Legislative Update

As the 2011-2012 legislative session nears the finish line, the California Medical Association (CMA) has had marked victories as well as some disappointments. One thing is for sure, there is much still to be done before the August 31 legislative deadline.

With little fanfare, the Legislature passed the main budget bill on June 15 in order to meet the constitutional deadline. Considered a budget “framework” bill, it included financing for various proposals but left several implementing policy measures to be discussed in the coming weeks. The budget includes savings “borrowed” from future savings earned from moving Medicare/Medi-Cal dual eligibles into managed care. CMA aggressively fought the Governor's proposal to eliminate the Healthy Families program and it appeared that CMA's tireless efforts were not in vain, when legislators in this budget agreed to a bright line compromise that would have restructured Healthy Families by moving only the “bright line” children—those whose parents earn under 133 percent of the federal poverty level into Medi-Cal. Weeks later, several “trailer” budget bills were passed implementing policies already budgeted.

Despite lobbying efforts from CMA, engagement of over 70 health care organizations, news articles outlining the negative impact on children and the Legislature’s previous agreement, the Assembly and Senate passed budget trailer bill AB 1494, which eliminated the Healthy Families Program and will transfer 880,000 children into Medi-Cal over the next three years. Late negotiations behind closed doors resulted in Democratic leaders agreeing to the Governor’s demand to dissolve Healthy Families as part of an overall deal to spare deeper cuts to subsidized children and welfare-to-work programs.

Also among the trailer bills was SB 1008 that gave the Department of Health Care Services (DHCS) the authority to implement pilot projects for dual eligibles in up to eight counties, but not without CMA successfully getting two major protections for physicians into the bill. The default rate for non-contracting physicians will be the Medicare fee schedule for Medicare services and Medi-Cal for Medi-Cal services. The state will also require plans to contract with solo and small practice providers who have traditionally seen dual patients. There will likely be a “clean-up” bill in the coming month and CMA will continue to advocate for our members on this important issue.

Our sponsored bills designed to improve California’s immunization policy continue to move through the process, despite heavy opposition from the anti-vaccination communities as well as organized labor. AB 2109 (Pan) would require a parent or guardian seeking a personal belief exemption to vaccinating their children before entering the public school system to also obtain education about vaccines from a licensed health care provider. The bill draws hundreds of individuals testifying in opposition, including most recently Saturday Night Live alum Rob Schneider. The bill has passed out of both policy committees, and will be heard on the Senate Floor next month.

SB 1318 (Wolk) will require health care facilities to reach a 90 percent flu vaccination compliance rate for workers, or implement an evidence-based policy to get to that 90 percent compliance rate. Traditionally, masking policies have proven to the most effective policy and because the bill points to that policy for workers, the bill has been heavily opposed by organized labor. This bill has garnered media attention and contentious committee hearings, but it is still moving through the process. SB 1318 has passed out of both policy committees and will go to the Assembly Appropriations Committee next, then on to the Assembly floor for a full vote.

CMA sponsored bills addressing California’s physician shortage, AB 589 (Perea) and SB 1416 (Rubio) continue to move through the process. Working with partner organizations, we continue to look for funding sources to create a scholarship program for medical students and a graduate medical education trust fund to administer grants to expand residency programs.

Also part of CMA’s sponsored bill package is SB 1483 (Steinberg), which would establish a physician health program in California. California is one of only five states in the nation that does not have such a program, after the Medical Board of California (MBC) decision to eliminate its 27-year-old Diversion Program in 2007. This program, a voluntary model encouraging physicians to actively seek treatment before their problems progress to the level that would lead to possible complaints, is different than its predecessor. Establishing a physician health program in California is critical in order to ensure easy access to these services for physicians struggling with addiction and other issues. SB 1438 has gained tremendous bipartisan support in the Legislature, and will be heard in Assembly Appropriations on August 8, 2012.

The Legislature will return from its summer recess on August 6, 2012, and the deadline to pass all bills out of both Houses is August 31,2012. While this seems like a short timeline for the amount of work to be done, a month is a lifetime in the legislative process. August will be full of wild changes, but CMA will be staked out at the Capitol, advocating for physicians and riding the crazy wave to come.

For a look at CMA’s Legislative Hotlist, please click here.

CMA's Legislative Hot List provides a summary and current status of CMA-sponsored bills, as well as the progress of other significant legislation followed by CMA's Center for Government Relations. The Hot List represents only a small sampling of the hundreds bills CMA is following this year. For the current status or more information on a specific bill, please contact the appropriate lobbyist identified in each bill summary by calling CMA's Center for Government Relations at (916) 444-5532.

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