Talks on Health Care Overhaul Plan Inching Toward Compromise
Assembly Speaker Fabian Núñez (D-Los Angeles) and Gov. Arnold Schwarzenegger (R) are negotiating a deal that aims to overhaul California's health care system through a simple majority vote in the Legislature this session followed by a ballot initiative next year on a funding mechanism, the Los Angeles Times reports.
The plan would require all California residents to obtain health care coverage and would provide subsidies to residents who cannot afford coverage.
Under the plan, the Democrat-controlled Legislature would approve a bill containing all of the provisions except funding. Lawmakers also might establish a special board to hash out the details.
Next year, voters would be asked on the ballot to approve mandatory employer contributions, as well as contributions from hospitals and possibly a sales tax increase to finance the plan.
An analysis commissioned by some California hospitals released last week found that only a small percentage of facilities would be net losers from the mandatory contributions.
Duane Dauner, president of the California Hospital Association, has opposed the proposed mandate if any hospitals lose money under it. However, the full board meets Tuesday to discuss the proposal.
Senate President Pro Tempore Don Perata (D-Oakland) has not signed on to the proposal, nor have other Democratic lawmakers (Rau, Los Angeles Times, 9/1).
Núñez and Perata are carrying legislation (AB 8) that aims to expand health care coverage in large part by requiring employers to spend at least 7.5% of payroll on employee benefits.
The governor's proposal, meanwhile, seeks to expand coverage to all uninsured Californians through mandatory contributions from employers, employees, hospitals and physicians.
Schwarzenegger's plan would require two-thirds majority approval of the Legislature, while the Democrats' bill would require only a simple majority vote (Zapler, San Jose Mercury News, 8/27).
The governor in August announced that he would veto the Democrats' bill or any final health care reform plan that only would rely on employer contributions for funding (Goldmacher, Sacramento Bee, 8/25).
Schwarzenegger announced on Friday that he has canceled a trip to England and postponed a trade mission to India in case he needs to call a special legislative session if compromises on health care reform and other issues are not reached before the session ends Sept. 14 (Rojas, Sacramento Bee, 9/1).
The governor said, "While I am confident that we will be able to accomplish quite a bit before the end of the legislative session, I need to maintain the flexibility to call a special session" (Myers, "Capital Notes" KQED, 8/31).
Senate Minority Leader Dick Ackerman (R-Irvine) said Republicans told the governor they want "adequate time" to review any final reform proposal before it is signed into law.
Perata said he's "not optimistic anything substantial" will be achieved this year, regardless of the extended session (Rojas, Sacramento Bee, 8/29).
Núñez on Thursday postponed a scheduled Assembly vote on Schwarzenegger's health care reform proposal after negotiations improved on reaching a compromise plan, the Sacramento Bee reports.
Núñez intended to put the governor's plan up for a vote to demonstrate its lack of support among Democrats and Republicans (Rojas, Sacramento Bee, 8/31).
Núñez said, "I think the governor understands at this point the votes are not there." He added, "That was my message all along. He now got the message."
Aaron McLear, spokesperson for Schwarzenegger, said closed-door negotiations on Thursday were "very positive" but that the governor remains committed to his proposal (Chorneau, San Francisco Chronicle, 8/31).
Schwarzenegger on Friday held a news conference in San Diego to continue to rally support for his plan.
The governor said that legislators "have different ideas, but ... there is a willingness to work together to make this work." He added, "I can gauge that from the meetings that we have had."
Schwarzenegger was joined by representatives from business, unions and local government who support his proposal (Marelius, San Diego Union-Tribune, 9/1).
Núñez said he and Schwarzenegger are building on "commonalities to get us to a point where we can compromise on our differences" (Sacramento Bee, 8/31).
The California Retailers Association, California Restaurant Association and California Small Business Association are calling for a ballot initiative that would increase the sales tax by one cent to fund health care reform.
Perata said, "I would like to see [Schwarzenegger] sign something." He added, "If he wants to go later and get a funding mechanism on the ballot, that's fine, too."
However, Perata said he was "highly skeptical" that the sales tax increase would pass unless it was backed by Schwarzenegger and lawmakers from both parties (Sacramento Bee, 8/31).
Republican leaders in the Legislature contend that their party opposes a tax increase (Myers, "Capital Notes" KQED, 8/29).
Núñez said the proposed sales tax increase was "regressive" and "a way to pass the buck" for businesses not to provide coverage to their workers.
Children Now, a children's health care advocacy group, held a rally on Wednesday calling for lawmakers to at least expand coverage to all children in California if a more comprehensive deal cannot be reached this year.
Sen. Darrell Steinberg (D-Sacramento) said, "Our first priority must be children." Steinberg, along with Assembly member John Laird (D-Santa Cruz) are carrying bills, SB 32 and AB 1, that would expand coverage to all uninsured children (York, Capitol Weekly, 8/30).
The measures currently do not provide a funding source, but Steinberg said, "If our bills become the vehicle (for health care changes), they will be amended to include a funding source to either fund the full amount or at least a significant start for year one" (Rojas, Sacramento Bee, 8/30).
Schwarzenegger opposes the bills, arguing, "We're not going to go and do just one thing." He added, "It takes the same amount of energy as it does to do the whole thing" (Capitol Weekly, 8/30).
As part of an effort to enact universal coverage for children in California, the state's First 5 Commission will provide a one-time donation of $20 million to help cover the initial cost of the coverage expansion, commission Chair Chris Perry announced.
Ted Lempert, president of advocacy group Children Now, emphasized the significance of the donation given that the annual cost of the expansion is estimated at $100 million (Herdt, Ventura County Star, 8/30). (News low in story).
A compromise on health care reform in California could largely impact similar efforts taking place in other states and pressure presidential candidates to find a solution on the national level, the Washington Post reports (Lee, Washington Post, 8/26).
Schwarzenegger said, "We want to make it so the rest of the country can look and say it's a great model." He added, "Ours is the most complicated and most problematic system in the country right now. If we can get it done here, anything is possible."
Larry Levitt, a health policy analyst at the Kaiser Family Foundation, said, "Any progress in California would make a substantial dent in the problem of the uninsured nationally." He added, "Action in California would create real momentum, both in the presidential debate and in other states" (Appleby, USA Today, 8/29).
Robert Ross, president of the California Endowment, said, "If we fail, it will have the effect of a wet blanket on health reform nationally." He added, "I think the presidential candidates will all look with a very watchful eye at what happens in California" (Kurtzman, AP/Contra Costa Times, 8/30).
Gov. Schwarzenegger discussed health care reform in his weekly radio address on Friday. Audio and text of the governor's speech are available on his Web site.
In addition, KCRW's "Which Way, L.A.?" recently included a discussion on the chances for a compromise health care reform plan. Guests on the program included:
- Mike Zapler, a reporter for the San Jose Mercury News;
- Ross; and
- Bill Bradley, a political writer for the L.A. Weekly (Olney, "Which Way, L.A.?," KCRW, 8/28).
Audio of the segment is available online.
KPCC's "Patt Morrison" also recently included a discussion on the health care reform negotiations. Guests on the program included:
- Daniel Zingale, senior adviser to Schwarzenegger; and
- Ross (Morrison, "Patt Morrison," KPCC, 8/28).
Audio of the segment is available online. 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.