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April 8, 2013
Editorial: Pérez bill could add to health reform costs


(April 8 -- By the Editorial Board)

Assembly Bill 1263 by Speaker John A. Pérez seeks to improve and expand medical interpreter services for Medi-Cal patients. The measure highlights a real health care dilemma. Access to care can be difficult if patients don't speak English well. Without a qualified interpreter, it's sometimes difficult for non-English speaking patients to describe their symptoms or for health care providers to make sure, for example, that patients understand a drug regimen.

A University of California, Los Angeles, survey in 2009 found that 12 percent of Medi-Cal patients had a hard time understanding their doctors because of limited English skills. That number is expected to swell as the federal Affordable Care Act is fully implemented in coming years.

The speaker's bill would create a new statewide system to train, test and monitor medical interpreters. The bill also directs state health officials to take advantage of enhanced federal funding for interpretation services.

Currently, California is reimbursed at a 50-50 rate by the federal government for medical interpretation services. Under some circumstances it could collect a 75 percent reimbursement from the federal government.

If all the bill did was improve testing, training and monitoring of health care interpreters, and push the state to draw down more federal funding available for their services, it might merit support. But nearly half the bill deals with setting up a process for interpreters, most of whom are private contractors now, to join a public employee union, pay dues and collectively bargain for wages, benefits and working conditions. It also sets a guaranteed minimum compensation of $60 an hour, more than what most interpreters earn now. The bill is sponsored by the American Federation of State, County and Municipal Employees.

Creating a new unionized work force within the health care field is certain to increase financial pressures in a system stressed by soaring costs. The Department of Finance pegged the cost to the state's general fund at $12.5 million annually for an almost identical measure the speaker introduced last year. Pérez's office estimates the price tag on this year's bill could go even higher - $35 million annually after five years of implementation.

If approved and signed by the governor, this bill would require complicated new interpreter services to be implemented as California and the rest of the nation struggle to absorb a huge expansion of people eligible for health care under the Affordable Care Act. The law is expected to add 1.4 million more poor people to the state's Medi-Cal rolls alone. The health care system needs time to adjust to the changes and to absorb the expected new costs. It should not have to take on the burdens and the increased expense of AB 1263 at the same time.

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