July 21, 2017 Edition

After Chaotic Week, Path Forward for Senate’s Health Care Bill Unclear

This week featured a flurry of activities around the Senate’s attempt to strike consensus on how to proceed with repealing and replacing the Affordable Care Act. Senate Majority Leader Mitch McConnell had initially hoped to hold a procedural vote to begin debate on the Better Care Reconciliation Act (BCRA) this week but was forced to postpone the vote after failing to secure support from four Republican senators. Due to their slim majority, Republicans cannot afford to lose support from more than two Republican senators.

After failing to establish consensus on the BCRA early this week, Majority Leader McConnell announced his intention to hold a vote for a repeal-only measure, entitled the Obamacare Repeal Reconciliation Act (ORRA), next week. Almost immediately after McConnell’s repeal-only announcement, four Republican senators announced their public opposition to the plan, citing concerns over the drastic impact a full ACA repeal would have on Americans. President Trump convened all Republican senators at the White House for lunch on Wednesday where he urged the senators to reconcile their differences and come to an agreement on health care, even if it required them to stay in Washington into the August Congressional Recess.

Following the Senate Republican gathering at the White House Wednesday afternoon, Majority Leader McConnell indicated he would restart discussions of repealing and replacing the ACA, with a procedural vote to debate the health care measure to be held next Tuesday. However, it is unclear which measure the Senate will be voting on next week. Republicans continue to hold meetings with members of their own party, attempting to strike a consensus on the two leading options – the repeal-only ORRA measure or an updated version of the BCRA. The latest reports suggest that both options lack the necessary votes to even to take up one of the selected measures on the Senate Floor.

The Congressional Budget Office (CBO) released an analysis of the repeal-only ORRA measure on Wednesday, which indicated by 2026, the number of uninsured Americans would increase by 32 million, average premiums would double, and federal deficits would decrease by $473 billion.

On Thursday, the CBO released an analysis of the updated version of the BCRA, which indicated by 2026, the number of uninsured Americans would increase by 22 million, premiums would decrease by 25 percent, and federal deficits would decrease by $420 billion. Notably, the updated version of the BCRA strips the Cruz Amendment, keeps some taxes the initial BCRA repealed, and makes other minor technical modifications.

Further, Senator John McCain announced this week he has been diagnosed with brain cancer and may be limited in his ability to debate or vote on the health care measure next week, which only complicates matters for Majority Leader McConnell as his margin for losing supporting votes likely becomes even slimmer. As the week concludes and a vote early next week nears, it remains unclear how the Senate plans to proceed with their attempt at repealing and replacing the ACA.

Legislature Adjourns for Summer Recess

The Legislature has officially adjourned for its one-month summer recess, concluding a steady week of policy committee hearings and legislative actions. Much of the focus this week was on the Legislature’s bipartisan passage of major climate change policy which extended the state’s cap-and-trade program to 2030, with concessions made for continued tax exemptions and an affordable housing package to be fleshed out after recess. Despite climate change policy taking the main stage, policy committees arrived at today’s deadline to meet and take action on remaining non-fiscal bills, resulting in a significant number of measures becoming two year bills.

Below, we highlight several bills of interest to CHEAC Members. Our full bill chart for this week is available here.

Drug & Alcohol Services

AB 40 (Santiago) as amended 7/10/17 – Support

Assembly Member Miguel Santiago’s AB 40 was advanced from the Senate Judiciary Committee to the Senate Appropriations Committee this week. The measure would allow the CURES database to integrate with other health information technology systems and permit health practitioners and pharmacists to access the database. CHEAC supports this measure as a modest, but important strategy in addressing the complicated and rising opioid epidemic in California.

AB 182 (Waldron) as amended 5/26/17 – Watch

AB 182 by Assembly Member Marie Waldron was heard in the Senate Appropriations Committee this week where it was placed on the Suspense File. The measure establishes the Heroin and Opioid Public Education (HOPE) Act to require the California Department of Public Health (CDPH) to develop a comprehensive and multicultural public education program to address the rising heroin and opioid epidemic upon appropriation of the Legislature or receipt of grant funding.

Health Coverage

SB 323 (Mitchell) as amended 4/25/17 – Support

SB 323 by Senator Holly Mitchell was placed on the Assembly Appropriations Suspense File this week. The measure would allow federally qualified health centers (FQHCs) and rural health centers (RHCs) to have Drug Medi-Cal, specialty health services, and specialty mental health services reimbursed as contracted with the Department of Health Care Services (DHCS) or a county.


SB 386 (Glazer) as amended 7/13/17 – Support

Senator Steven Glazer’s SB 386 was placed on the Assembly Appropriations Suspense File this week. The measure would ban all smoking (including e-cigarettes) and cigar and cigarette waste at state coastal beaches, state parks, public campgrounds, monument sites, landmark sites, and sites of historical interest. The state director of parks and recreation is permitted to exempt certain areas of state parks from the ban, and the ban does not apply to Native American ceremonial activities.

Sonoma County Department of Health Services Recognized with National Award

The Sonoma County Department of Health Services was named the Local Health Department of the Year by the National Association of City and County Health Officials (NACCHO) during the recent NACCHO Annual Conference. The award recognizes and honors outstanding health department accomplishments, of which Sonoma County received special recognition of its efforts in cardiovascular disease treatment and prevention. Sonoma County was selected as the Gold Level Recipient, the top honor, among counties with a population of 500,000 or more. The full press release is available here. Please join us in congratulating Sonoma County!

Counties Cannabis Summit Held in Sacramento

This week, the California State Association of Counties (CSAC), Rural County Representatives of California (RCRC), and the Urban Counties of California (UCC) hosted a one-day Counties Cannabis Summit to explore the changing policy landscape related to medical and adult use cannabis in California. In attendance were key state regulators, county supervisors and senior staff, and cannabis industry experts to discuss critical policy implementation, county priorities, and local regulatory approaches. A handful of CHEAC members were present for the event, as well as CHEAC Staff. Materials from the summit sessions and a summary of the event have been posted on CSAC’s website.

New LHD Health Equity Resource Guide Launched This Week

With support from The California Endowment, Human Impact Partners launched HealthEquityGuide.org this week to assist local health departments navigate issues of health disparities and health equity within their own communities. The guide features strategic practices to build internal infrastructure, work across government agencies, foster community partnerships, and champion transformative change. The guide also provides over 25 case study examples of how local health departments have implemented strategies to advance health equity; featured in the case study examples are initiatives led by Alameda, San Francisco, San Mateo, Santa Clara, and Solano counties. Case study examples are available here. A full press release on the new guide is available here.

de Beaumont Foundation, Aspen Institute Announce New Public Health Initiative

This week, the de Beaumont Foundation and the Aspen Institute Health, Medicine, and Society (HMS) Program announced the planned launch of the Public Health Reaching Across Sectors (PHRASES) Initiative. The PHRASES Initiative is a multiyear project designed to provide the tools and training public health practitioners need to effectively engage, communicate, and work with local partners, including mayors, housing commissioners, hospital executives, and school superintendents. The initiative aims to provide easily accessible toolkits and online resources for use by LHDs, disseminate core elements of communications strategies, and conduct outreach and training for the public health community. The full press release is available here.