California Senate Committee Rejects Plan To Overhaul State Health Care System
The proposal, approved by the California Assembly last month, would have required most state residents to obtain health coverage. Under the bill, residents with incomes up to 250% of the federal poverty level would have received state subsidies for coverage, and residents with incomes up to 400% of the poverty level would have received tax credits to ensure that health care premium costs do not exceed 5.5% of their incomes. Insurers would have been prohibited from denying coverage to residents because of pre-existing medical conditions. A ballot initiative submitted by Schwarzenegger and Nunez would have asked voters to approve about $9 billion in fees and taxes to partially fund the $14 billion plan. The initiative -- which would have gone before voters in November -- called for an increase in the state tax on cigarettes, as well as a fee on hospital revenues. It also included an employer requirement to contribute towards health coverage in amounts ranging from 1% to 6.5% of their payrolls, depending on the level of payroll (Kaiser Daily Health Policy Report, 12/18/07).
The legislation "ran into trouble" last week when the nonpartisan state Legislative Analyst's Office released a study that found by fiscal year 2014-2015, the annual cost of the program could exceed revenue by $300 million to $1.5 billion, the Washington Post reports (Lee, Washington Post, 1/29). Legislators raised concerns about approving the measure at a time when the state is facing a $14.5 billion budget shortfall. Committee Chair Sen. Sheila Kuehl (D) said, "It doesn't matter how many good things are in the bill if there isn't money to pay for them" (Washington Times, 1/29). State Sen. Leland Yee (D) said, "Nothing that came out of last week's hearing gives me the comfort level that working people of California won't be left holding the bag," adding, "I was around when the energy deregulation came about and there are lessons I learned from that" (Chorneau, San Francisco Chronicle, 1/29).
Monday's vote leaves proponents "no time to regroup in time to put something before voters this year," according to the Wall Street Journal (Rundle, Wall Street Journal, 1/29). However, according to legislative rules, the bill still can be amended and reconsidered by the health committee at its next scheduled meeting, which would be this week (San Francisco Chronicle, 1/29). Reaction
Schwarzenegger said, "I am someone who does not give up. Especially when there is a problem as big and as serious as health care that needs to be fixed," adding, "One setback is just that -- a setback. I still believe comprehensive health care reform is needed in California. We will keep moving forward. I can promise you that." Nunez called the bill's defeat "a victory for tobacco companies, the insurance industry and the shameful status quo."
Opponents of the measure -- including Californians Against More Deficit Spending, a coalition of pro-business and anti-tax groups -- commended the committee for rejecting the proposal. Jon Coupal, president of coalition member Howard Jarvis Taxpayers Association, said, "This state had a horrible experience with energy deregulation, and this health care proposal had all the earmarks of another disaster" (Washington Times, 1/29).
Jonathan Gruber, a health economist at the Massachusetts Institute of Technology and an adviser to Schwarzenegger and the state Legislature on the proposal, said it "was pretty clearly doomed by the larger fiscal deficit" (New York Times, 1/29).
Senate President Pro Tempore Don Perata (D) on Monday in a letter to Schwarzenegger and Nunez suggested removing certain provisions from the proposal, such as the hospital fee and a requirement that insurers spend 85% of health care premiums on medical care, and passing them as separate legislation (Zapler, MediaNews/Contra Costa Times, 1/29). Perata added that despite problems with the proposal's funding mechanisms, state leaders "have come a long way to solve some of the most intractable policy problems imaginable. The significant progress we have made can assure swift future steps when the state's budget and economic climate improve" (San Francisco Chronicle, 1/29). National Impact
According to the New York Times, the loss in California "bodes poorly for universal health coverage, an issue that just a year ago appeared to have found its moment." The New York Times notes that of the three ambitious health care proposals in 2007 -- in California, Illinois and Pennsylvania -- "nothing of national significance was passed" (New York Times, 1/29). In addition, the Los Angeles Times reports that the three leading Democratic presidential candidates -- Sens. Hillary Rodham Clinton (N.Y.) and Barack Obama (Ill.) and former Sen. John Edwards (N.C.) -- all have announced similar health care proposals that aim to expand private insurance while allowing people to retain coverage they already have (Rau, Los Angeles Times, 1/29).
The defeat of the California plan "is a significant blow, but not a fatal blow, to the growing momentum for health reform nationally," Drew Altman, president and CEO of the Kaiser Family Foundation, said. "California's failure, after coming so close, underscores the lesson that too many states don't have the political will or resources to reform health care on their own, and thus the need for a national solution of some kind," he added (Washington Post, 1/29).
According to MediaNews/Contra Costa Times, "The next best hope for changing health care may be at the federal level," as the three leading Democratic presidential candidates have proposed plans similar to Schwarzenegger's, and Republican candidates are pitching market-based proposals to extend coverage insurance to more people and lower costs. However, "Washington has deadlocked on health care reform for decades, and any action isn't likely until well into 2009" (MediaNews/Contra Costa Times, 1/29).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.
California Senatului Comisia respinge planul de reparatii la sistemul de îngrijire a sãnãtãþii de stat - California Senate Committee Rejects Plan To Overhaul State Health Care System - articole medicale engleza - startsanatate