May 26, 2017 Edition

23 Million Americans Uninsured under House AHCA, CBO Reports

The Congressional Budget Office (CBO) released their updated score on the American Health Care Act (AHCA) of 2017, passed by the House of Representatives on May 4, which considers provisions included in the MacArthur Amendment.

The CBO estimates 14 million more individuals would be uninsured in 2018, 19 million in 2020, growing to 23 million in 2026. The number of uninsured changed only slightly compared to the CBO score in March, which estimated 14 million more individuals would be uninsured in 2018, 21 million in 2020 and 24 million by 2026.

The most recent amendments fall short of significantly reducing the number of individuals that would become uninsured and yet now would allow states to opt out of essential health benefits and restrict coverage by offering higher premiums for those with pre-existing conditions. In addition, young healthy individuals would likely benefit from premium savings, at the expense of older individuals.

In response to the release of the CBO score, House Republican Leadership praised the AHCA for lowering premiums and the federal deficit. The Administration – Secretary Price in particular – disagreed with the accuracy of the CBO score, stating “…they are wrong again”.

Senate Republicans provided early indications that they would not be supporting the AHCA in its current form; however, with the release of the CBO score, they will face continued scrutiny and pressure to devise a plan that preserves coverage for Americans, among other key considerations.

Trump Administration Releases FY18 Budget Proposal

On Wednesday this week, the Trump Administration released their FY 2018 Budget proposal. Please recall that in March the Administration released a budget blueprint, which only outlined President Trump’s discretionary funding proposals.  The release of the full budget document now includes federal mandatory budget proposals; however, the released budget does not provide any details on tax reforms.  Broadly speaking they are proposing a total FY 2018 budget of $4.094 trillion, but it also includes nearly $3.6 trillion in cuts over the next ten years.

Administration officials characterized the FY 2018 budget as a “Taxpayer First Budget” and that this proposal would usher in a sustained period of strong economic growth.  Democrats immediately denounced the plan with House Minority Leader Nancy Pelosi calling it “literally a killer” for the American people.  Senate Majority Leader, Mitch McConnell, acknowledged that Republicans would eventually have to negotiate with Senate Democrats on a “top line” agreement.

CHEAC’s summary of the President’s budget proposal can be found here.  Staff will continue to monitor developments as budget negotiations progress.

Budget Spending Plans Adopted; Conference Committees Announced

After months of Subcommittee budget hearings, the full Senate and Assembly Budget Committees convened hearings to adopt their respective spending plans.

Actions consistent within both spending plans include:

  • Approving $30 million from Proposition 56 (Tobacco Tax) funding for the Oral Health Program.
  • Adopting the Administration’s May Revision proposal to mitigate the impact of shifting In-Home Supportive Services costs to counties.
  • Rejecting the Administration’s proposal to eliminate the state-only aspects of CHDP.
  • Rejecting the Administration’s proposal related to clarifying the responsibility of the CCS Medical Therapy Program for the provision of medically necessary physical and occupational therapy.
  • Rejecting the proposed trailer bill restrict contracting for 340B entities.

The Budget Conference Committee – intended to reconcile differences between the two houses – is expected to begin its work on Tuesday, May 30.

The Conference Committee will be chaired by Senator Holly Mitchell (D-LA) and co-chaired by Assembly Member Philip Ting. Other members include: Senators Ricardo Lara, Richard Roth, Jim Nielsen, and John Moorlach; and Assembly Members Philip Chen, Kevin McCarty, Jay Obernolte, Shirley Weber, and Joaquin Arambula serving as the Democratic Alternate.

More than 800 Suspense File Bills Heard This Week

Today was the legislative deadline for fiscal committees to hear and report bills in their house of origin to the floor. Over the course of two days, more than 800 bills were reviewed by the Senate and Assembly Appropriations Committees. Below, we highlight several bills of interest to members.

This week’s CHEAC bill chart is available here.

Environmental Health

AB 626 (E. Garcia) as amended on 5/2/17 – Oppose

Assembly Member Eduardo Garcia’s AB 626 was scheduled to be heard in the Assembly Appropriations Committee on Wednesday. The author waived presentation and the measure was referred to the Suspense File. AB 626 seeks to create a new type of food facility under the California Retail Food Code for “microenterprise home kitchens” and allow for the sale of foods directly to consumers from private homes. CHEAC is opposed to the measure, along with the Health Officers Association of California (HOAC), California State Association of Counties (CSAC), Urban Counties of California (UCC), and Rural County Representatives of California (RCRC).

AB 626 was held in committee and is now a two-year bill, meaning it will not move forward this year, but the measure can still be considered next year.

Health Coverage

 SB 562 (Lara) as amended on 4/17/17 – Special Interest Bill

SB 562, by Senator Ricardo Lara, was heard this week by the Senate Appropriations Committee. The measure would establish the Healthy California Act to provide universal, single-payer health coverage for every Californian. Notably, the Senate Appropriations Committee analysis placed a $400 billion annual price tag on the measure and indicated significant uncertainty in projected costs. Despite an unclear funding mechanism, the measure was moved from the Suspense File to the Senate Floor with an amendment making the measure contingent on funding.

Suspense File Bills

CHEAC had an eye on over 75 other Suspense File bills this week. The following items are Suspense File bills on which CHEAC has taken a position. For all other Suspense File bills, please reference this week’s full bill chart.

Passed

AB 40 (Santiago) – Support – Drug & Alcohol Services – Do Pass as Amended

AB 64 (Bonta) – Special Interest Bill – Cannabis – Do Pass as Amended

AB 74 (Chiu) – Special Interest Bill – Health Equity – Do Pass

AB 175 (Chau) – Support in Concept – Cannabis – Do Pass as Amended

AB 340 (Arambula) – Support – Health Care Coverage – Do Pass

AB 391 (Chiu) – Support – Health Care Coverage – Do Pass as Amended

AB 725 (Levine) – Support – Tobacco – Do Pass

AB 1092 (Cooley) – Support – Health Care Coverage – Do Pass as Amended

AB 1591 (Berman) – Support – Health Care Access – Do Pass

SB 323 (Mitchell) – Support – Health Care Coverage – Do Pass

SB 386 (Glazer) – Support – Tobacco – Do Pass

SB 562 (Lara) – Special Interest Bill – Health Coverage – Do Pass as Amended

Held on Suspense

AB 15 (Maienschein) – Support – Dental Health – Held on Suspense

SB 222 (Hernandez) – Support – Jail Medical – Held on Suspense

SB 382 (Pan) – Support – Communicable Disease – Held on Suspense

SB 708 (Skinner) – Support – Health Equity – Held on Suspense

Two Year Bills

AB 626 (E. Garcia) – Oppose – Environmental Health – Two Year Bill