CMA Legislative Hot List (September 3, 2010)
Legislative Hot List From CMA’s Center for Government Relations
— September 3, 2010
The 2009–10 regular legislative session came to a tumultuous end late Tuesday evening, August 31, with a slew of bills racing to beat the midnight deadline. Between August 16 and August 31, several hundred bills were debated and heard, many needing rule waivers in order to be eligible for a vote.
Many of CMA's sponsored and co-sponsored bills were passed and sent to the governor's desk with bipartisan support, including AB 2470 (De La Torre), which protects patients from unlawful rescission of health insurance, AB 583 (Hayashi), which requires health care professionals in various settings to disclose to patients information about their license, education, and board certification, AB 1235 (Hayashi), which helps to improve and strengthen the peer review system, AB 2093 (M. Perez), which requires health plans and insurers to reimburse physicians for administering immunizations, and AB 2248 (Hernandez), which addresses weaknesses in the accounting practice of counties for the EMS/Maddy Fund.
CMA chose to hold back two sponsored bills that needed more work, AB 2533 (Fuentes), which would have required the disclosure of policies and procedures for any kind of health insurer physician rating system, and SB 1031 (Corbett), which would have provided malpractice insurance coverage to volunteer physicians. CMA will continue to be active in these important areas on behalf of physicians and will discuss the possibility of future legislation on these topics.
CMA also soundly defeated several bills that would have been detrimental to patients and to the practice of medicine. All three bills that would have eroded the ban of the corporate practice of medicine failed to pass and are now dead: AB 646 (Swanson), AB 648 (Chesbro) and SB 726 (Ashburn). After the two Assembly bills were defeated in the Senate Business & Professions Committee (B&P) earlier in the year, SB 726 became the sole vehicle for direct-hire language and was still clinging to life. Once again, at the request of legislative leadership, CMA government relations staff engaged in discussions with the proponents of the bill. In the waning days of the legislative session, after intense negotiations, exchanging of language, calls from CMA member physicians and countless meetings, the proponents once again rejected a reasonable compromise offered by CMA, and the bill was referred to Senate B&P. With less than a week left in the session, the bill was brought up for a hearing with little notice. After yet another robust discussion in the evening hearing, the bill failed on a final vote of 3–4, with two abstentions — even fewer votes than the Assembly bills had garnered earlier in the year.
The health reform bills were largely successful, despite facing opposition through the process. The measures on the Health Insurance Exchange, AB 1602 (Perez) and SB 900 (Alquist), and the market reform / coverage expansion bills, AB 1825 (De La Torre), AB 2244 (Feuer), SB 890 (Alquist) and SB 1088 (Price), were sent to the governor for his consideration. CMA expects the governor to sign many of them in order to tout the prompt implementation of important provisions of federal health reform. The bills concerning health premium rate review and rate regulation were the subject of much debate and behind-the-scenes lobbying, with CMA being a strong voice for responsible legislation that doesn't harm providers and patient care. After AB 591 (De La Torre) failed to get out of the Senate Appropriations Committee, the two remaining vehicles presented two very different choices. AB 2578 (Jones) which would have given the government the authority to set healthcare premium rates, failed on the Senate floor on the last night of the session. CMA had opposed AB 2578 and had worked with stakeholders to craft a more reasonable, balanced approach in SB 1163 (Leno), which is consistent with federal law and increases transparency for health plan rate filings while protecting providers' proprietary information. SB 1163, which received bipartisan support on its way to the governor's desk, will also help the state draw down federal grants for rate review purposes.
Even though legislators wrapped up bill activity for the year without a new spending plan in place, their work is not complete. They will have to return to Sacramento for a budget vote in the coming weeks, notwithstanding a vote the last day of session on competing versions of the budget, which just added more fuel to the political fire blazing in the Capitol. Both houses had rousing debates on the measures, but the result was as fruitless as expected, lending validity to the claim that the vote was in fact a "drill." Two different budget proposals were taken up for votes by the legislature. AB 1636 and AB 1609 (both Blumenfield) contained the "Democratic version" of the budget, and AB 1633 (Garrick) and SB 873 (Hollingsworth) contained the "Republican version." The Assembly tally had the Democratic plan four votes shy of passage and the Republican version 32 votes short. In the Senate, the Democratic proposal was six votes short and the Republican budget plan needed 15 more votes to pass. As of Friday September 3rd, the budget will be 65 days overdue, closing in on the record of 86 days late. The budget deficit is reported to be $19.1 billion, and the crisis worsens at an estimated rate of $52.3 million dollars per day. Although the governor has made pension reform a "must have" in a budget that would earn his signature, he has reported being optimistic that a deal is within reach. We also expect to see more activity on the Medi-Cal waiver, since the federal Health and Human Services Agency granted California an extension to its current waiver until October 31. We'll likely see a budget bill and a waiver bill handled together, which of course could complicate both. September 30 is the last day for the governor to act on legislation sent to him in the final two weeks of the session. For months, CMA has been laying the groundwork with the governor's office and the relevant state departments to ensure that our sponsored legislation has a fair shot at becoming law. We will continue our advocacy, pressing our positions with the governor and keeping you posted on developments.
For more information on these and other bills of interest to physicians, see CMA's Legislative Hot List.