Wilson Moves to Block HMO Reform Bills

Gov. Pete Wilson abruptly slammed the brakes on dozens of managed health care reform bills Tuesday, warning the Legislature that, with one exception, he will sign none of them this year.

Unmistakably implying use of his veto power, the Republican governor demanded that the Legislature suspend forward progress on managed care bills until a task force of experts makes recommendations for reform early next year.

Wilson described the current crop of nearly 100 bills as “uncoordinated, reactive, piecemeal” measures. In contrast, he said the task force recommendations would be “comprehensive and coherent” for an industry that is proving increasingly difficult to manage.

Disclosure of the governor’s surprise action, contained in a veto message for a popular health care bill for women, won praise from the industry as a prudent step but angry criticism from consumer advocates and some lawmakers.

Assemblyman Martin Gallegos (D-Baldwin Park), a leading health care reformer, deplored the governor’s announcement as “unconscionable.” He predicted that the Democratic-controlled Legislature would test the veto threat.

“We are determined to do our work and move these bills along to the governor,” Gallegos said. “If the governor wants to veto all 88 of them, we’re prepared to bring each and every one back for a veto override vote.”

No gubernatorial veto has been overridden since 1979, when Democrat Edmund G. “Jerry” Brown Jr. was governor.

Gallegos and consumer activists accused Wilson of using the 30-member task force, 20 of whose members Wilson appointed, as an industry-dominated device to kill legislative reforms.

“This is an appointed HMO-industry committee that Gov. Wilson has given veto rights over legislation that the industry could not stop in the Legislature,” said Jamie Court, director of Consumers for Quality Care.

One Wilson appointee to the task force, Peter Lee, who represents the Los Angeles-based Center for Health Care Rights, said he was “appalled” by the governor’s decision. “I think this confirms many of the worst fears that some of us had when asked to serve on the task force,” Lee said.

Lee said the action “politicizes the task force to a degree that it will undercut its ability to reach a consensus.”

Gallegos said he had been assured repeatedly that Wilson would not use the task force as a political instrument to delay or thwart reforms proposed by the Legislature. “I think it is an outright sense of betrayal,” he said of Wilson’s decision.

Beth Capell of Health Access California, a consumer advocacy coalition, charged Wilson with making a “deliberate effort to discourage consumers from advocating changes in managed care by delaying and postponing. But that’s not going to happen.”

Sources said they had heard speculation some weeks ago that Wilson might call a timeout on health care reform. Even so, the move caught many by surprise.

Wilson disclosed his position in an unpublicized letter that his aides said was written Monday night when he vetoed a bill by Assemblywoman Susan A. Davis (D-San Diego). The bill (AB 1354) would have allowed women enrolled in managed care plans to bypass their primary care physician and make appointments directly with gynecologists.

Wilson said he vetoed the bill, which easily had passed the Legislature on a bipartisan vote, without regard to its merits. He said he also will “defer consideration” of the merits of “all others relating to managed care until we have the benefits of the wisdom” of the task force in January.

The one exception, Wilson said, was a bill (AB 38) by Assemblywoman Liz Figueroa (D-Fremont) that would immediately provide newborns and their mothers with 48 hours in the hospital, if the mother and doctor asked for it. A free follow-up visit also would be ensured if the woman left before 48 hours.

In the veto letter, Wilson seemed to anticipate the criticism that he was using an advisory task force to thwart proposed legislative remedies. “I do not ask or expect the task force to assume responsibility for the consideration of specific legislation,” Wilson said.

He said it was the “prudent course of action” for lawmakers to take a five-month “hiatus from uncoordinated, reactive, piecemeal decisions” and pursue the issue again in January based on what he called the “thoughtful, comprehensive, reasoned” recommendations of the task force.

The advisory task force was created by the Legislature and Wilson last year to examine broad and uncharted health care issues raised by the swiftly expanding phenomenon of managed care. Members include representatives of insurance carriers, consumers, labor, health care plans, employers, utilities and academics.

Nancy Monk, a vice president of regulatory affairs for PacifiCare Health Systems, one of the state’s biggest health maintenance organizations, said the industry has been recommending tackling complex health care issues “in a more comprehensive way.”

“Look at all the bills introduced this year,” Monk said. “We appear to be grasping at straws about problems that may or may not exist.”

Alan Tomiyama, spokesman for the California Assn. of Health Plans, an industry trade organization, called Wilson’s decision “prudent” even though the association’s own bills “appear to be put in the holding pattern.”

Ingram reported from Sacramento and Olmos from Los Angeles.