mark ($13,100) (no longer in Assembly)