'Health for All Act' stalls in committee; drug formulary bill advances

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The state senate appropriations committee postponed voting on a bill to provide subsidized health insurance to people in the US illegally, while it passed on to the full senate legislation that would require health insurers to provide information on which drugs they cover and how much the consumer would have to pay for them. 

The committee voted to hold SB 1005, also known as the Health for All Act,  until the summer, to give its backers more time to figure out how to pay for the bill. The legislation, authored by Sen. Ricardo Lara (D-Long Beach), would permit people in the US illegally to purchase Medi-Cal coverage or private insurance partially subsidized by the state.

RELATED: Sen. Lara introduces SB 1005 in February 2014

Because the committee delayed action on the bill, it will require a two-thirds vote to pass the senate in the summer.

KPCC reported Wednesday that it would cost more than $350 million next year to implement the part of the legislation related to expanding Medi-Cal. The cost would increase to more than $420 million by 2019, according to Lara. That cost projection did not include a plan for how the state would pay to expand Medi-Cal to those without legal status.

"In my view, expanding health care for all Californians is not a question of if, but a matter of when," Lara said in a statement. "Over the next few months, I will work tirelessly with my Senate colleagues and interested stakeholders to explore funding options so that we continue the momentum we’ve built to advance our goal of health care for everyone."

The committee voted 6-1 to pass SB 1052, which would require all health plans to post – in a usable format - their drug formulary, and the cost-sharing associated with each drug. The bill, authored by Sen. Norma Torres (D-Pomona), would cover plans offered on the private market, as well as those offered through the state's insurance marketplace, Covered California. If SB 1052 becomes law, Covered California would have to set up a search window, where people could type in their medication, and find out which plans would cover it, and at what cost.

KPCC’s Impatient blog reported earlier this month that SB 1052 would make it easier for people to shop for plans based on which drugs they take. For people who rely on a medication to save their life, or dramatically improve the quality of their life, knowing how much the drug costs under a specific health plan is as important as knowing whether a specific doctor is covered, Alison Ramey, with the American Cancer Society’s Cancer Action Network told Impatient.

RELATED: Will my health plan cover my drugs? Right now, it's hard to tell

"Californians living with serious and chronic conditions should have clear information about which health plans cover the prescription drugs they need," Torres said in a statement.

Consumers need this information when shopping for a health plan, said Torres.

"Making apples-to-apples comparisons among competing health plans on the market is extremely difficult to do when there is no consumer-friendly search function online," she said. "We can do better."

 

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