January 4, 2019 Edition

Legislature Returns on Monday, Committee Assignments Announced

The California Legislature will convene in Sacramento on Monday, January 7 to begin its official business of the 2019 Legislative Session. A very busy week ahead is expected with the swearing-in of Governor-Elect Gavin Newsom on Monday, the release of the governor’s proposed budget on Thursday, and new bill introductions by members of the Legislature throughout the week.

Both Senate President pro Tempore Toni Atkins and Assembly Speaker Anthony Rendon recently announced leadership positions and committee assignments for the 2019-20 Legislative Session. Membership listings of key legislative committees are below. Full committee assignments may be accessed at the following links: Senate | Assembly

Senate Appropriations Committee

Senators Anthony Portantino (D; Chair), Pat Bates (R; Vice Chair), Steven Bradford (D), Jerry Hill (D), Brian Jones (R), Bob Wieckowski (D), and one vacancy

Senate Budget and Fiscal Review Committee

Senators Holly Mitchell (D; Chair), Jim Nielsen (R; Vice Chair), Jim Beall (D), Maria Elena Durazo (D), Melissa Hurtado (D), Brian Jones (R), Connie Leyva (D), Mike McGuire (D), Bill Monning (D), John Moorlach (R), Mike Morrell (R), Richard Pan (D), Richard Roth (D), Nancy Skinner (D), Henry Stern (D), Jeff Stone (R), Thomas Umberg (D), and Bob Wieckowski (D)

Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services

Senators Richard Pan (D; Chair), Melissa Hurtado (D), and Jeff Stone (R)

Senate Health Committee

Senators Richard Pan (D; Chair), Jeff Stone (R; Vice Chair), Maria Elena Durazo (D), Shannon Grove (R), Melissa Hurtado (D), Connie Leyva (D), Holly Mitchell (D), Bill Monning (D), and Susan Rubio (D)


Assembly Appropriations Committee

Assembly Members Lorena Gonzalez (D; Chair), Frank Bigelow (R; Vice Chair), Richard Bloom (D), Rob Bonta (D), William Brough (R), Ian Calderon (D), Wendy Carrillo (D), Ed Chau (D), Tyler Diep (R), Susan Eggman (D), Vince Fong (R), Jesse Gabriel (D), Eduardo Garcia (D), Jay Obernolte (R), Cottie Petrie-Norris (D), Bill Quirk (D), and Robert Rivas (D)

Assembly Budget Committee

Assembly Members Phil Ting (D; Chair), Jay Obernolte (R; Vice Chair), Joaquin Arambula (D), Richard Bloom (D), William Brough (R), David Chiu (D), Jim Cooper (D), Vince Fong (R), Jim Frazier (D), James Gallagher (R), Cristina Garcia (D), Reginald Jones-Sawyer (D), Tom Lackey (R), Monique Limón (D), Brian Maienschein (R), Devon Mathis (R), Kevin McCarty (D), Jose Medina (D), Melissa Melendez (R), Kevin Mullin (D), Al Muratsuchi (D), Adrin Nazarian (D), Patrick O’Donnell (D), Jim Patterson (R), James Ramos (D), Eloise Gómez Reyes (D), Luz Rivas (D), Blanca Rubio (D), Mark Stone (D), Shirley Weber (D), Buffy Wicks (D), and Jim Wood (D)

Assembly Budget Subcommittee No. 1 on Health and Human Services

Assembly Members Joaquin Arambula (D; Chair), Jim Frazier (D), Devon Mathis (R), Jim Patterson (R), James Ramos (D), Blanca Rubio (D), Jim Wood (D), Phil Ting (Democratic Alternate), and Jay Obernolte (Republican Alternate)

Assembly Health Committee

Assembly Members Jim Wood (D; Chair), Chad Mayes (R; Vice Chair), Cecilia Aguiar-Curry (D), Frank Bigelow (R), Rob Bonta (D), Autumn Burke (D), Wendy Carrillo (D), Heath Flora (R), Monique Limón (D), Kevin McCarty (D), Adrin Nazarian (D), James Ramos (D), Freddie Rodriguez (D), Miguel Santiago (D), and Marie Waldron (R)

Federal Judge Issues Stay on ACA Ruling, Legal Challenge Continues

U.S. District Court Judge Reed O’Connor on Sunday issued a stay on his December ruling, allowing the Affordable Care Act (ACA) to stand while his judgement undergoes an appeal. Recall, last month Judge O’Connor of Texas struck down the ACA on the grounds that the individual health insurance mandate is unconstitutional and the remaining ACA provisions cannot stand without the individual mandate. In issuing his stay, Judge O’Connor underscored his belief that the ACA cannot stand without the individual mandate but indicated his ruling should not take effect while the case is being appealed. O’Connor also noted in his stay that “many everyday Americans would otherwise face great uncertainty” without the issuance of a stay on his previous ruling, but also stressed that “courts must refrain from resolving policy disputes” created by Congress.

On Thursday, 16 states and the District of Columbia, led by California Attorney General Xavier Becerra, filed a notice of appeal of O’Connor’s December ruling, which is the first formal step in advancing their legal challenge to the U.S. Court of Appeals 5th Circuit in New Orleans. Becerra underscored the intent of appealing the ACA ruling, indicating in a statement, “Our goal is simple: to stand up for the law of the land – the Affordable Care Act – in order to keep healthcare affordable and accessible for millions of Americans.” While it remains to be seen if the 5th Circuit Court of Appeals will overturn Judge O’Connor’s initial December ruling, the matter could eventually become the third significant ACA case to land in the U.S. Supreme Court.

CDC Designates 2019 as Year of Tobacco Cessation

The U.S. Centers for Disease Control and Prevention (CDC) Office on Smoking and Health (OSH) has designated 2019 as the Year of Cessation. The Year of Cessation is intended to call attention to opportunities to promote and coordinate key activities related to tobacco cessation. Each quarter throughout the year will feature various themes related to cessation, including emphasis on increasing quit attempts among smokers, establishing linkages with broader tobacco control policies, and increasing use of evidence-based cessation interventions. Additional information and resources are available here.

CDCR Releases Report on Impact of Medi-Cal Expansion on Formerly Incarcerated Individuals

The California Department of Corrections and Rehabilitation (CDCR) Council on Criminal Justice and Behavioral Health (CCJBH) recently released a report examining patterns of health care service access and utilization among individuals formerly incarcerated in California state prisons. The report finds that in 2012 (prior to Medi-Cal expansion) seven percent of CDCR’s formerly incarcerated individuals received a Medi-Cal service. In 2016 (after Medi-Cal expansion), 36 percent of CDCR’s formerly incarcerated individuals received a Medi-Cal service. An increase in access and utilization of health care services for individuals experiencing the most severe forms of mental illness also occurred after Medi-Cal expansion; in 2012, 22 percent of CDCR’s formerly incarcerated received mental health services, and in 2016, 52 percent received those services.

The report details demographic profiles of CDCR release cohorts, utilization trends, and types of services. Also of note, the report finds that there was a significant growth in utilization from 2012 (prior to Medi-Cal expansion) to 2016 (after Medi-Cal expansion) in 50 of the 58 California counties. The rise in percent of individuals receiving Medi-Cal services ranged from 19 percent to 60 percent. Overall, the Medi-Cal expansion is determined to have provided access to health services not previously available to many formerly incarcerated individuals in California state prisons. The full report is available here.

CDI, DMHC Issue First Prescription Drug Cost Transparency Reports

The California Department of Insurance (CDI) and the California Department of Managed Health Care (DMHC) recently issued their first Prescription Drug Cost Transparency Reports as required by SB 17 (Hernandez, Chapter 603, Statutes of 2017). The reports present information from health insurers and health plans in California about covered prescription drugs, including the 25 most frequently prescribed drugs, the 25 most costly drugs by total annual plan spending, and the 25 drugs with the highest year-over-year increase in total annual plan spending. This reporting requirement by insurers and plans is intended to demonstrate the overall impact of drug costs on health insurance premiums in California. Notable findings from the reports include:

Department of Insurance Report

  • CDI-regulated health insurers and their policyholders spent over $1.2 billion on prescription drugs in 2017
  • Generic drugs comprise 84 percent of prescriptions and 21 percent of spending while specialty drugs comprised three percent of prescriptions but 52 percent of spending
  • The cost of prescription drugs (after rebates) is 13.4 percent of premiums
  • The 25 most costly specialty drugs alone accounted for more than a quarter of the total annual spending for all drugs

Department of Managed Health Care Report

  • Health plans paid nearly $8.7 billion for prescription drugs in 2017
  • Prescription drugs accounted for 13.1 percent of total health plan premiums
  • Specialty drugs accounted for 1.6 percent of all prescription drugs, but accounted for 51.5 percent of total annual spending on prescription drugs
  • Generic drugs accounted for 87.8 percent of all prescribed drugs but only 23.6 percent of the total annual spending on prescription drugs
  • Health plans paid 91.2 percent of the cost of the 25 most costly drugs across all three categories of generic, brand name, and specialty drugs

The full CDI report is available here and the DMHC report is available here.