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CEO Message: Change Needed on Flawed Office of Health Care Affordability Proposal

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On Tuesday, as expected, the bill to create California’s Office of Health Care Affordability unanimously passed out of the Assembly Health Committee, with a couple legislators choosing not to vote.

The bill, which has the power to fundamentally change how health care in California is delivered, saw minimal debate — just a few brief questions from committee members — before it advanced to the next stage of the legislative process.

I had the opportunity to deliver several key messages during a few minutes of testimony to express CHA’s oppose-unless-amended position, including:

  • The fact that this bill doesn’t address, in any way, health care costs; it simply caps how much California spends on care and penalizes individual hospitals, doctor groups, or others if amounts paid to them exceed the capped rate of increase. This comes at a time when California already has lower-than-national-average per capita hospital spending.
  • The fact that this bill doesn’t differentiate between good spending — more for primary care or an aging population — from bad spending — unnecessary care or inflated drug prices.
  • The fact that this bill will create real, serious, and long-lasting unintended consequences for California. This includes locking in inequity for under-resourced communities, inhibiting needed investments in behavioral health and coverage expansion, and limiting the state’s ability to invest in new technologies and systems to prepare for the next, unknown widespread crisis.

In place of the bill, I shared CHA’s alternative proposal to create a commission, similar to one at the federal level that Congress uses to inform and make policy recommendations on the Medicare program. This commission, with data and expertise, would determine key cost drivers, what should be measured and how, what should be limited, and what policies would be needed to make care more affordable in California.

While there were a couple of questions following testimony, the lack of substantive debate on a bill that could bring such sweeping change is concerning. The concern stems from every California hospital leader’s duty to care for those in their charge, and the clear path that this bill takes toward a deterioration of that ability.

To guard against the slow erosion of our health care system, as the legislative process continues, every voice from the hospital field will be needed. We will need to reinforce, as a chorus, that we are, at once, committed to working on the affordability problem, but cannot abide a law that will hurt patients and communities. We must make clear that there is another solution to this problem, one that doesn’t jeopardize the people we all must protect.