Monday, September 10, 2007

AB8: Healthcare Reform, California-style

Sacramento legislators passed significant healthcare legislation today. Hopefully this will be an important step toward improving the healthcare of all Californians, and appears to be the most comprehensive overhaul of healthcare so far in the United States.

I still want true universal healthcare in the model of Sheila Keuhl's SB 840. That's the real deal.

In the meantime, this is promising. I'm afraid the laws of unintended consequences will be sure to kick in if this gets past the governor, but I still think he should sign it because it will greatly expand coverage for children and the working poor, and that's an urgent short term goal in the big picture reform of our healthcare system. It can and will be tinkered with over time.

Governor Schwarzenegger has indicated that he's getting out his veto pen, but has also said he's calling the legislature into a special session to continue working on healthcare reform. I suspect that in the near future, something similar will pass again that has whatever changes Arnold wants to see, and he will sign it. Then he will go pose for the magazine covers again. That's what I'd bet on right now.

Though Frank Russo at California Progress Report says...

Senator Perata in presenting the bill acknowledged that the seven week impasse on the state budget had a big impact on failure to negotiate a last minute deal that the Governor could commit to in advance to sign. He said if there was a special session, it will be incumbent on the Governor to provide us with his legislation—a not so gentle reminder that the Governor has never had a bill proposal introduced in this, the “year of health care” that he proclaimed.

....which concerns me a bit. Are we going to get something more like Arnold's not so great plan? I hope they're not just setting us up for disappointment. Keeping cynicism at bay is getting more difficult everyday.

The office of Assembly Speaker Fabian Nunez issued the following press release, which has a good, bullet point summary of the legislation passed in Sacramento today.

For Immediate Release: September 10, 2007
Contact: Beth Willon (Núñez) or Alicia Trost (Perata)
Phone: (916) 319-2408, (916) 524-6537 or (916) 651-4188, (916) 207-8245
California Legislature Sends Governor Nation's Most Comprehensive Health Care Reform Package in Decades. More than Two-Thirds of Uninsured Covered Under AB 8, Including All Children

SACRAMENTO - Historic health care reform legislation extending coverage to millions of California’s uninsured, including all children, was approved by the state Senate and Assembly today by votes of 22-17 and 45-31, respectively.

Assembly Bill 8, co-authored by Assembly Speaker Fabian Núñez (D-Los Angeles) and Senate President pro Tem Don Perata (D-Oakland), now heads to Governor Arnold Schwarzenegger’s desk for consideration.

"I believe today is an historic opportunity for California to put itself on the map once again, to send a loud and clear message to Washington, D.C. that the inaction of Congress and our President to deliver on health care reform is falling on California and the state legislature," Speaker Núñez said on the Assembly floor. "This year we will lead the nation in real comprehensive health care reform."

"This bill is not perfect, but it’s the best we could come up with this year and better than anything produced by any other state in the nation so far," Perata said. "We’ve taken a giant, important step here by coming up with a practical, workable plan to make sure every working Californian has access to affordable health care."

"The Governor should sign this," Perata added. "However, if the Governor rejects this, we will pick up ourselves and go at it again. I am committed to fixing California’s broken health care system, and if we need to do it in a special session, so be it."

"AB 8 is based on the principal that health care shouldn't just be available for those that can afford it, but that it should be a right for each and every Californian," Speaker Nunez added. "This bill represents more than a year and a half of work on the part of Democrats in both the Assembly and Senate to come around to a comprehensive health care reform package for California."

AB 8 would extend health insurance to more than two-thirds of the 5 million Californians now uninsured. AB 8 would also insure all children, take steps to rein in spiraling medical costs and guarantee coverage for people who have pre-existing medical conditions.

The legislation does this through a system of shared responsibility in which employers, employees and government each pays a portion of the costs.

AB 8 is backed by a diverse array of labor groups, children’s health advocates, and others, including the American Federation of State, County and Municipal Employees (AFSCME), California Labor Federation, AARP, Health Access, 100% Campaign, Association of Community Organizations for Reform Now (ACORN), California Teachers Association (CTA), and Service Employees International Union (SEIU).

AB 8 is the product of close to two years of negotiation and engagement with health care providers, businesses, labor, hospitals, doctors, children’s health advocates, and others interested in promoting comprehensive health care in California. AB 8:

  • Builds on the employer-based system in which most Californians already get their health care

  • Promotes shared responsibility from employers, employees, and where necessary the state

  • Mandates that most employers must meet a minimum spending threshold of 7.5% of payroll on insurance, contributing that fee into a statewide fund or spending it directly on their employees

  • Allows all employees whose employers pay a fee to get coverage through a statewide purchasing pool that will negotiate for discounted prices with health insurers

  • Encourages employees to use pretax income to pay for health insurance premiums

  • Provides prorated subsidies for families below 300% of the federal poverty level so working people can afford to pay their insurance premiums

  • Mandates that insurance companies must use 85 cents out of every premium dollar to go to health care, not administration

  • Ends cherry picking by insurers, ensuring that most people will have to be offered coverage by insurance companies at a competitive rate

  • Establishes the new California Health Care Cost and Quality Transparency Commission and requires the commission to develop, implement and update a health care quality and cost containment plan to help improve health outcomes for Californians and keep health care costs affordable

  • Expands access to Medi-Cal/Healthy Families, broadening eligibility to include both parents and children with incomes between 133% and 300% of the federal poverty level

  • Promotes prevention and management of chronic disease such as asthma and diabetes

  • Assists with personal health and wellness management

  • Simplifies benefit choices in the insurance market so that everyone can make real world, apples to apples comparisons when they are choosing a health plan.



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