Last year, California Gov. Pete Wilson vetoed several managed care reform bills, saying he was waiting for a report from the Managed Health Care Improvement Task Force that he and the state legislature appointed.
Now that the report and its 100 recommendations are in, the focus of reform moves back to the legislature.
"Some will criticize the task force for being modest," Philip J. Romero, the panel's executive director, wrote in summary. "Others will say it was too radical. It produced a package of centrist, incremental proposals that emerged as thoughtful compromises between highly opposed interests."
Romero, who is the Republican governor's chief economist, was right about reaction. Consumer groups say the proposals offer inadequate protection to patients, while managed care trade groups blast them for not considering costs and for seeking to micromanage plans.
Calling the task force's proposals "industry-friendly, weak and rather soft," Assembly Health Committee Chairman Martin Gallegos, a Democrat and a task force member, said he will propose a managed care reform in the form of a constitutional amendment he hopes to place on November's statewide ballot. To reach the ballot, the bill must be approved by two thirds of each house of the legislature, but it does not need approval by the governor.
The task force proposals, if adopted, would:
The task force did not address the issue of whether patients should have the right to sue health plans for malpractice when they are wrongly denied coverage.
The state's largest HMO, Kaiser Permanente, says it will enact nearly all of the panel's recommendations regarding dispute resolution. Last summer the state Supreme Court criticized Kaiser, saying the plan had manipulated its self-administered arbitration system against patients. Kaiser plans outside of California will not be affected by the change.
The report can be found at http://www.chipp.cahwnet.gov/mctf/front.htm on the Internet.