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Tuesday, May 21, 2013

Bill would bring sunshine to California health-care reform

BY MICHAEL R. BLOOD/ASSOCIATED PRESS

LOS ANGELES -- Two lawmakers are pushing legislation to strip broad secrecy provisions from the state agency overseeing health-care reforms in California that could shield from the public how hundreds of millions of dollars are spent, officials said Monday.



The bill by Republican Sen. Bill Emmerson and Democratic Sen. Mark DeSaulnier was introduced in the state Senate less than two weeks after The Associated Press reported the degree of privacy granted Covered California appears unique among states attempting to establish their own health insurance exchanges under President Barack Obama's signature law.

"It should all be transparent," Emmerson said in an interview. The California agency was given authority "to do things no one else could do. There was no sunlight on it."

An AP review of the 16 other states that opted for state-run marketplaces found the California agency was given powers that are the most restrictive in what information is required to be made public, and that explicit exclusions from open-records laws might run afoul of the state constitution.

The bipartisan bill, if passed in the Legislature, would take effect immediately "in order to ensure that public resources are managed efficiently," according to the text. Only narrower, temporary exemptions would be allowed, consistent with long-standing state law.

In August 2010, when California was sprinting to become the first state to embrace the most extensive health care changes since Medicare, state lawmakers gave the new agency the authority to keep all contracts private for a year and the amounts paid secret indefinitely.

According to agency documents, Covered California plans to spend nearly $458 million on outside vendors by the end of 2014, covering lawyers, consultants, public relations advisers and other functions.

By reversing the law, the bill, SB 332, would make public meeting minutes and records that reveal recommendations, research or strategy of the board or its staff, or those that provide instructions, advice or training to employees.

The indefinite ban on releasing rates of pay to companies and individuals receiving contracts would be scrapped. That provision goes beyond exemptions for other state health programs, such as Healthy Families, which withholds rates of pay from disclosure for up to several years, but not permanently.

The new law would mirror Healthy Families, providing a one-year delay in release of contracts only with large health plans and a three-year delay for rates of pay with only those firms, which are intended to promote fair competition.
However, those contracts would be open for inspection -- at any time -- by the Joint Legislative Audit Committee.
All other contracts would be pulled under state open-records laws, rather than exempted from them.

It's routine in government to keep bids secret until contracts are awarded, so one vendor does not get an unfair advantage over others. After a bid is awarded, contracts generally become fully public.

"I am proud that California was the first in the nation to establish a health care exchange, but we should also be taking the lead in promoting transparency and accountability," DeSaulnier said in a statement. "An open process will only benefit the implementation of the" health overhaul.

Currently, it's not clear how many contracts the agency has executed, for how much or with whom.

In Massachusetts, the state that served as the model for Obama's health overhaul, the Health Connector program is specifically covered by open-records laws. The same is true in Idaho, where its exchange was established as a private, nonprofit corporation, and in New Mexico.

The Maryland Legislature subjected its exchange to the state's public information act, but protected some types of commercial and financial information.

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