Gov. Jerry Brown (D) vetoed a number of health care bills over the weekend. They ranged from a program designed to improve flu vaccinations among health care workers, to a proposal to define and promote patient-centered medical homes, to a regulation on hospital-nurse staffing ratios.
The governor had a variety of reasons he gave for the different vetoes, but at least one of those explanations didn't make much sense, according Assembly member Henry Perea (D-Fresno). Perea is the author of AB 1000, a measure designed to make oral chemotherapy more affordable and accessible for Californians.
"While I support the author's efforts to make oral chemotherapy treatments more affordable for the insured, this bill doesn't distinguish between health plans and insurers who make these drugs available at a reasonable cost and those who do not," Brown wrote in his veto message.
Perea said he has heard a lot of arguments, both for and against the measure, but that was not an argument he'd really heard before, he said.
"I didn't quite understand it," Perea said. "My sense is, maybe some health plans are already in compliance with the [proposed] law. But I don't know.
That caught me off guard."
The governor advised Perea to work with the Department of Managed Health Care on implementing some form of the oral chemotherapy legislation, which provided some hope, Perea said.
He didn't directly attack the policy," Perea said. "If there's a silver lining, it's that he suggested we work with DMHC. I don't actually know how they could help, what they could do, but we're going to find out."
Perea hopes to take up an amended version of the legislation during the special session in December that has been called by the governor to work out health care issues.
"We will find out what they wanted to do differently, and then we'll do that," Perea said.
Vetoes of Other Health-Related Legislation
Other rejections of proposed laws were a little more straightforward:
SB 393 by Sen. Ed Hernandez (D-West Covina) would have encouraged use of the patient-centered medical home model of care. "While this concept is not new, it is still evolving," Brown wrote in his veto message. "For this reason, I think more work is needed before we codify the definition contained in this bill."
SB 1318 by Sen. Lois Wolk (D-Davis) proposed a requirement to raise flu vaccine compliance among health care workers. Rather than the national target of a 90% compliance rate by 2020, the proposed law called for mandatory state compliance by 2015. Brown wrote that those "are requirements I do not believe are reasonable."
SB 359 by Hernandez would have regulated hospital charges for out-of-network emergency care. "I am not convinced, however," Brown wrote, "that the rate-setting formula in this bill has it right."
AB 2152 by Assembly member Mike Eng (D-Monterey Park) would have required insurers to give more notice about health coverage changes.
SB 961 and AB 1461 by Hernandez and Assembly member Bill Monning (D-Carmel) would have changed market rules within the individual market, in order to mirror federal rules under the Affordable Care Act. These bills still are expected to be among the topics addressed in the special session held in December. "This bill got almost all the way there," Brown wrote in identical veto language for both bills. "Unfortunately, this measure failed to adequately link our state reforms to the federal law."
There were several other vetoes that affected health care legislation:
SB 411 by Sen. Curren Price (D-Los Angeles) which would have regulated private home care;
SB 970 by Sen. Kevin de León (D-Los Angeles), which would have, among other things, established a work group to integrate human services and work support programs;
AB 369 by Assembly member Jared Huffman (D-San Rafael), which would have limited insurers' requirements that patients must try and fail two medications before a more experimental one is tried; and
SB 1246 by Hernandez, which dealt with hospital-nurse staffing ratios.