This week, all four of CHA’s state advocacy priorities converged in Sacramento, with significant developments on each. Sharing a brief recap of this week’s activities and next steps.
Seismic Mandate Reform
CHA’s bill to provide relief from the 2030 seismic construction mandate passed the Senate Health Committee on Wednesday on an 11-0 vote. The bill now heads to the Senate Appropriations Committee before a potential floor vote and then crossover to the Assembly.
Some key amendments were made to the initial proposal in the first committee, with the bill now providing:
- A three-year extension for all hospitals, as well as the potential for an additional five years based on financial capacity, the impact of construction on patient access to care, or concerns such as delays in the construction approval process
- A reporting requirement to the Legislature by government agencies to analyze the cost of seismic compliance and the impact on access to health care services
- For rural and critical access hospitals, a grace period from compliance until funding is available and hospitals can demonstrate that they lack the financial capacity to fund the seismic work
As this bill heads to the next phase, it’s critical that hospital and community partner voices remain at the forefront. Information and resources to share your story are available here.
Many thanks to CommonSpirit’s Chief Advocacy Officer Shelly Schlenker for her testimony on seismic relief this week.
Insurer Accountability
On Tuesday, CHA filed a lawsuit against Anthem, one of the largest insurance companies operating in California. The suit, which seeks an injunction to end practices that are harmful to patients, demonstrates that Anthem and other insurance companies that prioritize bottom lines over patients routinely violate state law requiring them to maintain adequate post-acute networks, authorize post-acute care in a timely manner, arrange for timely transfer to post-acute facilities, and more.
CHA’s complementary digital media campaign has launched, shining even more light on these pervasive practices. CHA’s press release on the lawsuit and recent discharge delay survey provide more details about the rationale for the litigation.
Following a press conference on Tuesday (many thanks to Vicki White, CNO, Henry Mayo Newhall Hospital, and Enloe Health CMO Sean Maiorano, MD, for their participation), early media coverage of the lawsuit and the broader concerns with insurance company practices have been favorable and includes the following:
- CalMatters, April 23, 2024 “An ‘impossible situation’: Why California hospitals are suing a major health insurer”(Also appeared in ABC 10 Sacramento, Lost Coast Outpost)
- San Francisco Chronicle, April 23, 2024 “California hospitals sue Anthem Blue Cross for delaying patient discharges”
- Bloomberg Law, April 23, 2024 “California Hospitals Sue Anthem, Alleging Delays Cost Billions”
- Sacramento Business Journal, April 23, 2024 “California hospitals sue, blaming major insurer for patients languishing in hospital without discharge”
- Becker’s Payer Issues, April 23, 2024 “California hospitals sue Anthem Blue Cross over discharge delays”
- Modern Healthcare, April 24, 2024 “Anthem Blue Cross faces suit for alleged patient discharge delays”
- Fierce Healthcare, April 24, 2024 “California Hospital Association sues Anthem Blue Cross over discharge delays”
- KOVR-TV13 (CBS Sacramento) April 24, 2024 *Video*
- KSBW-TV8 (NBC Monterey) April 24, 2024 *Video*
- KFBK-AM (iHeartMedia Sacramento) April 23, 2024 *Audio*
- KQED-FM (NPR San Francisco) April 24, 2024 *Audio*
- KBUU-FM (99.1 KBU Los Angeles) April 24, 2024 *Audio*
- KOGO-AM (San Diego) April 24, 2024 *Audio*
- KFI-AM (Los Angeles) April 24, 2024 *Audio*
Office of Health Care Affordability
On Wednesday, the Office of Health Care Affordability Board approved a five-year health care spending target that will be phased in as follows:
- 3.5% non-enforceable target in 2025
- 3.5% enforceable target in 2026
- 3.2% enforceable target in 2027
- 3.2% enforceable target in 2028
- 3.0% enforceable target in 2029
The growth target sets up the significant potential for unintended consequences resulting from this trajectory. CHA’s public statement on the decision shares with the media the hospital field’s ongoing, high-level concerns with the target.
CHA’s April 19 letter outlines more detailed concerns with the decision, including:
- Deficiencies with the proposal’s methodology, such as disregard of general inflation and other cost drivers (seismic mandate compliance and minimum wage increases, for example)
- The creation of a five-year target prior to collection of data and analysis of even a single year’s effort
- Establishing California as an extreme outlier among other states with similar efforts
- No analysis of the impact on access, quality, equity, or workforce stability
CHA will continue to engage with the board as this target and its impacts begin to play out over the coming months and years.
Preserving Access to Rural Health Care
CHA’s bill to provide additional funding to critical access hospitals that are in financial distress passed the Senate Health Committee on Wednesday on an 11-0 vote. Key amendments made at this stage include an opt-in structure, clarifications to the financing methodology, and inclusion of an analysis of the causes of critical access hospitals’ financial distress.
The bill now moves to the Senate Appropriations Committee, as a parallel budget path continues to secure this much-needed relief. A social media campaign aimed at Sacramento policymakers is helping raise awareness in the capital about this issue. Videos featuring hospital leaders discussing their challenges in keeping services available to their communities can be seen here and here.
Many thanks to Darren Beatty, COO at Plumas District Hospital, and Mary Casillas, CEO at Hazel Hawkins Hospital, for their testimony this week.
We’ll continue to keep you posted with developments on each of these critical issues as they advance through the legislative and regulatory process.
