A California Health Care Reform Round-up

Health care reform took a giant step forward yesterday with the Assembly’s passage of ABX1-1 (Nunez), the compromise package ironed out by Governor Arnold Schwarzenegger and Assembly Speaker Fabian Nunez. As my previous post pointed out, enacted of reform is still very much up-in-the-air. I’ve been getting lots of questions about what happened and what’s going to happen. So I thought readers might benefit from a list of sites and documents they can use to get caught up. As I discover new material I’ll add them to this post.

Governor Arnold Schwarzenegger’s web site has a video of his press conference lauding the Assembly’s passage of ABX101.

Governor Schwarzenegger’s office even prepared a Summary of ABX1-1, The Health Care Security and Cost Reduction Act (Governor’s version). Needless to say it glosses over a few problem areas, but it’s useful to see how the Governor sees the compromise.

It takes two to compromise: here’s Speaker Nunez’s press release concerning the Assembly’s passage of ABX1-1.

And it takes three to have a troika: here’s Senate President Pro Tem Don Perata’s press release and letter to the Legislative Analyst asking for a review of the impact of ABX1-1 on the state’s finances. There will be a lot of pressure on Senator Perata to move quickly to get the Senate to move the health care reform proposal forward. However, during a story on San Jose’s CBS affiliate, Channel 5, on Monday Senator Perata described the bill as “DOA.” The statement is made about 3:15 into the clip. After CapitolAlert posted these comments, Senator Perata’s spokeswoman Alicia Trost clarified the Senator’s position: “We need to know the details of the financing plans as well as the details of the budget before the Senate takes it up. We remain committed to passing health care reform and getting it done right, but we only get one shot at doing this correctly.

If you’d like to read the bill for yourself, here’s the place to get the full text of ABX1-1. This page also provides information concerning the vote on ABX1-1 (46 ayes, 31 nays). For those looking for a short cut to learning what’s in the bill (good training for becoming a legislator) here’s the official Bill Analysis of ABX1-1 delivered to Members prior to the vote.

The California Health Care Foundation FAQ on ABX1-1 and what comes next is worth reviewing. They also have updated a summary of the compromise health care reform bill on their site.

The folks over at Health Access have a post providing a blow-by-blow account of the Assembly Appropriations Committee vote on ABX1-1. They also offer a summary of the bill. (Their blog doesn’t have a search feature, so if there’s a lot of new posts, you’ll want to find the ones dated December 18th).

Health Access has a “support if amended position on ABX1-1. The California Nurses Association are in outright opposition (This link is to a press release published before ABX1-1 was amended on December 17th. However, I doubt any of the changes appeased the Nurses Association which is adamant the only solution is a single-payer solution).  Senator Sheila Keuhl take a similar view of the Governor and Speaker’s compromise

For perspectives from the right on the compromise health care reform package, take a look at this post by Joel Fox, president of the Small Business Action Committee (written before the vote, but still relevant) and this op-ed piece published in the Orange County Register by Assemblyman Chuck DeVore of Irvine.

Happy reading.

Chances for Meaningful Health Care Reform Dim as Positions Harden

Unions and others have decided it’s their way or the highway when it comes to health care reform. According to the Los Angeles Times, these interest groups are mounting a full-on campaign to defeat Governor Arnold Schwarzenegger’s health care reform package. Their campaign will include prayer vigils, television ads and demonstrations at the Governor’s public appearances. Joining the California Federation of Labor will be organizations like Health Access, Consumers Union and It’s Our Healthcare! Their main argument is that the Administration’s plan gouges the middle-class by requiring every resident to obtain health care coverage, but failing to provide sufficient subsidies to enough residents. For example, while the Governor would offer tax credits to households with annual income of 350 percent of the Federal Poverty Level (about $72,000); the coalition wants this eligibility level to at least 400 percent of the FPL (a bit more than $82,600) — which is a bit lower than the $103,000 target union officials mentioned last week. They also maintain California’s businesses pay too little of the funding toward the state’s health care system under the Governor’s plan.

So the gloves are now off and rationale debate is about to flee the scene (demonstrations and prayer vigils rarely lend themselves to civil, reasoned discussions). Passing health care reform during the current special legislative session was a tough assignment to begin with. Given Labor’s influence with the Democratic majority, this turn of events virtually eliminates any chance of responsible health care reform any time soon.

Reform is not impossible, however. Governor Schwarzenegger can be one of the most skillful politicians Sacramento has seen in decades (he can also be one of the most clumsy politicians Sacramento has seen in decades, but during the health care reform debate his most artful political persona has been on display). Speaker Fabian Nunez and Speaker Pro Tem Don Perata are no political slouches either. Plus, they would like to see health care reform enacted to help justify the changes to term limits they are seeking on the February 2008 ballot.

Even the Labor coalition has incentives to reach a compromise. They are looking at putting a health care reform initiative on the ballot in 2008 (presumably it would look a lot like Assembly Bill 8, which the Legislature passed and the Governor vetoed). The Governor is threatening to sponsor a competing initiative of his own. Meanwhile business groups and advocates of a government-run single payer system are also considering initiatives. When multiple ballot measures on one topic are put before the voters, historically it’s been easier to defeat all of them than to get any one of them passed (although there are exceptions). So if Labor and their allies aren’t careful they could wind up with no health care reform passing at all and starting over from square one in 2009. That would be squandering not only two years, but all the momentum behind the current reform efforts. And it would be bad news for all those who effective reform could help much sooner if a responsible compromise could be reached.

I was talking to someone today (who prefers to remain anonymous) who pointed out another dynamic in this situation that could make Labor’s position uncomfortable. The unions are supporting employer-centric reforms like AB 8. Governor Schwarzenegger supports an individual-centric approach. Senators Hillary Clinton and Barack Obama, Governor Bill Richardson are among the Democratic presidential candidates whose health care reform proposals mirror, to some degree, Governor Schwarzenegger’s approach. So all the rhetoric this coalition is aiming at Republican Governor Schwarzenegger may apply just as strongly to Democratic presidential candidate <fill in the blank> come 2008. And the unions will be strong supporters of that nominee. 

Politics is politics. Attacking an opponent while praising an ally who has the same position is not uncommon. For all but professional contortionists, however, it’s not a lot of fun either. But that will be then and this is now. For now, positions are hardening and the hope for meaningful health care reform any time soon is growing faint.