Assembly Bill No. 1810
Approved by Governor June 27, 2018. Filed with Secretary of State June 27, 2018.
PART 4. Council on Health Care Delivery Systems
1001. (a) Effective January 1, 2019, there is hereby established the Council on Health Care Delivery Systems as an independent body to develop a plan that includes options for advancing progress toward achieving a health care delivery system in California that provides coverage and access through a unified financing system for all Californians.
002. (a) On or before October 1, 2021, the council shall submit to the Legislature and Governor a plan with options that include a timeline of the benchmarks and steps necessary to implement health care delivery system changes, including steps necessary to achieve a unified financing system.
Assembly Bill No. 2472: An act to add Section 1002.5 to the Health and Safety Code, relating to health care coverage.
Approved by Governor September 22, 2018. Filed with Secretary of State September 22, 2018.
AB 2472, Wood. Health care coverage.
From the Legislative Counsel’s Digest
Existing state law establishes the Council on Health Care Delivery Systems as an independent body to develop a plan that includes options for advancing progress toward achieving a health care delivery system in California that provides coverage and access through a unified financing system for all Californians. Existing law requires the council, on or before October 1, 2021, to submit to the Legislature and the Governor a plan with options that include a timeline of the benchmarks and steps necessary to implement health care delivery system changes, including steps necessary to achieve a unified financing system. [AB 1810 (Committee on Budget), Chapter 34, Statutes of 2018]
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SEC. 2. Section 1002.5 is added to the Health and Safety Code, to read:
1002.5. (a) The council shall prepare an analysis and evaluation, known as a feasibility analysis, to determine the feasibility of a public health insurance plan option to increase competition and choice for health care consumers.
(d) (1) The council shall submit the feasibility analysis to the Legislature and the Governor on or before October 1, 2021.
(e) This section does not authorize the council to apply for a waiver under Section 1332 of the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any amendments to, or regulations or guidance issued under, those acts.
CONCURRENCE IN SENATE AMENDMENTS AB 2472 (Wood)
As Amended August 17, 2018
COMMENTS: According to the author, in California there are some counties that only have one health plan choice, including Monterey, San Benito, San Luis Obispo, Santa Barbara, Inyo, Mono, and in most of Kings County. Additionally, 22 other counties have two or fewer health plan choices. This limited plan choice has impacted not just the prices of health care in these areas but also the quality of health care that consumers receive. Although the federal Patient Protection and Affordable Care Act has greatly reduced the number of uninsured in California, premiums continue to rise for many consumers. Policymakers have an obligation to find ways to make healthcare more affordable and accessible to consumers. One proposed solution to the problem of limited health plan competition in the individual market is the establishment of a public option as an alternative to existing private plans. However, among other considerations, the structure, financing, and governance of a public option needs to be evaluated. This bill would require the Council to conduct an analysis and evaluation of a public health insurance plan option and determine if this public option is possible to implement in California.
A March 2018 issue brief published by the Insure the Uninsured Project (ITUP) entitled “Exploring Public Option in California,” highlights the issues and options related to public option. The issue brief defined public option as a publicly operated health plan choice that directly competes with private health plans in specified target markets. A public option does not include public programs such as Medicare, Medi-Cal, or the Children’s Health Insurance Program, but may be modeled after, or offered as an adjunct to, public programs. The issue brief highlights California-specific factors that will influence a public plan choice, including: an active purchaser exchange (Covered California); existing network of local public health plans; strong California standards and consumer protections; California communities with severe provider shortages and lack of competition; and, a state safety net linked to public health plans. In the issue brief, ITUP also developed three scenarios of how a public plan choice might be organized in California and notes that the scenarios acknowledge California’s extensive network of local health plans and the heavy concentration of managed care in the existing Medi-Cal program.
By Don McCanne, M.D.
In June of this year, the California Legislature passed and Gov. Jerry Brown signed AB 1810 – a bill that, amongst other measures, would establish the Council on Health Care Delivery Systems with instructions to develop a plan that would provide coverage and access through a unified financing system for all Californians, whatever that means. This week, Gov. Brown signed AB2472 – a bill that instructs the Council on Health Care Delivery Systems to determine the feasibility of a public health insurance plan option to increase competition and choice for health care consumers, or, simply stated, a public option, and report back October 1, 2021 (deferring further consideration until after the next two year legislative session in California and after the next presidential election). So much for California’s single payer proposal.
Lest California’s single payer supporters go off in a funk, it should be realized that there is an opportunity here. What we really want is an improved Medicare that covers everyone throughout the entire nation. Californians should join in a coalition effort with other states to bring us, in the next presidential election, a Congress and an administration that would enact and implement such a national health program. We should encourage all political parties to participate, especially now that close to half of Republicans support the concept.
When do we start? Now! Don’t even consider waiting until after the midterm elections to begin the effort. There are many proponents of Medicare for all running now. We can start by electing them, thereby establishing an environment in Congress more conducive to serious deliberation of the clear superiority of a well designed, single payer, improved Medicare for All.
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