January 20, 2017 Edition
Yesterday, the California Senate Health Committee convened a hearing in Kern County – home to United States House of Representatives Majority Leader Kevin McCarthy – discussing the risks to California should the Federal Government repeal the Affordable Care Act (ACA). Assembly Member Joaquin Arambula, a Central Valley native and former emergency room physician, joined the Senate Health Committee for the hearing. Kern County Supervisor Leticia Perez provided opening remarks regarding the potential impact to her county residents and health system. The hearing included testimonies from consumers who shared their appreciation for and fear of losing the coverage afforded them through the ACA. Representatives from the Department of Health Care Services and Covered California provided overviews of the coverage offered through their respective programs. Deborah Kelch, Executive Director of the Insure the Uninsured Project (ITUP), illustrated and reminded the Committee of the coverage gaps that existed prior to the ACA. Tony Iton, Senior Vice President of Healthy Communities at the California Endowment, shared new research regarding lower life expectancies of Central Valley residents and emphasized the need for health to be perceived as a bipartisan issue. The Committee also heard testimony focused on provider impacts from the California Association of Public Hospitals and Health Systems (CAPH) and others representing the provider community.
Members of the Senate Health Committee and Assembly Member Arambula underscored the leadership California has shown in implementing the Affordable Care Act, their concern surrounding a potential repeal of the ACA, and their commitment to every consumer having access to affordable health coverage.
The Committee hearing can be viewed here.
Today, Assembly Speaker Anthony Rendon announced the Assembly Committee assignments for the 2017-18 Legislative Session. Key committee assignments are listed below.
Assembly Committee on Budget
Assembly Members Phil Ting (D) (Chair), Jay Obernolte (R) (Vice Chair) Travis Allen (R), Joaquin Arambula (D), Richard Bloom (D), Anna Caballero (D), Rocky Chávez (R), David Chiu (D), Steven Choi (R), Jim Cooper (D), Vince Fong (R), Cristina Garcia (D), Matthew Harper (R), Jacqui Irwin (D), Reginald Jones –Sawyer, Sr. (D), Tom Lackey (R), Monique Limón (D), Devon Mathis (R), Kevin McCarty (D), Jose Medina (D), Melissa Melendez (R), Kevin Mullin (D), Patrick O’Donnell (D), Jim Patterson (R), Blanca Rubio (D), Mark Stone (D), Shirley Weber (D), and Jim Wood (D)
Assembly Budget Subcommittee No. 1 on Health and Human Services
Assembly Members Joaquin Arambula (D) (Chair), Matthew Harper (R) (Vice Chair), Devon Mathis (R), Blanca Rubio (D), Jim Wood (D), Phil Ting (Democratic Alternate) and Jay Obernolte (Republican Alternate)
Assembly Health Committee
Assembly Members Jim Wood (D) (Chair), Brian Maienschein (R) (Vice Chair) Rob Bonta (D), Autumn Burke (D), James Gallagher (R), Monique Limón (D), and Kevin McCarty (D)
Assembly Appropriations Committee
Assembly Members Lorena Gonzalez Fletcher (D) (Chair), Frank Bigelow (R) (Vice Chair), Richard Bloom (D), Raul Bocanegra (D), Rob Bonta (D), Bill Brough (R), Ian Calderon (D), Ed Chau (D), Susan Eggman (D), Vince Fong (R), Laura Friedman (D), James Gallagher (R), Eduardo Garcia (D), Adam Gray (D), Al Muratsuchi (D), Jay Obernolte (R), and Eloise Reyes (D)
Senate pro Tempore Kevin de León announced his committee assignments in back in December, however key committees are listed below.
Senate Budget and Fiscal Review Committee
Senators Holly Mitchell (D) (Chair), Jim Nielsen (R) (Vice Chair), Ben Allen (D), Joel Anderson (R), Jim Beall (D), Steve Glazer (D), Mike McGuire (D), Tony Mendoza (D), Bill Monning (D), John Moorlach (R), Janet Nguyen (R), Richard Pan (D), Anthony Portantino (D), Richard Roth (D), Nancy Skinner (D), Jeff Stone (R), and Bob Wieckowski (D)
Senate Budget Subcommittee No. 3 on Health and Human Services
Senators Richard Pan (D) (Chair), Jeff Stone (R) (Vice Chair), and Senator Bill Monning (D)
Senate Health Committee
Senators Ed Hernandez (D) (Chair), Janet Nguyen (R) (Vice Chair), Toni Atkins (D), Connie Leyva (D), Holly Mitchell (D), Bill Monning (D), Josh Newman (D), Jim Nielsen (R), and Richard Roth (D)
Senate Appropriations Committee
Senators Ricardo Lara (D) (Chair), Patricia Bates (R) (Vice Chair), Jim Beall (D), Steve Bradford (D), Jerry Hill (D), Jim Nielsen (R), and Scott Wiener (D)
On Monday, the Senate Budget and Fiscal Review Committee convened their first hearing on the Governor’s 2017-18 budget proposal. Members serving on the Committee include Senator Holly Mitchell (Chair)(D) – who previously served as chair of Senate Budget Subcommittee No. 3 on Health and Human Services –, Jim Nielsen (Vice Chair) (R), Joel Anderson (R), Jim Beall (D), Steven Glazer (D), Hannah-Beth Jackson (D), Mike McGuire (D), Tony Mendoza (D), Bill Monning (D), John Moorlach (R), Richard Pan (D), Anthony Portantino (D), Richard Roth (D), Nancy Skinner (D), Jeff Stone (R), Bob Wieckowski (D) and Scott Wilk (R).
Amy Costa, representing the Department of Finance, along with other key staff, provided the Committee with a general overview of the Governor’s budget proposal and emphasized the Governor’s prudent approach in light of a $1.6 billion deficit and slowing revenue growth. Mac Taylor, representing the Legislative Analyst’s Office, provided comments on the various proposals set forth by the Administration and remarked that the LAO projected the state would receive higher personal income tax revenues than the Governor, noting that the state could have considerably more General Fund revenue in the coming fiscal year.
Legislators questioned the Governor’s $1.6 billion deficit considering the $1.2 billion budgeted transfer to the State’s Rainy Day Fund. Additionally, members challenged the Governor’s savings proposals totaling roughly $3.5 million which exceeds the amount needed to avoid the deficit.
Members also voiced concerns regarding several items of particular interest to CHEAC members including:
Impacts of Repealing the Affordable Care Act. Though the Governor’s proposal continues to assume current federal policies and funding levels, members did inquire of the impact to California should the federal government move forward with a repeal of the Affordable Care Act, given that the Medi-Cal program draws down roughly $18 billion in federal funds for the optional expansion population alone.
The Usage of Proposition 56 (Tobacco Tax Initiative) Funds. The Governor proposes to allocate Proposition 56 funds to address the growing cost of Medi-Cal; however, members inquired whether this would be consistent with the supplantation of funds versus funding new costs. According to the LAO, despite the perception that the Administration is supplanting costs, proving so is difficult to do. For example, the State could argue that absent the tobacco tax revenue, spending in the Medi-Cal program would be cut, in which case the State would not be supplanting funds.
Coordinated Care Initiative (CCI)/In-Home Supportive Services (IHSS). The Administration has determined the CCI to not be cost-effective for the State. Despite the Governor’s budget proposal continuing the Cal MediConnect program and the mandatory enrollment of dual-eligibles, it discontinues the county MOE, which capped the growth in costs to the county at 3.5 percent. The Committee expressed concern regarding shifting roughly $625 million in costs from the State to counties and encouraged the State to mitigate the impact to counties.
Throughout the next few months, Budget Subcommittees will convene hearings on department specific issues and stakeholder proposals.
The California State Association of Counties (CSAC) will host a webinar next Wednesday, January 25, from 1:00 – 1:45 pm, to discuss how the ACA repeal will affect counties. To register for the webinar, click here.
Earlier this week, the California Association of Environmental Health Administrators hosted a two-day cannabis summit, which featured presentations representing the patient perspective, industry, experiences from other states, California’s regulatory agencies, and local environmental health departments. Presentations from the summit can be found here.
The Department of Health Care Services (DHCS) will host a webinar next Friday, January 27, from 9:30 – 11:00 am, for new entities interested in participating in the second round of the Whole Person Care pilots (WPC). The webinar will cover the application, budget, and program requirements. To sign up for the webinar, click here.
Last week, DHCS posted both an application for new pilots and instructions for first-round “legacy” pilots seeking to expand on the WPC website. The department also posted revised budget instructions. The second-round WPC applications are due on March 1, 2017.