Health Reform in California is Like Threading a Camel Through the Eye of a Needle

[courtesy of California Progress Report]

By Frank D. Russo

I’m skeptical there will be a California health care deal in 2007 or 2008. But I’d be happy to be proven wrong as there is a rare opportunity to get something done that would be remarkably similar to the plans proposed by many of the Democratic candidates for President. The devil is in the details as to AB 1X 1 which will be voted on today in the Assemblhy, but it’s the only game in town for the foreseeable future.

Don’t get me wrong, I’d love to see a single payer plan—SB 840 by Senator Sheila Kuehl passed and signed into law by Governor Schwarzenegger. It was passed in 2006, but vetoed by the Governor. Senator Kuehl could have brought the bill up in 2007 in either the regular or special session, but has chosen not to do so, as it would only end up being vetoed by the Governor. It has the Democratic votes to pass and can be voted on next year before adjournment of the current session. It should be easier to finance than other plans as it would save the 25% to 30% of every premium dollar now paid in California that goes to insurance company overhead and profits. Medicare handles this share of cost for about 5%.

But with this Governor as a fixture for the next three years, single payer is not in the cards until at least 2010—and as is true with any comprehensive health care plan—will be phased in over time and only after a referendum or other vote of Californians on the ballot—whether by proposition or referendum. It would also need as a condition precedent a Democratic Governor willing to sign the bill.

That leaves the question: What do we do in the meanwhile with the millions of uninsured in California including children who lack health insurance coverage? The Nunez-Perata bill, AB 1X 1, that will insure 5 million Californians currently without health care including coverage for every child in the state in 2009 will be voted on today in the Assembly and probably passed. The bill has been called “The biggest public program coverage expansion since the creation of Medicare and Medicaid 40 years ago,” by Anthony Wright, the head of Health Access California, an alliance of over 200 consumer groups throughout our state.

We’ve published wonkish articles by Wright about the bill including a detailed analysis of the amendments to this proposal on Friday and an update of what is expected today to be amended into the bill.

Not that it’s perfect. An article we are publishing today by Donna Gerber of the California Nurses Association, analyzes AB 1X 1 differently. You can read these side by side and get a good view of the differences of opinions amongst Democrats.