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HomeMy WebLinkAbout1HCITY COUNCIL STAFF REPORT DATE: April 22, 2021 CONSENT CALENDAR SUBJECT: RESOLUTION OF SUPPORT FOR ASSEivlBL Y BILL 1400, GUARANTEED HEAL TH CARE FOR ALL FROM: Justin Clifton, City Manager BY: Anthony J. Mejia, MMC, City Clerk RECOMMENDATION: Adopt a Resolution entitled, "A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PALM SPRINGS, CALIFORNIA, DECLARING ITS SUPPORT FOR ASSEMBLY BILL 1400, GUARANTEED HEAL TH CARE FOR ALL." BACKGROUND: At the request of Councilmember Kors, the City Council is requested to consider whether to adopt a resolution in support of Assembly Bill 1400, Guaranteed Health Care for All. AB 1400, introduced by Assembly Members Ash Kalra, Alex Lee, and Miguel Santiago would enact the following changes to existing law: • This bill would create the California Guaranteed Health Care for All program, or CalCare, to provide comprehensive universal single-payer health care coverage and a health care cost control system for the benefit of all residents of the state. The bill, among other things, would provide that CalCare cover a wide range of medical benefits and other services and would incorporate the health care benefits and standards of other existing federal and state provisions, including the federal Children's Health Insurance Program, Medi-Cal, ancillary health care or social services covered by regional centers for persons with developmental disabilities, Knox-Keene, and the federal Medicare program. The bill would require the board to seek all necessary waivers, approvals, and agreements to allow various existing federal health care payments to be paid to CalCare, which would then assume responsibility for all benefits and services previously paid for with those funds. • This bill would create the CalCare Board to govern CalCare, made up of nine (9) voting members with demonstrated and acknowledged expertise in health care, and appointed as provided, plus the Secretary of California Health and Human Services or their designee as a nonvoting, ex officio member. The bill would provide the board with all the powers and duties necessary to establish CalCare, including determining when individuals may start enrolling into CalCare, employing necessary staff, negotiating pricing for covered pharmaceuticals and medical supplies, establishing a prescription drug formulary, and negotiating and entering into necessary contracts. ITEM NO. _.i-=--· +f __ 1 City Council Staff Report April 22, 2021 --Page 2 Assembly Bill 1400, Guaranteed Health Care for All The bill would require the board to convene a CalCare Public Advisory Committee with specified members to advise the board on all matters of policy for CalCare. The bill would establish an 11-member Advisory Commission on Long-Term Services and Supports to advise the board on matters of policy related to long-term services and supports. • This bill would state the intent of the Legislature to enact legislation that would develop a revenue plan, taking into consideration anticipated federal revenue available for CalCare. The bill would create the CalCare Trust Fund in the State Treasury, as a continuously appropriated fund, consisting of any federal and state moneys received for the purposes of the act. Because the bill would create a continuously appropriated fund, it would make an appropriation. FISCAL IMPACT: There is no fiscal impact as a result of adopting this Resolution. Attachments: 1. Resolution of Support 2. Assembly Bill 1400 Fact Sheet Justin lifton City Manager 2 ATTACHMENT 1 3 RESOLUTION NO. -- A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF PALM SPRINGS, CALIFORNIA, DECLARING ITS SUPPORT FOR ASSEMBLY BILL 1400, GUARANTEED HEAL TH CARE FOR ALL WHEREAS, every Californian should have a right to health care; and WHEREAS, while the federal Patient Protection and Affordable Care Act (PPACA) brought many improvements in health care and health care coverage, it still leaves many Californians without coverage or with inadequate coverage; and WHEREAS, Californians, as individuals, employers, and taxpayers have experienced a rise in the cost of healthcare and health care coverage in recent years, including rising premiums, deductibles, and copays, as well as restricted provider networks and high out-of-network charges; and WHEREAS, businesses have also experienced increases in the costs of health care benefits for their employees, and many employers are shifting a larger share of the cost of coverage to their employees or dropping coverage entirely; and WHEREAS, Assembly Bill 1400 (AB 1400) would state the intent of the Legislature to enact legislation that would create a "comprehensive universal single-payer health care coverage program and a health care cost control system" for the benefit of all Californian residents; and WHEREAS, AB 1400 would consistently cover all Californians, because coverage is based on residency, not a person's changing income or employment status; and WHEREAS, AB 1400 would eliminate out of control co-pays and high deductibles, and reduce costs by cutting out insurance company waste and duplication; and WHEREAS, AB 1400 would give consumers the freedom to choose their doctor, and would manage prescription drug costs; and WHEREAS, CalCare would establish the CalCare Trust Fund in the State treasury for creating cost controls and maintaining a reserve of funding for responding to health emergencies. THE CITY COUNCIL OF THE CITY OF PALM SPRINGS HEREBY DETERMINES, DECLARES, APPROVES, AND RESOLVES: SECTION 1. that the City of Palm Springs hereby supports Assembly Bill 1400, Guaranteed Health Care for All. 4 Resolution No. Page2 SECTION 2. The City Clerk shall transmit this resolution to the author(s) of Assembly Bill 1400. PASSED, APPROVED AND ADOPTED BY THE PALM SPRINGS CITY COUNCIL THIS __ DAY OF APRIL, 2021. ATTEST: Anthony J. Mejia, MMC City Clerk Justin Clifton City Manager CERTIFICATION STATE OF CALIFORNIA ) COUNTY OF RIVERSIDE ) ss. CITY OF PALM SPRINGS ) I, ANTHONY J. MEJIA, City Clerk of the City of Palm Springs, hereby certify that Resolution No. __ is a full, true, and correct copy, and was duly adopted at a regular meeting of the City Council of the City of Palm Springs on _________ _ by the following vote: AYES: NOES: ABSENT: ABSTAIN: IN WITNESS WHEREOF, I have hereunto set my hand and affixed the official seal of the City of Palm Springs, California, this __ day of _________ _ Anthony J. Mejia, MMC City Clerk 5 ATTACHMENT 2 6 Assembly Bill 1400 California Guaranteed Health Care for All Act (CaICare) Assembly Members Ash Kalra, Lee, Santiago Principal Co-Authors: Assembly Members Chiu and Ting and Senators Lena Gonzalez, McGuire and Wiener Co-Authors: Assembly Members Carrillo, Friedman, K.amlager, McCarty, Nazarian, Luz Rivas, Wicks Senators Becker, Cortese, Laird and Wieckowski SUMMARY Today's U.S. health care system is a complex, fragmented multi-payer system that still leaves wide gaps of coverage and poses significant issues of affordability. Despite health care spending in the U.S. far exceeding other high-income, industrialized countries that offer a publically financed single- payer system, we consistently report worse health outcomes and disparities among vulnerable populations. AB 1400 sets in motion a single-payer health care coverage system in California, called CalCare, for all residents, regardless of citizenship status. By streamlining payments and lowering per-capita health care spending, CalCare guarantees quality health care and long-term care without creating barriers to care or out-of-pocket costs. By affirming health care as a right to all Californians and establishing a payment system that eliminates waste and aligns reimbursements with the actual cost of care, we can make significant progress on financing and acquiring state and federal approvals. HEALTH SYSTEM STATUS Quo An estimated 2. 7 million Californians remain uninsured 1 and millions more with coverage often delay or are unable to access necessary medications or health care services due to cost. Since the COVID-19 pandemic, that number has grown as many workers have lost their employer-based coverage or were unable to afford the high cost of health care due to economic constraints. 1 Covered California estimates, January 12, 2021 Health care spending in the United States far outpaces other industrialized countries. 2 Based on prior years of health insurance rate filing data, hospital costs and physician services represent an overwhelming proportion of the overall projected premium dollar-75% of the projected 2018 premium dollar. Americans use significantly less health care services than people in other industrialized countries3 - including physician visits and hospital admissions - yet spending is greater due to higher prices. Despite higher spending, Americans have worse health outcomes, including shorter life expectancy and greater prevalence of chronic conditions. 4 Another challenge with our health care system is the pervasiveness in health disparities. California is a diverse state -racially, ethnically, economically, and geographically -and vulnerable populations face greater health risks and have less access to safety net programs. California's growing senior population, aged 60 years and over, is expected to grow more than three times as fast as the total population5, which will place additional strain on health care services. As more aging adults enter Medicare, there will be a need to improve access and lower costs by pooling state and federal funds. 2 I. Papanicolas, L.R. Woskie, and A.K. Jha, "Health Care Spending in the United States and Other High-Income Countries," JAMA, March 13, 2018 3 H ea/th at a Glance 2017: 0 ECD Indicators -number of doctor consultations per person, hospital discharges, and average length of stay in hospital. 4 "U.S. Health Care from a Global Perspective: Spending, Use of Services, Prices, and Health in 13 Countries," The Commonwealth Fund, October 2015 5 California Department of Aging website, "Facts About California's Elderly." https://aging.ca.gov/Data_and_Reports/ AB 1400 (Kalra et al)• Fact Sheet• February 19, 2021 7 CALIFORNIA'S GUARANTEED HEALTH CARE FOR ALL (CALCARE) The COVID-19 pandemic has exposed how grossly flawed and inequitable our multi-payer health system is and how critical it is for all Californians to be guaranteed access to health care. AB 1400 will bring California closer to achieving a single-payer health care system by setting in place a comprehensive framework of governance, eligiblity and enrollment, benefits, delivery of care, and health care cost controls and program standards. By passing the California Guaranteed Health Care for All Act, the state can position itself to seek consolidated federal waivers from the U.S. Department of Health and Human Services. These waivers would make it easier for California to consolidate health care dollars, provide flexiblity, expand benefits, and eliminate cost-sharing. Upon being authorized and financed, CalCare will establish a comprehensive universal single-payer health care coverage program and a health care cost control system. CalCare will be set up as an independent public entity governed by a nine member executive board with expertise in health care policy and delivery. The CalCare Board's composition shall be reflective of California's diversity and free of any conflicts of interest. The Board shall convene a Public Advisory Committee to advise on all matters of policy and make informed recommendations. THE CALCARE MISSION AND DUTIES CalCare will be charged with overseeing the state's single-payer system, and will ensure the following: Comprehensive Benefits and Freedom of Choice Californians will have access to comprehensive health care coverage, including all primary and preventive care, hospital and outpatient services, prescription drugs, dental, vision, audiology, reproductive health services, maternity and newborn care, long-term services and supports, prescription drugs, mental health and substance abuse treatment, laboratory and diagnostic services, ambulatory services, and more. Patients will have freedom to choose doctors, hospitals, and other providers they wish to see, without worrying about whether a provider is "in-network." No Premiums, Copays, or Deductibles Californians would receive health care services and other defined benefits without paying any premiums or deductibles. Upon receiving care, patients would not be charged any copays or other out-of-pocket costs. Addressing Health Care Disparities CalCare would remove barriers to care and create a special projects budget to fund the construction, renovation, or staffing of health care facilities in rural or underserved communities. Long-Term Services and Supports for People with Disabilities and the Elderly Long-term services and supports for daily living will be fully covered for medically determinable conditions, whether physical, mental or due to age. Reducing Health Care Spending and Improving Care CalCare would move the state to a simplified health care payment system that will free health care providers from devoting time on billing and instead focus on patient care. The new system would establish reasonable payment methodologies for providers that are aligned with the actual costs of care rather than driven by profits. Health care professionals and institutional providers would be prohibited from over utilizing services. CalCare can negotiate bulk drug prices for all Californians and take other measures to lower the costs of prescription drugs. Global Budgets for Institutional Providers CalCare would negotiate fair, adequate global budgets to hospitals and other institutional providers to help contain the exorbitant costs by aligning health care payments with the actual cost of care and eliminating waste present in the system today. Institutional providers may submit appeals to the global budget to address justifiable or unforeseen circumstances. AB 1400 (Kalra et al)• Fact Sheet• February 19, 2021 8