Residents Ryan Gamlin, MD, and Mariam Sarwary, MD, journeyed to Sacramento to take part in the California Medical Association’s annual Legislative Day on April 24, visiting legislators and aides in their State Capitol offices and speaking on behalf of public health and the profession of medicine. They joined CSA officers including myself and other members of the CSA’s advocacy team.
The State Capitol saw more excitement than usual as an estimated 800 people who oppose vaccination crowded the halls to protest against Senate Bill 276, which would tighten the rules governing medical exemptions to vaccination. The CMA and CSA strongly support the bill, and a number of physicians including myself testified in its favor before the Senate Health Committee. They had to be escorted by security through the crowds of vocal anti-vaccine protesters in order to reach the committee hearing room, some of whom were yelling and haranguing the physicians as they were entering.
“As a Past President of the California Society of Anesthesiologists, and the mother and grandmother of fully vaccinated children, I speak in strong support of this measure,” I said.
Our group met with several state senators and assembly members and their aides, explaining the key concepts behind several current bills related to healthcare. With a staggering total of more than 2500 bills introduced in the California Assembly and Senate this year, it’s easy to see how hard it is for lawmakers to keep track of them.
Dr. Sarwary said the day was “an amazing and eye-opening experience,” and expressed surprise at how much of the focus was simply on informing and educating both lawmakers and their aides about the major points in bills concerning healthcare. The day changed “the way I think not only about my career but my responsibility as a citizen,” she said.
The bills that were the primary focus of our day in Sacramento included:
- Assembly Bill 764: Would support healthier diet choices by prohibiting soda companies from offering promotional and marketing incentives to subsidize low retail costs of sugary beverages. These sales tactics often make it cheaper to buy soda than water, and indirectly contribute to obesity and diabetes particularly in economically disadvantaged communities. This bill is endorsed by the California Dental Association and the American Academy of Pediatrics.
- Senate Bill 276: Would tighten the rules around medical exemptions to vaccination. This bill is championed by pediatrician and State Senator Richard Pan, MD. After California law eliminated the personal belief exemption for children who attend public school or day care, numbers of medical exemptions soared, leading to questions about their legitimacy. This new bill would strengthen the medical exemption process by requiring final approval from the California State Health Officer, and by creating a database of approved exemptions.
- Assembly Bill 1174: Would require health plans and insurers to notify state regulators of any proposed termination of contracts with anesthesiology groups, and to demonstrate that the plan would still provide adequate in-network anesthesia coverage for its hospitals. This bill would prevent a situation where an insurer tries to terminate an existing anesthesiology contract without any replacement. Insurers may be motivated to do this in states such as California where “surprise billing” laws have created an incentive for insurers NOT to negotiate fair contracts, since mandated out-of-network payment rates are lower than current contracted rates. CMA has been a critical partner in creating a system that encourages contracting and holds patients harmless during billing disputes.
The morning began with an orientation by Janus Norman, the CMA’s chief lobbyist, about the key issues up for consideration, and a video demonstrating right and wrong ways to approach legislators. He reminded the audience that the goal is to foster a relationship of trust with the legislators so that they will look to physicians as their primary source for reliable healthcare information.
After lunch, the audience heard a keynote address from California Governor Gavin Newsom, who has made healthcare a major focus of his campaign and his new administration. The governor has repeatedly expressed support for universal healthcare. In his remarks, he noted that a small percentage of Medi-Cal beneficiaries require a high level of service due to their health conditions, and 25 drugs constitute more than 50 percent of pharmaceutical costs. The governor has already created a state purchasing group to help control pharmaceutical expenses for Medi-Cal and CalPERS, the California public employees’ retirement system.
The CSA will continue to monitor and follow pertinent bills, and everyone updated.