Special Session Last Hope for Health Reform in California for 2007

The debate over reforming California's health care system has shifted to a special legislative session as Gov. Arnold Schwarzenegger (R) and lawmakers remain intent on reaching a compromise this year, the MediaNews/Contra Costa Times reports.

The governor and Democratic leaders likely would agree on an overhaul plan that does not include a funding mechanism. Lawmakers would vote on the deal, while a ballot measure next year would ask voters to approve funding.

However, before a deal is reached, several sticking points must be resolved, including:

• Whether all California residents should be required to obtain health coverage, as proposed by Schwarzenegger;
• A limit proposed by Assembly Speaker Fabian Núñez (D-Los Angeles) on how much workers would be required to spend on coverage;
• Obtaining more funding sources, such as a state sales tax increase;
• Reaching bipartisan support, which could be critical for the ballot initiative to pass; and
• How much employers would be required to contribute toward coverage (Zapler, MediaNews/Contra Costa Times, 9/17).

Schwarzenegger and Núñez on Friday held a rally at the California Hospital Medical Center to support a health care overhaul. Participants are listed on the governor's Web site and include representatives of hospitals, medical groups and businesses, as well as physicians and consumers (Office of the Governor release, 9/14).

Summaries of editorials and opinion pieces regarding health care reform in California appear below.

• Contra Costa Times: "The governor and legislators should build upon the progress already made and try to reach a compromise next year if one cannot be achieved this fall," a Times editorial states. "It is far better to get health care reform right than to quickly pass a flawed plan in the Legislature or at the ballot box," according to the editorial (Contra Costa Times, 9/16).
• San Diego Union-Tribune: "It is close to conventional wisdom that the health insurance problem is so huge that only some mass overhaul can help," a Union-Tribune editorial states. "[T]he task most central to health reform is creating a system in which both individuals and providers have incentives to hold down costs instead of just passing the tab on to third parties (insurers or the government)," according to the editorial (San Diego Union-Tribune, 9/16).
• San Diego Union-Tribune: "To date, far too much of the emphasis in Sacramento has been on enacting health reform in general, with strikingly little attention paid to the details," a Union-Tribune editorial states. "Before California's leaders ask voters to make sweeping changes in our health care system, this cavalier approach must stop," according to the editorial. "Good intentions are not nearly good enough," the editorial concludes (San Diego Union-Tribune, 9/16).
• San Diego Union-Tribune: The number of uninsured California residents "has been consistently exaggerated" by Schwarzenegger and Núñez, a Union-Tribune editorial states. However, according to the UCLA Center for Health Policy Research, the number of residents who are uninsured "because it is beyond their means is three million -- less than half" of the 6.7 million cited by the governor and Núñez, according to the editorial. "So, yes, the state has a problem. But it is far less sweeping than the public has been led to believe," the editorial states (San Diego Union-Tribune, 9/16).

• J. Mario Molina, Tracy Press: "Any workable solution must ensure that all Californians have access to affordable coverage and participate in the health care insurance program," Mario Molina, president and CEO of Molina Healthcare, writes in a Tracy Press opinion piece. "Our leaders need to engage in a serious discussion immediately to find a funding solution that spreads the costs across all Californians without burdening business or individuals unfairly" (Molina, Tracy Press, 9/14).
• Steve Wiegand, Sacramento Bee: "Whether Schwarzenegger will" expand coverage to all uninsured children if a more comprehensive agreement fails "is problematical," Wiegand writes in his Bee column. "He has said repeatedly that he isn't interested in a piecemeal approach to reform," according to Wiegand. "But if the special session fails to harness the lightning and imbue life into what is currently an amalgam of body parts, he might have to accept the kids' portion as the best he can get and then find a way to finance its $225 million general fund price tag," Wiegand writes (Wiegand, Sacramento Bee, 9/15).
• Dan Walters, Sacramento Bee: The health care reform debate has "sprouted almost countless factions and subfactions, each with a different agenda, and these 'stakeholders' often cancel out one another, which largely explains why" the issue has "hovered over the Capitol for so many years without being resolved," Walters writes in his Bee column. "Despite his so-so record, Schwarzenegger still believes that he can, by sheer force of will, succeed where others have failed. We'll see" (Walters, Sacramento Bee, 9/17).
• Daniel Weintraub, Sacramento Bee: The health care reform proposal "now on the table" is an example of "ballot-box budgeting, with lawmakers and the governor asking voters to raise taxes and dedicate most of the new money to health insurance subsidies," Weintraub writes in his Bee column. "Through ballot-box budgeting and formulas written into state law, voters and legislators have limited the ability of policymakers to respond to new challenges," Weintraub writes (Weintraub, Sacramento Bee, 9/16).

Speaking on behalf of Schwarzenegger in his weekly radio address, Lloyd Dean, president and CEO of Catholic Healthcare West, discussed efforts to reform California's health care system.

Audio of Dean's remarks and a Spanish translation are available on the governor's Web site (Office of the Governor release, 9/15).