The Governor wants the bill passed. The Assembly Speaker wants the bill passed. The Senate President Pro Tem may want the bill passed — or not, it’s hard to tell. Anyway, several powerful unions want the bill passed. So do some business groups and consumer groups. So why is Assembly Bill X1-1, California’s comprehensive health care reform package in danger of failing to make it past its first committee hearing?
On January 23rd, the Senate Health Committee is expected to dive deeply into ABX1-1. The hearing will start in the morning and is likely to go into the evening. (Here’s the anticipated agenda). But how thoroughly a bill is reviewed doesn’t always correlate with its viability.
What’s endangering ABX1-1 is the make-up of the Committee. There are seven Democrats and four Republicans on the Senate Health Committee. When it comes to ABX1-1, the four Republicans will certainly oppose it. That means supporters can only afford to lose one of the Democrats. Lose two and the bill fails.
There are at least two Democrats who could vote against the measure. The Committee Chair, Senator Sheila Kuehl, has been an outspoken critic of the compromise bill. The legislature’s chief proponent of a single-payer health care system for California, Senator Kuehl voted against Speaker Fabian Nunez and Senator Perata’s previous health care reform bill, Assembly Bill 8. And most observers would be surprised to see her vote for that bill’s successor.
Another Democratic considering a “no” vote on ABX1-1 is Senator Leland Yee of San Francisco. The Associated Press, in a story posted on the San Francisco Chronicle’s SFGate.com web site, quotes Senator Yee as saying, “It’s rather difficult for me to vote for a health care plan that’s going to cost $14 billion at the same time I’m looking at cutting $14 billion” due to the fiscal crisis facing the state.
The non-partisan and highly regarded Legislative Analyst’s Office (LAO) is preparing a detailed report on the legislation’s impact on the state’s finances. Senator Yee will be relying heavily on this report in determining his vote. “I think all of us are trying to find something that’s going to be of help to the people of California and not in any of the out-years find that there are unintended consequences or that it’s going to shift the burden of costs to workers unfairly,” the Associated Press writer Steve Lawrence quotes Senator Yee as saying.
None of this means that ABX1-1 is doomed. Senator Kuehl could vote for it in Committee as a courtesy to the authors regardless of how she intends to vote on the bill when it reaches the Senate floor. The LAO report could show, as some believe it will, that the state’s financial situation would benefit from passage of ABX1-1, meaning Senator Yee could comfortably support the legislation. There’s numerous plausible scenarios that have the bill sailing through the Committee.
Then again, it’s easy to come up with scenarios that have ABX1-1 crashing in flames. It’s tough to tell how hard Senator Perata will be pushing to get the legislation through his chamber, so the pressure to pass the bill along may not be as strong in the Senate as it was in the Assembly. The LAO report could raise questions that make Senator Yee — and perhaps others — unable to support it. Or the Committee’s thorough review of the bill could bring to light previously unknown structural or drafting problems with ABX1-1 that are severe enough to have the committee hold the bill over. This is, after all, the first real vetting this version of the legislation is receiving.
We won’t know until Wednesday evening. What’s surprising, at least to me, is that the outcome is in doubt at all. It’s actually an encouraging turn of events. After all, this is how the legislative process is supposed to work: lawmakers making up their minds based on public input, thorough analysis and their political beliefs.