Elements of Governor’s Health Care Overhaul Land on His Desk

Legislation before Gov. Arnold Schwarzenegger (R) contains elements of his health care reform plan, but it is unclear whether the governor will sign or veto the proposals before tomorrow's deadline for action on bills approved by the Legislature this year, the San Jose Mercury News reports.

Some of the measures before Schwarzenegger take aim at specific practices by health insurers.  Two of the highest profile bills are:

• AB 1945, by Assembly member Hector De La Torre (D-South Gate), which would bar health plans from rescinding individual health insurance policies unless they could prove that members intentionally misrepresented or omitted information on applications. In addition, an independent board would have to approve all rescissions.
• SB 1440, by Sen. Sheila Kuehl (D-Santa Monica), which would require insurers to spend 85% of revenue from patient premiums on medical care.

Coverage Mandates

The governor also is considering proposals to expand services that health plans are required to cover, including:

• Diagnosable mental illnesses under AB 1887, by Assembly member Jim Beall (D-San Jose); and
• Maternity services under AB 1962, also by Beall (Zapler, San Jose Mercury News, 9/27).

Other proposals before the governor would require health plans to cover:

• HIV screenings for all insured Californians;
• Tests for human papillomavirus; and
• Orthodontia for people receiving treatment for cleft palates.

In total, the new coverage mandates would increase premiums by $383 million annually, or 0.5% of the $74 billion that employers and individuals now pay insurers every year, according to the California Health Benefits Review Program, a UC office that reviews legislative proposals.

The office's report estimates that higher health insurance costs would translate to more Californians dropping their coverage.  According to the Los Angeles Times, more state residents likely would turn to state programs for health care.

Health plans oppose the proposals to expand the number of services they are required to cover.

Chris Ohman, president of the California Association of Health Plans, said, "How do you explain to someone who doesn't have coverage at all that it's OK to give someone else more coverage?" (Rau, Los Angeles Times, 9/29).