BILL ANALYSIS Ó
AB 2345
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Date of Hearing: April 27, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
AB
2345 (Ridley-Thomas) - As Amended April 18, 2016
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|Policy |Health |Vote:|19 - 0 |
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Urgency: No State Mandated Local Program: NoReimbursable: No
SUMMARY:
This bill creates the Commission on Health Care Cost Review
(Commission) to study and analyze public policies relating to
health care costs and access to health care coverage, and
requires the Commission report its findings to the Assembly and
Senate Committees on Health every two years, as specified. It
also:
1)Allows the Department of Managed Health Care (DMHC) to accept
voluntary contributions to pay for the costs of operation of
the Commission.
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2)Creates the Health Care Affordability Fund and requires that
implementation of the Commission is contingent upon a
determination by the DMHC that sufficient voluntary
contributions exist or will exist in the Health Care
Affordability Fund.
3)Sunsets on January 1, 2020 if sufficient voluntary
contributions are not available, and sunsets in January 1,
2025 if sufficient voluntary contributions are available.
FISCAL EFFECT:
1)Unknown, significant cost pressure, likely in the low millions
annually for staff and contract costs to support the
commission (Health Care Affordability Fund, funded by private
donations). For comparative purposes, the California Health
Benefits Review Program (CHBRP), which has a narrower mission
than the commission envisioned by this bill, has an annual
budget of $2 million. A health policy commission with more
expansive duties in Massachusetts has a budget of about $10.5
million, about one-third of which is attributed to market
review activities similar to those envisioned by the bill.
2)Minor administrative costs to DMHC to establish and administer
funds to create the commission (Managed Care Fund).
COMMENTS:
1)Purpose. According to the author, legislators do not have
adequate information to respond to the myriad of policy
concerns regarding health care. The author states the intent
of this bill is to enhance the information available to
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legislators, in order to assist them in identifying and
responding to issues related to cost, coverage, and access to
services. The California Primary Care Association has
expressed support and the bill has no opposition.
2)Current California efforts. As of 2013, health care accounted
for 12% of California's Gross State Product. Pursuant to
Governor Brown's Executive Order B-19-12 on May 3, 2012,
California established the Let's Get Healthy California Task
Force under the Secretary of the Health and Human Services
Agency to develop a 10-year plan for improving the health of
Californians, controlling health care costs, promoting
personal responsibility for individual health, and advancing
health equity. The Secretary convened a task force and issued
a report, and recently unveiled a website to track progress
towards health goals.
Various types of state health policy decisions are also made
by the CoveredCA Board, CalPERS for health benefits for
government workers, and the Department of Health Care
Services, often with stakeholder input. CHBRP is housed
within the University of California Office of the President
and is tasked with reviewing the costs, medical effectiveness,
and public health impacts of legislation that proposes to
institute or repeal health insurance benefit mandates.
Private foundations regularly commission health policy reports
and issue related recommendations. Recent studies have
discussed regional market reviews, surveys of access to health
care in Medi-Cal, and other issues.
However, the state does not have a centralized commission to
review issues relating to health care costs, coverage, and
access broadly.
3)Other states. Colorado, Maryland, and Massachusetts have
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established health policy commissions. Maryland's commission
appears to focus on hospital care. Colorado's is envisioned as
a one-time commission tasked with specific recommendations,
while the commission in Massachusetts determines the state's
health care cost growth benchmark, assesses market
performance, and researches cost trends, as well as other
activities.
4)Prior legislation. AB 1801 (Pacheco) of 2002 created the
Commission on Health Care Cost Review and required the
commission to study and report to the Legislature and the
Department of Finance on specified matters, including the
public policies affecting health care costs and access to
health care coverage in California. AB 1801 was not in any
policy Committee.
5)Related legislation. SB 1159 (Hernandez), currently pending in
Senate Health Committee, requires the Secretary of
California Health and Human Services to convene an advisory
committee composed of a broad spectrum of health care
stakeholders and experts, as specified, to, among other
things, develop the parameters for establishing, implementing,
and administering a health care cost and quality database. SB
1159 also requires the secretary to arrange for the
preparation of an annual report to the Legislature and the
Governor that examines and addresses specified issues,
including, among others, containing the cost of health care
services and coverage.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081
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