Nation, Richman Announce Legislation To Mandate Health Insurance Coverage

Assembly members Joe Nation (D-San Rafael) and Keith Richman (R-Northridge) on Thursday announced a proposal for legislation that would require California residents to maintain health care coverage, the Sacramento Bee reports. They plan to introduce next week a package of eight bills that comprise the proposal.

The legislation would:

Require individuals to maintain at least catastrophic coverage with an annual deductible of no more than $5,000 (Rojas, Sacramento Bee, 2/11);
Establish "purchasing pools" organized by county or region to help individuals and small employers buy health insurance at lower rates;
Provide government subsidies for state residents whose annual incomes do not exceed 200% of the federal poverty level;
Cap the amount for health care expenses that companies could deduct from their state income taxes (Silber, Contra Costa Times, 2/11);
Enroll all low-income residents who qualify for Medi-Cal and Healthy Families;
Implement a gross premium tax on health insurance companies and health plans;
Withhold money from residents' state income tax if they do not provide evidence that they are insured (Sacramento Bee, 2/11);
Require hospitals, health insurers and health plans to implement electronic medical records systems by 2010 and doctors to implement such systems by 2012; and
Allow Medi-Cal to dispense only generic drugs unless there is evidence showing that a brand-name drug is medically necessary (Feder Ostrov, San Jose Mercury News, 2/11).

Nation and Richman estimated that a $5,000 deductible covering catastrophic expenses would cost an individual $50 per month, and that a more comprehensive plan would cost about $160 per month. State and federal funds would pay for three-quarters of a more comprehensive plan they say would cost about $160 monthly (Contra Costa Times, 2/11).

Nation and Richman estimated the package initially would cost $1 billion to $2 billion but would reduce costs in the long term (Sacramento Bee, 2/11).

Reaction

"We're just looking at it and evaluating it now," Assembly member Kevin McCarthy (R-Bakersfield) said (Contra Costa Times, 2/11).

Assembly member Dario Frommer (D-Glendale) said, "[I]t's a very dangerous plan" because "an individual mandate without a mechanism to provide affordable health insurance means many people will not be able to afford [insurance]. Many employers will stop offering it."

"It's hard to sell the notion that the way we're going to solve the health care problem is by making you buy health insurance," Larry Levitt, a vice president at the Kaiser Family Foundation said, adding, "An individual mandate has a really high bar to reach politically" (San Jose Mercury News, 2/11).

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