Politics & policy

Insight into federal and state health care legislation & CMS regulation

7 Managed Care Reform Measures Vetoed by California's Gov. Wilson

For the second straight year, California Gov. Pete Wilson cited the prospect of rising health costs as he vetoed a host of managed care reform bills passed by the state legislature.In the weeks after the end of the legislative session, Wilson vetoed seven managed care reform bills, including three that would have tightened regulation of utilization review procedures.

All three proposals would have required that UR decisions be made by physicians licensed in California. One of the measures would have required HMOs to re-examine gravely ill patients before denying payment for services recommended by the patients' physicians.

Wilson rejected the most far-reaching of the bills as "a transparent effort to eliminate the appropriate use of utilization review and a bald attempt to increase the number of lawsuits in the health care system."

He also vetoed a bill that would have created a consumer commission to oversee managed care plans and one that would have required physicians and health officials to report HIV cases to the state using an anonymous coding system.

Last year, Wilson vetoed eight HMO bills on a single day, in a move that came to be known as the "Columbus Day Massacre." This year's vetoes came over a two-week period in late September.

Business groups welcomed the vetoes, claiming that every 1 percent increase in health insurance rates would push 40,000 people into the ranks of the uninsured.

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