HOAC Sponsored AB 511 (Arambula) Stalls in Senate Health
I don’t think I’ve ever written an opinion piece in one of our weekly updates, but I’m eager to share some thoughts after what unfolded at last week’s AB 511 (Arambula) hearing. Our sponsored TB control legislation was a hotly debated item in the Senate Health Committee last Wednesday. The committee spent over an hour hearing testimony on AB 511, but before I go further in updating you on its outcome, I want to first express HOAC’s gratitude for Dr. Louise McNitt, who served as an expert witness in support of the bill. Throughout the hearing, she was a fearless defender of evidence-based public health policy. It takes a lot to go before a committee and field tough questions in a highly contentious environment, like the one we encountered last week. HOAC cannot be thankful enough for her expertise and leadership in Wednesday’s hearing.
As we’ve shared in past updates, AB 511 is facing strong opposition from the California Nurses Association. However, there was a shift in the tone of CNA’s opposition from previous hearings – they likely think Senate Health is their best chance to kill AB 511 and have taken their opposition to new highs (or lows?). You can view the AB 511 hearing at Digital Democracy. CNA’s often disrespectful testimony showed little regard for intellectual honesty or professional courtesy, referring to the bill’s author, a physician specialized in emergency medicine, as “Mr. Arambula” before beginning a slanderous attack on the integrity of public health officers. CNA misleadingly characterized TB risk-assessment as a veiled attempt for our members to “shift emphasis” from public health to cost-savings. They implied that HOAC was aiming to “segregate” populations based on TB risk, an offensive remark on many levels. However, they dodged many questions requiring TB expertise with a phrase like “ask them, they’re the experts.”
Ultimately, AB 511 was not taken up for a vote last week. Opponents created a lot of confusion around the bill and it became clear committee members needed more time to understand the issue at-hand. Rather than risk not having the votes, which would kill the bill right then and there, the decision was made to postpone the vote for a week or two. This gives us time to respond in more detail to the specific and complex questions asked by committee members. With that said, the confusion around this bill has created an opportunity for your expertise to be of incredible value to members of the Senate Health Committee. By suggesting in committee that we postpone the vote, these senators have indicated their need and sincere willingness to learn from you.
Senate Republicans Reveal ACA Replacement
Republican leaders in the Senate revealed the Better Care Reconciliation Act (BCRA), their attempt at a more palatable version of the Affordable Health Care Act narrowly passed by the House in early-May. Senate Republicans are hopeful they can vote on the bill before the July 4th recess. Here is some of the key information:
- Cumulatively cuts billions in funding to the Public Health and Prevention Fund
- Converts Medicaid to a per capita cap model
- Eliminates individual and employer mandates
- Eliminates Essential Health Benefit provisions
- Defunds Planned Parenthood
- Allows states to enact work requirements to receive Medicaid benefits, exempting disabled, elderly, and pregnant women
- Authorizes $2 billion to support substance use treatment and recovery
- Congressional Budget Office estimates number of uninsured will increase by 15 million, while reducing the federal deficit by $321 billion by 2026.
- Provides $10 billion in safety net funding for non-expansion states
- Results in 16 percent drop in Medicaid enrollment
BCRA can be passed by a simple majority. The Senate’s 100 members are comprised of 52 Republicans, 46 Democrats, and 2 Independents who caucus with Democrats. No Democrats are expected to vote for the bill and 5 Republicans have already expressed their opposition. However, there is still time for Senate Republicans to iron out the issues keeping at least 2 of their colleagues from supporting their proposed ACA replacement. With the count being so close, there is a chance Vice President Pence would get to cast the tie-breaking vote.
California Single-Payer Health Proposal Gets Shelved in the Assembly
Assembly Speaker Anthony Rendon made the call to shelve SB 562 (Lara and Atkins), a bill to establish a single-payer healthcare system in California. SB 562 passed the Senate, but did not advance to a policy committee in the Assembly, with Speaker Rendon calling the bill “woefully incomplete.” Many senators who voted for the bill did so while also acknowledging the difficult challenges – most notably its price tag – that would need to be resolved in the Assembly. Senators Ricardo Lara and Toni Atkins, the bill’s authors, issued a joint statement expressing disappointment that the “robust debate about healthcare for all… won’t continue in the Assembly.” The authors insist “this issue is not going away.” We are in the first-year of a two-year legislative session, so SB 562 may be acted on in 2018.