By JOCELYN WIENER
Deep breath.
Christine Matlock Dougherty inhaled, pursed her lips and exhaled slowly.
She stared intently at the Scrabble game on her phone, trying to calm her nerves as she waited to testify before the Assembly health committee.
Deep breath.
She checked her texts. She moved on to a dice game.
“It gets to be a little much sometimes,” she said, quietly.
On a sunny afternoon last month, hers was the privilege no parent wants: The chance to convince a roomful of lawmakers to fix the broken system she believes contributed to the death of her child.
For the second time in two weeks, she would testify before the state Legislature as a key witness for not one, but two separate bills targeting the health insurance industry. They were among several such measures percolating through the Capitol, hastened along by public outrage that boiled over after the fatal shooting of the chief executive officer of UnitedHealthcare this past December.
In an attempt to push through policy reforms targeting commercial health plans, lawmakers had invited Dougherty to share her family’s story. Matt Haney, a Democratic state assemblymember from San Francisco, has said her story inspired him to author one of the bills for which she would testify, a measure intended to prevent health plans from prematurely pushing patients out of substance use treatment facilities.
Today wouldn’t be her first time testifying; she had recently flown up to the capital to speak on behalf of a bill that would require health plans to report data to the state about how often they deny treatment. Before that, she hadn’t been to Sacramento for years, since her young family had taken a road trip here when the kids were little. They’d taken a picture of her son, Ryan, standing next to the bronze bear in the Capitol building.
Dougherty’s fingernails, painted in sparkly, bright pastels to delight the first graders at the Yucaipa elementary school where she works, rested on eight sheets of paper. There, double-spaced in 20-point font, was the chain of events that ended with Ryan dying of a fentanyl overdose at the age of 23.
But how does one capture in two minutes a nightmare that has lasted four years? Her health plan’s denial of coverage for her son’s addiction treatment. His ensuing discharge from the rehabilitation facility. The wrongful death lawsuit she filed.
The Assembly room grew crowded.
Was it hot in here?
In college, Dougherty had taken a public speaking class. The day she was supposed to deliver her first speech, she’d felt so nervous that she’d fainted. But now, after more than three decades teaching elementary school, she knew the trick: Sound confident and they’ll believe you.
She knew her being here is what Ryan would have wished for. She wanted to make him proud.
“It helps me find a reason why it was him,” she said.
Dougherty had cried several times that morning on the flight from Palm Springs to Sacramento. Since Ryan’s death, even the smallest things could provoke tears. The color of a shirt. A song on the radio.
Some days were better than others.
“All I’m doing is breathing right now,” she told a reporter.
At today’s hearing, she’d testify for a bill that would stop health plans from reviewing a patient’s eligibility to stay in substance use treatment until at least 28 days after an in-network provider initially approved the treatment. Ryan’s health plan had decided it would no longer cover his stay in the treatment facility after he had spent just three days there.
Less than 48 hours after his sister picked him up and drove him home, he’d overdosed.
Dougherty took her seat in the middle of the crowded Assembly hearing room. She waited as committee members discussed other bills designed to rein in insurers’ power over patients.
An hour passed.
And then, finally, Dougherty’s turn.
She walked to the front of the room and took her seat at the table facing the lawmakers. One of the bill’s sponsors had told her that if she felt nervous, she should train her eyes on the committee chair, Mia Bonta, a Democratic state assemblymember from Oakland.
Bonta had a son.
Haney introduced the bill. Dougherty had never seen him before. Now he told the committee that while other states have already passed laws to address the problem, “California has failed to act.”
“The case of Ryan Matlock is a devastating example,” he said.
Deep breath.
Haney slid a box of tissues in front of Dougherty.
“Without speaking to Ryan, they denied the care he needed,” she said, her voice tight with unspilled tears. “They said he could control his addiction if he really wanted to.”
His health plan has said it always follows the law.
“Four years later, I still miss him every day.”
Bonta called for a moment of silence for Ryan.
Representatives of several organizations lined up at a microphone to voice their support. A few dabbed their eyes.
Representatives of the insurance industry responded with their opposition to the bill:
Steffanie Watkins, the representative from the Association of California Life and Health Insurance Companies raised concerns that the bill would prohibit the use of common health plan review processes to determine the length of a patient’s stay. She said the bill would keep health insurers from protecting patients from “falling victim to the unscrupulous practices” of some facilities,“putting patients at risk and driving up the cost of care.”
“We believe this bill goes too far,” she said.
Olga Shilo, representing the California Association of Health Plans said current health plan review processes help ensure that treatments are medically necessary, protect against fraud, waste and abuse, and provide safeguards against unnecessary costs.
“We are concerned about the implications of removing accountability in the system without improving the quality of care,” she said.
Haney called a 28-day minimum stay a “no brainer” and “the bare minimum.”
“That would have made a difference in Ryan’s life,” he said.
Dougherty swallowed.
Haney thanked her for her courage.
She blinked back tears.
Later she would learn that the committee had voted in favor of the bill, 12-0. It would move on to the next step in the process.
After her testimony, out in the hallway, Haney told Dougherty she had powerful people behind her.
“Your story makes it real,” he said.
He wrapped her in a hug.
She patted her damp cheeks, then pulled on dark sunglasses.
Outside, the roses in the Capitol garden exploded with color, filling the sunny afternoon with their divine perfume.
