CMA Capitol Insight: July 6, 2015

July 06, 2015
Area(s) of Interest: Public Health Vaccination 

CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature.

Signatures and special sessions

A controversial measure was signed into law last week by Gov. Jerry Brown – Senate Bill 277 (Pan), which eliminates the personal belief exemption from mandatory vaccinations for all public school children. The real question now is what comes next.

Brown’s signature sets off a 90-day clock for opponents of the bill to qualify a referendum. If the requisite signatures are gathered, the measure would not go into effect until voters have their say in November 2016.

The question is whether or not the money will materialize for a referendum effort. The California Chiropractic Association has led the anti-vaccination charge in the Capitol, but is not believed to be able to muster the seven figures it would take to place a potential repeal on the ballot.

All eyes now turn to Hollywood. Several celebrities, including Jim Carrey and Kirstie Alley, took to Twitter to lambaste Gov. Brown’s signature on the bill. The question is whether any of them will put their money where their mouth is, and pony up the money needed in short order to try to repeal the measure.

Former GOP Assemblyman Tim Donnelly has joined the anti-vax crusade, but does not have the fundraising ability to get a referendum on the ballot. If the bill is to be put on hold, it will take a strange alliance of the far right, far left and Hollywood fringe to make it happen.

Another controversial bill, SB 128, which would allow patients to seek help from a physician to end their own life, hit a legislative road block, but proponents say the bill will be resurrected before the end of the year.

The bill’s author, Sen. Lois Wolk (D-Davis), agreed to pull the bill from the Assembly Health Committee when support appeared to waiver for the bill. Wolk said she will bring the bill back for a vote later this week.

“At this point, we feel that without the certain votes in the Assembly Health Committee today, it is best to postpone the hearing…to July 7th,” Wolk said in a statement. “We hope that during this time, members of the committee can take more time to consider the bill carefully.”

The measure, dubbed the End of Life Option Act, has already cleared the state Senate on a mostly party-line vote. It is modeled after a law passed by voters in Oregon in 1997.If the bill becomes law, two physicians would have to confirm a patient's mental competence and a prognosis of less than six months to live. The patient would need to make two oral requests to a physician at least 15 days apart, with witnesses. The doctor and patient must meet once alone, but a translator could be present, and it would be a felony to coerce someone into requesting the drugs.

Medication would have to be self-administered, absolving physicians of that responsibility. No religious hospitals would be required to participate.

In the Capitol, lawmakers have gaveled down a special session on health care to discuss Medi-Cal reimbursement rates and other sticky legislative issues that were not resolved during the state budget. With Medi-Cal now serving more than one-third of all Californians, the governor has raised concerns about network adequacy and state funding.

Financing the Medi-Cal program may not be sustainable, Brown said, given its expansion over the past two years because of the Affordable Care Act and the looming loss of the managed care organization (MCO) tax, which could cost the state about $1.1 billion.

There is some bipartisan support for the MCO tax, but the question is whether hospitals that do not serve Medi-Cal patients will agree to it. The federal courts recently ruled that a state proposal to assess the tax only on those facilities that serve Medi-Cal patients was not legal, and had to be reworked in order to meet federal requirements.

Lawmakers will also consider permanently raising rates for in-home support workers, who received a 7 percent bump in this year’s budget. However, Brown made clear his support was only good for this year, and that any longer-term fix would have to find an additional source of funding to sustain it long-term.


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