California Offers Lessons for National Health Reform Debate
California's unsuccessful attempts to extend health insurance coverage to all state residents could offer lessons for U.S. lawmakers currently embroiled in debate over national health care reform, the San Jose Mercury News reports.
Following in California's Footsteps
Many elements of President Obama's plan to overhaul the U.S. health care system echo measures backed by Gov. Arnold Schwarzenegger (R) in 2007. Both proposals called for:
- A requirement for all residents to have health insurance;
- Mandates for employers to provide coverage or pay into a public fund; and
- Subsidies to help lower-income residents obtain coverage.
Learning From Prior Missteps
Ultimately, California's efforts to expand health insurance coverage died in a legislative committee amid cost concerns.
Advocates say reform backers should take heed of California's experiences to prevent current national health care reform proposals from meeting a similar fate.
Anthony Wright, executive director of Health Access California, said Democratic lawmakers and other supporters should unite behind a cohesive plan to reform the U.S. health system.
Others say Democrats should be willing to accept weaker reform legislation in exchange for garnering support from Republicans (Zapler, San Jose Mercury News, 9/28).
More Lessons on Health Insurance Exchanges
Observers say the authors of national reform legislation also should learn from California's experiences with a health insurance exchange system.Â A health insurance exchange allows individuals and small businesses to purchase health coverage from a pool of insurers.
In 2006, California's PacAdvantage system dissolved in part because of low participation rates. Without a large pool of purchasers, small businesses were unable to muster the collective bargaining power to negotiate lower insurance rates.
Experts say California's exchange failed because it did not require all stakeholders to participate.
However, unlike California's model, current national health care reform proposalsÂ would make participation mandatory.All of the major congressional proposals would require U.S. residents to have employer-based coverage, coverage through a government health plan or coverage from an insurance exchange. In addition, two proposals would compel insurers to participate in the exchange if they wanted to provide policies for individuals or small businesses (Calvan, Sacramento Bee, 9/29). This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.