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.  

DIANA CONTI FOR ASSEMBLY 2014

    “Because California Deserves Better”

College of Marin Trustee Diana Conti  is running for Assembly because she believes California and the 10th District needs someone who will stand up for a good affordable education for all, including higher education that will prepare our young people for the good well-paying jobs of the 21st century, that our coastline is a resource for all Californians and not something to be exploited by oil companies and large developers and that special interests have too much influence on who makes our laws in California.  She would fight for a true single payer system in California.

“California is in a crisis,” said Conti. “With a drought, the specter of fracking and loss of funding for essential services such as education and parks, and the true crisis in trust and confidence in our legislators felt by a majority of California.

“We need someone strong enough to stand up to special interests in the legislature, and experienced and practical enough to work for consensus,” said Conti. “This means a government that is focused on the needs of the people of the state, not the needs of special interests and big contributors; all people deserve the right to live with dignity and know they can have a safe place to live, a good education for their children and jobs that are meaningful and pay a living wage,” stated Conti, currently in her second term as a trustee for the College of Marin.

As a College trustee, Diana has seen the devastation that lack of funding and the loss of courses students need to succeed can have. She has worked to build consensus with her Board colleagues and the surrounding community in the expenditure of bond funding for new classrooms and infrastructure improvements.

Conti has been called a “pragmatic peacemaker,” a description that has served her well in her career working with social service agencies in both Marin and Sonoma and the non-profits she has led, such as in her former position as Deputy Drug Program Administrator for the County of Sonoma, executive director of the Marin Institute, and Executive Director of the Novato Human Needs Center.

She currently is CEO of Parca, an organization that helps people with developmental disabilities and their families and serves on the Board of West Bay Housing Development Corporation (housing for people with special needs). She is a member of the Governing Council, and past Executive Board member, of the American Public Health Association.

Contact Diana at 415-990-8798 or email her at [email protected]

See her Facebook page at http://tinyurl.com/n3eqwhp

 

by Steve Smith, California Labor Federation

It’s easy to be pessimistic about the future these days. Tea Party extremists are threatening to push our federal government into default. Federal immigration reform is on the back burner until the shutdown and debt ceiling messes are sorted out. In a host of states, anti-worker governors are hell-bent on gutting workers’ rights while giving more power to corporate special interests.

But in California, a decidedly different story is playing out. The end of the legislative session here brought huge gains to workers and their families that boost our state’s economy and bolster the middle class.

With the federal minimum wage stuck at $7.25, Gov. Brown signed AB 10, taking California’s minimum wage to $10 per hour by January of 2016, a 25 percent wage increase for low-wage workers in the state. While immigration reform is stalled in DC, Gov. Brown signed a slew of bills to protect immigrants and ensure greater inclusion. We’ve tackled the underground economy. Promoted good jobs. Axed a boondoggle of a corporate tax break that wasted taxpayer dollars.

This all comes on the heels of the passage of Prop. 30 in 2012 (which funded our schools and stabilized our budget) and the election of Democratic super-majorities in both the State Assembly and State Senate, ensuring Tea Party extremists couldn’t hold California hostage like they’re doing with the shutdown and debt ceiling debacle in DC.

In short, California is accomplishing what few in Washington DC can even imagine these days: Progress for working people.

California Labor Federation Executive Secretary-Treasurer Art Pulaski:

Labor led the way this year in bringing real equality and progress to working people in California. We reformed tax breaks that cost jobs, we won rights for domestic workers and car wash workers, we brought greater equality to hard-working immigrants, and we began the essential work of rebuilding the state’s middle class. With these new laws, there’s no question that California is the national leader in supporting workers and their families.

Among the notable legislative victories this year were the following bills Gov. Brown signed into law:

• AB 10 (Alejo/Steinberg): Increased the minimum wage to $10 per hour by January of 2016.

• AB 60 (Alejo): Expanded drivers licenses to all Californians, with key protections for immigrant drivers.

• AB 93 (Assembly Budget Committee): Reformed the wasteful Enterprise Zone corporate tax breaks to reward employers who create good jobs.

• AB 241 (Ammiano): Granted daily and weekly overtime protection to domestic workers who have been excluded from most labor laws.

• AB 263 (Hernandez)/AB 524 (Mullin)/SB 666 (Steinberg): Enacted the strongest protections for immigrant workers in the country to stop retaliation when workers speak out about unfair wages or working conditions.

• AB 537 (Bonta): Improved process for public sector bargaining to resolve disputes more effectively.

• AB 1387 (Hernandez): Protected car wash workers by preserving the car wash registry and increasing the bond to crack down on the underground economy.

• SB 7 (Steinberg): Raised wages for construction workers by incentivizing compliance with prevailing wage laws.

• SB 168 (Monning): Helped protect workers working for farm labor contractors by providing successor liability to ensure wages are paid.

• SB 400 (Jackson): Helped domestic violence survivors keep their jobs and promotes a safer workplace by asking employers to work with survivors to identify and minimize the risk of workplace violence.

• SB 770 (Jackson): Expanded paid family leave to include time providing care for parents-in-law, siblings, grandparents and grandchildren.

Learn more about California Labor’s legislative victories in 2013

If America needs a path forward, it ought to be looking to California. Big things are happening here. And we’re just getting started.

Progressives push legislature to use supermajority for big change

by Brian Leubitz

When the Legislature hit the magical 2/3 mark after the November 2012 election, a lot of progressives started dreaming big. Prop 30 just passed, and a statement had been made for a progressive vision of California. A majority of Californians had just voted to raise their taxes. Whether thanks to the strong field campaign around Prop 32 or through changing demographics of a presidential election, the Democrats gained big on the Legislative front.

But muddying these waters was a lot of mixed messaging. Gov. Brown had at least signaled that he thought Prop 30 was the only tax revenue measure that we should pass for a while, and some of the Democratic legislators had more or less said the same thing.

On the other side, the dreams were building for those who focused less on the immediate political future and more on the long term progressive vision. Progressive leaders were looking at Prop 13 reform, oil severance taxes, minimum wage increases and more. A lot of powder has been kept dry over the past few years with the constant budget fight, and with that superminority concern out of the way, some looked to really mount the pressure. And to be clear, they have mounted a lot of pressure. I’ve seen enough of these discussions between progressive leaders and legislators to know that the pressure on them is real.

“The supermajority is something that you have to use it or lose it,” said Rick Jacobs, head of the 750,000-member Courage Campaign, which has been at the liberal vanguard of several grassroots and online campaigns. “It is time to be bold. What is anybody afraid of?” (SF Chronicle)

To some extent, this is about two competing theories of politics. One says that you have a limited supply of “capital.” Under this model, you can only expect to do so much progress on the legislative front. Gov. Brown is pushing for a gradual and slow movement that prioritizes consensus and getting buy in from as many as possible. On the other hand, progressives tend to favor an idea of politics that promotes efficiency. You get into it what you put in kind of thing. Voters will respect action, even if they don’t get every component right away.

But for now, Speaker Perez and Sen. Steinberg seem to be of the same mind as the Governor. They’re taking it slow for the time being. Steinberg has said that he doesn’t plan on [touching Prop 13 this year, and Speaker Perez thinks this is just the beginning of a larger fight.

Even though Democrats could override Brown’s veto with their two-thirds majority, “a lot of Democrats from more conservative areas don’t want to vote to raise taxes because they know it would kill them in their districts,” said Steve Maviglio, a spokesman for Assembly Speaker John Pérez.

Plus, say Democratic leaders, it is still relatively early in the legislative calendar. Budget negotiations are just beginning.

“C’mon, it’s only the second inning. There’s a lot of time left in the session,” said Maviglio. “We’re moving forward on a lot of bills that are friendly to labor and progressives.

“I would tell some of the people who are saying these things to just relax,” Maviglio said.(SF Chronicle)

Now, perhaps that last sentence could be more eloquently phrased, but Mr. Maviglio speaks of building a long term progressive supermajority in the Legislature. It’s a laudable goal by any Democratic perspective, but getting everybody on the same page isn’t necessarily the easiest task, even within the same party.

Right-leaning groups took on traditional Democratic power base with the help of “top-two” voting

by Brian Leubitz

Both Michael Allen and Betsy Butler faced difficult reelections in 2012. Butler decided to run in what was basically a new district when she opted for the progressive AD-50 seat. She did represent a small portion (less than 10%), but she certainly didn’t carry the same incumbent advantage you typically expect.  She defeated Torie Osborn and Richard Bloom in the primary, but with top-two she had to come back again to face Democratic Santa Monica mayor Bloom.

Meanwhile in Marin County, Michael Allen had to move from his Santa Rosa base to a Marin district due to the new districts. Like Butler, Allen, while an incumbent, was new to these voters. San Rafael City Councilman Marc Levine was something of a grassroots champion. He was very involved with the state Democratic party, serving as eboard rep for the old AD-6, as well as the local party.  However, he saw the writing on the wall after his second place finish, and started aggressively courting independent and Republican voters.

The CalBuzz team took a deep dive into how the two races went downhill for the two “incumbents,” and the story is well worth a careful read and a tale on how typically conservative interest groups will look at influencing a new one-party Legislature.

We also know that we’ll see lots more of this kind of thing in the future – in both Democratic and Republican races – as the top-two primary system encourages moderate candidates with guts and gumption to take on left- and right-wingers in hopes of getting into a run-off election where independent and other-party voters can provide the margin of victory.

What makes these two Assembly races particularly intriguing is the fact that both Republican and Democratic strategists were crucial in electing moderate-to-liberal Democrats who were perceived as less beholden to labor unions and thus more palatable to business interests.

There’s also the fact that the California Chamber and Western Growers – after thumping Mr. Speaker Himself – appear to have tried to hide their involvement by working through shell vendors, sharing valuable data and personnel and failing to report their spending until they were exposed months later. (HT to Dan Morain for digging into this whole issue.)(CalBuzz)

I won’t spend a long time going over their article, but rather implore you to read the whole thing, and maybe again a second time. While I won’t rehash the viscous AD-50 race that was already well documented here, I happen to personally like Marc Levine. I’ve known him for several years through CDP and other events, and he ran a strong campaign. The IEs that supported him, however, were hardly paragons for progressive values. Maybe a bit more disclosure will blunt the impact of these IEs, but they are clearly here to stay.

Termed out Assemblyman looks to spread cash with treasurer “campaign account”

by Brian Leubitz

I love it when people are honest. I particularly love it when they say things that most people don’t dare to actually mention.  So, hats off to Asm. Dan Logue for admitting that his “campaign” for treasurer is actually a fundraising trick to allow big donors to double give money to Republican extremists:

Logue acknowledged that his setup could allow donors to essentially donate to GOP candidates twice — once directly and once through a transfer of funds given to his campaign account — circumventing campaign contribution limits. But he said he saw the move as necessary to protect the interests of businesses.

“I am absolutely terrified that the Democratic majority is going to dismantle the business formula in Sacramento and make it even worse than it is now,” he said. “So I’m really committed to making sure small business has a voice in Sacramento, and this is how I’m doing it.”(SacBee)

In case you forgot Logue, he’s the guy that worked very diligently to get Prop 23 on the ballot. You know, the one that would have ditched our landmark climate change legislation.  Logue likes to look at businesses and corporation as pure good in the world. Which is awesome for him, becuase that sounds like a great way to live.

However, in the real world, we need regulations to protect our environment, consumers, and our general safety. But, Logue is all-in on his worldview, so no surprise that he’s looking to any and all techniques that can help him out.

For better or worse, our campaign finance system has more holes than a good Emmental cheese. This is just one of them, and elected officials from both parties use the trick. But, credit where credit is due, Logue told the truth about his plan to circumvent the finance restrictions with the loophole.

But, as the adage goes, don’t hate the player, hate the game.

Photo credit: photobucket user AmRivCn2-. . Logue is in the upper left, supporting Tom McClintock’s 2008 congressional campaign.

Brown adviser to seek open AD-16 in East Bay

by Brian Leubitz

Well, this is interesting news: Steve Glazer, Gov. Brown’s top campaign strategist and a long time local politician in Orinda, is looking to replace the termed out Joan Buchanan.

Gov. Jerry Brown’s political adviser, Steve Glazer, will run for a state Assembly seat in 2014, Glazer announced this morning. The Orinda councilman will seek election in the Democratic-leaning Assembly District 16, the East Bay district from which Assemblywoman Joan Buchanan, D-Alamo, will be termed out.

Glazer cast himself as a moderate in a prepared statement, criticizing a legislative process he said is captive to “the extremes of both political parties.” (SacBee)

Glazer just started his third term on the Orinda council, so he has the local connections that are often the key to the endorsements that make races in the low turnout June off-year elections.

The district is a fairly moderate district, so it hardly shocks to see him to go moderate. Brown, for his part, has been called the “most powerful conservative in Sacramento.” Glazer’s campaign would fit right in on both levels.

The top-2 format will treat such a “moderate” campaign well, and his name ID and connections to money should put him as a favorite to at least get in that top 2.  However, there are a long list of viable candidates for this district, so there is more to shake out before next June.