California Legislation

California Legislation

Last week, there was legislation introduced in California that has the potential to radically reduce both patient care and access, increase out-of-pocket costs, and seriously affect medical care throughout the state.

Here are the facts of the bill:

  • This bill could lead to an exodus of physicians from California and worsen the state’s physician shortage.
  • A nine-member, politically appointed commission would set all commercial physician, health care provider and hospital prices throughout California.
  • Payments would be based on Medicare rates. In anesthesiology, more than any other specialty, this could be devastating.
  • Physicians would be specifically prohibited from being appointed to the commission.
  • Even though physicians are specifically excluded from the commission, physician licensing fees would fund the commission.
  • The bill could reduce patient choice and move back from value to volume-based fee for service.
  • The bill (erroneously) cites physicians as the drivers of health care costs, and this legislation has the potential to lead to an exodus of physicians from California.
  • The bill contains a blanket prohibition on balance billing, walking back agreements providers have come to with state regulators.
  • It would allow lawyers and lobbyists to engage with the commission, AND the commission will pay them to do just lobbying.

I commend our colleagues from the California Society of Anesthesiologists (CSA) who have responded aggressively to this dangerous legislation. Their members are engaged and are working with the California Medical Association, other physician groups and California hospitals to stop this bill NOW. This legislation needs to go down, and hard. It could lead to a template for other states to follow. As we know, in anesthesiology, more than any other area of medicine, anything based on Medicare rates could be devastating. Please follow CSA and ASA action alerts to stay up to date and see if there are ways you can help defeat this bill.

This is a real alert for us to really step up our strategy to address the unfair 33% situation (anesthesiology is different than other specialties, as on the average we get paid from Medicare rates what most others get from other commercial payers). Medicare is different for us! We need to move the change needle forward.

This quote from the California Hospital Association wraps the situation up nicely: “#AB3087 cuts payments to hospitals, doctors, and other providers. It will force hospitals to close and cripple patient access to care. An estimated 175,000 health care workers could lose their jobs. It is a recipe for disaster.”

ASA will be working hand in hand with the CSA leadership and our CSA members to engage on this critical issue. ASA has already reached out to our peer national organizations to ensure that they, too, understand the implications of this bill. We will be partnering with all of our stakeholders on this to help kill this in California before it metastasizes to other parts of the country. This is a big deal! Stay tuned. We are all over this one.