Republican Proposal Targets Narrower Group of Uninsured
Senate Republicans on Tuesday unveiled their anticipated health care reform proposal focused on providing incentives for uninsured residents to obtain coverage while not requiring contributions from employers or health care providers, the Sacramento Bee reports.
Sen. Dave Cox (R-Roseville) at a news conference said Republicans do not believe the state has the "ability or could afford universal health insurance."
Cox, along with Senate Republican leader Dick Ackerman (R-Tustin) and Sen. George Runner (R-Lancaster), said the state needs to expand access to health care services to about one million of the state's estimated 6.5 million uninsured residents. Citing data from the California HealthCare Foundation, Republican senators said of the remaining uninsured population:
- 2.5 million uninsured residents are undocumented immigrants;
- Two million choose not to purchase coverage; and
- One million are eligible for public assistance.
Republicans said the plan would not provide assistance for undocumented immigrants, but the proposal would attempt to bill the federal government $2.2 billion to subsidize medical care services for undocumented immigrants.
The plan also would:
- Offer tax credits to businesses through the use of health savings accounts;
- Allow employers to adopt more flexible work schedules;
- Raise Medi-Cal reimbursement rates over the next eight years to encourage physicians and hospitals to participate in the program;
- Allow insurers to offer plans with fewer benefits;
- Channel some hospital subsidies to clinics (Lin, Sacramento Bee, 1/31);
- Permit emergency departments to divert patients who do not require urgent care to clinics;
- Reduce benefits for Medi-Cal beneficiaries to ensure that their benefits are not more comprehensive than private insurance plans; and
- Allow nurses, instead of physicians, to run clinics (Rau, Los Angeles Times, 1/31).
Republicans said the plan would not require state spending, although it would rely on providing almost $1 billion in tax breaks to individuals (Kurtzman, AP/San Jose Mercury News, 1/31).
In addition, the Republican proposal calls for the Legislature to place on the next statewide ballot a measure that would redirect tobacco tax revenue toward children's health care. About $580 million in tobacco tax revenue currently is used to fund the First Five California Commission, which provides funds for early childhood health and education programs.
Cox said, "We believe these funds have been misused" (Sacramento Bee, 1/31).
Schwarzenegger, in response to the proposal, said, "I look forward to working with my Senate Republican colleagues on their health care proposal." He added, "Republicans and Democrats must work together to reform health care in the best interest of all Californians" (Chorneau, San Francisco Chronicle, 1/31).
Anthony Wright, executive director of Health Access California, said, "The proposal would increase underinsurance, encouraging high deductibles and scaled-back benefits. It would take money from safety-net hospitals on which we all rely" (Los Angeles Times, 1/31).
Sen. Sheila Kuehl (D-Los Angeles), chair of the Senate Health Committee, said the proposal is a "race to the bottom."
Apart from the larger proposal, Sen. Jeff Denham (R-Merced) has proposed legislation that would provide tax credits to small businesses that provide employee health benefits. Businesses with fewer than 100 workers would be eligible (Sacramento Bee, 1/31).
Morgan Crinklaw, a spokesperson for Assembly Minority Leader Mike Villines (R-Clovis), said Assembly Republicans would not announce a health care plan "per se" but instead would introduce several health care reform measures (Joseph, Orange County Register, 1/31).
"[T]he Senate GOP plan is vastly more honest and realistic than Schwarzenegger's" health care reform proposal, a San Diego Union-Tribune editorial states. "Especially given the state's history with ambitious initiatives ... California's leaders should be far more cautious before overhauling an entire industry," the editorial states, concluding, "Senate Republicans, at least, understand this" (San Diego Union-Tribune, 1/31).
Two broadcast programs reported on the Republican proposal. Summaries appear below.
- KPCC's "Patt Morrison": Panelists on the program include Ackerman and Dan Weintraub, a columnist for the Sacramento Bee (Morrison, "Patt Morrison," KPCC, 1/30). Audio of the segment is available online.
- Capital Public Radio's "KXJZ News": The segment includes comments from Runner (Russ, "KXJZ News," 1/30). Audio and a transcript of the segment are available online.