The Funhouse of Politics: CMA's 2010 Legislative Wrap-up
While some have referred to 2010 as a rollercoaster ride, I prefer to describe it as a trip through the funhouse. According to Wikipedia, "Funhouses seek to distort conventional perception and startle people with unstable and unpredictable circumstances within an atmosphere of whacky whimsicality." Whether or not the Legislature could be called fun or playful is debatable, but the terms unstable, unpredictable, and whacky are all keenly accurate. One of the elements of a funhouse is its design to surprise and challenge the visitor. Uncertainty about what lays ahead, what could be lurking around the corner, or what will jump out along the way can be both thrilling and daunting at the same time. Uncertainty was a key feature of this past legislative year.
With dramatic changes in federal healthcare, new legislative leadership, a slow economy, and dismal financial returns, the pathway to sound policy reform or a timely budget seemed anything but certain. Lawmakers ended the year by running out the final hours of the legislative clock debating controversial bills and a budget doomed to fail, leaving a handful of bills victim to the midnight deadline. The session ended with a Legislature running out of time.
The year began with the Assembly electing John A. Perez as their new speaker, a freshman with both political and policy experience, but still a greenhorn to leadership. Given that he is just concluding his first term in the Assembly, it is expected that he will have at least four years in the role, a long run by recent standards. Also new to leadership were minority leaders in both houses, Senator Dennis Hollingsworth and Assemblymember Martin Garrick. Despite a relatively smooth transition, the change inevitably left questions as to what type of leader each would become, how effective they would be, and what kind of political and policy values they would prioritize.
With unpredictability at the top, lawmakers continued to work in a way that has become quite predictable. In an era of term limits, politicians must campaign for new offices as they prepare to term out of their current job. 2010 proved no different, with dozens running for a new office, in many cases competing against their colleagues. The contests produced an atmosphere of posturing and high-stakes voting as legislators positioned themselves to also be good candidates.
To further complicate this dynamic, election season changed from taking place in the even-numbered years to being a year-round process. It seemed there was always a special election altering the roster in the Capitol, often producing a domino effect of other elections and political appointments. Scandal, untimely death, and chance political opportunities caused a handful of special elections that moved assemblymembers to the Senate and brought in new legislators mid-year. Most recently, Congresswomen Ellen Tauscher went to work for the Obama administration, allowing former Lt. Governor John Garamendi to run and win the congressional seat she vacated, prompting the governor to appoint Senator Abel Maldonado (last year’s key budget vote) to the second-in-command position, allowing then-Assemblymember Sam Blakeslee to win the 15th Senate seat, whose Assembly seat will now be vacant until yet another special election in November. Welcome to the funhouse.
The governor’s final months in office as a "lame duck” saw him taking on a quieter role than in previous legislative sessions. Years of political foibles and failed initiatives seem to have worn on him, coupled with a lack of allies on either side of the aisle. Still, Governor Schwarzenegger has been trying to solidify his legacy via AB 32 and his proactive position on global warming, as well as positioning California to be a leader in healthcare reform. Though California’s attempt to tackle healthcare reform was not a success, the governor has clamored to put California at the forefront of federal healthcare reform implementation.
Despite Sacramento’s climate of uncertainty, CMA’s Government Relations team continued to be a resource to lawmakers and successfully navigated through the obstacle course to protect and promote physician’s interests in the Capitol. Budget woes were at the forefront of everyone’s minds, but, with no solution in sight, legislators attempted to tackle the issues du jour in California, implement new reform laws and continue fights from the previous year. Raging battles were waged under the state’s dome over water rights, gun control, and even plastic bags, while the hospitals continued their efforts to erode the ban on the corporate practice of medicine.
Three bills were carried over from the previous year, and with AB 646 (Swanson) and AB 648 (Chesbro) virtually dead in the Senate Business and Professions (B&P) committee, proponents turned their energy toward SB 726 (Ashburn). With a Republican author and union-backed sponsors, SB 726 was a political dichotomy that proved difficult to stop. Ordered by legislative leadership, CMA met with key stakeholders and legislators numerous times throughout the year to hash out negotiations on the bill, to no avail. The peace-talks were clouded with insincerity as supporters of SB 726 continued to try to move the bill. The battle waged on, with the bill narrowly passing through the Assembly and was finally killed in the Senate B&P committee.
Federal healthcare reform was also at the forefront of many lawmakers’ minds. The complicated series of provisions mean changes at nearly every level of the healthcare process, from patient to provider. Responsively, many pieces of legislation to bring California into compliance with federal standards were introduced late in the session. There were bills establishing and implementing the state’s high-risk insurance pool, bills creating the health insurance exchange, several market reform and coverage expansions, and several bills directed at the health insurance rate hikes. CMA ramped up its advocacy efforts and teamed up with some interesting and unexpected allies in the course of events. Clever collaboration was a powerful and exciting tool for both lawmakers and healthcare interest groups, the result of which was an increase in bipartisan vote counts.
Overall, it was a year stymied by poor financial news, coupled with colossal changes at the national level. But despite the uncertainty that permeated through the session, CMA gained some decisive victories for the practice of medicine and for the healthcare system in general. We were largely victorious in passing our sponsored bill package through the legislative process and stopping the bills that we opposed in their tracks. CMA was pleased to advance five sponsored bills to the governor, two of which were signed into law. AB 583 (Hayashi), which helps patients better understand who their healthcare providers are by requiring disclosure of education, and AB 2470 (De La Torre), which cracks down on unlawful rescission, both received bipartisan support and will become law in 2011. Peer review protection, adequate vaccine reimbursement, and Maddy Fund transparency bills fell victim to a dismal economy and special interests. Throughout the year, CMA was at the forefront of the healthcare reform debates and was able to craft and support several bills on implementation in California as well as develop important relationships with legislative leaders and stakeholders.
Time will tell how a new governor will respond to nationwide changes on healthcare. Term limits will make for a Legislature in 2011 comprised of nearly one-third new members. Redistricting will add a new and potentially detrimental element for lawmakers, redrawing district lines, and throwing some legislators out of their represented seats. But for now, we made it through the funhouse. We’ll see what next year’s ride will be.