Universal Health Coverage Plans Under Consideration
Several different plans to provide universal health coverage to California residents are under consideration by state lawmakers, including Gov. Arnold Schwarzenegger (R), the Sacramento Bee reports.
One proposal -- based on a plan by the New America Foundation, a Washington, D.C.-based think tank -- would require all state residents to maintain health insurance, similar to existing state laws governing car insurance. The Bee reports that the "universal coverage, universal responsibility" model faces "numerous political hurdles," in part because it would entail state subsidies for low-income workers, contributions from employers and a requirement for health insurers to provide coverage to state residents with pre-existing medical conditions.
Meanwhile, Assembly members Keith Richman (R-Granada Hills) and Joe Nation (D-San Rafael) plan to introduce legislation next month that would mandate health insurance coverage for all state residents. The legislation would allow small businesses and individuals to form purchasing pools to help obtain health insurance at lower rates.
Richman said the legislation would require state residents to maintain "at least catastrophic coverage" and added that the law could be enforced through tax returns. Richman said that he and Nation had not finalized what the annual income threshold would be to qualify for state subsidies, but he added that it likely would be 200% or 300% of the federal poverty level.
Nation and Richman said their proposal could be implemented without contributions from employers, but Richman said he believed that most employers would continue to contribute to health coverage for workers.
"(The proposal) begins to move the system away from an employer-based system to a more individual system without taking the employer out of the system," Richman said.
Laurie Rubiner, director of the Universal Health Insurance Program at New America, estimated that providing health coverage to currently uninsured children would cost between $660 million and $800 million and added that state costs would increase significantly without employer contributions.
Beth Capell, a lobbyist for Health Access, said she had reservations about a plan that does not call for employer contributions, adding, "All this stuff about, 'Oh, we'll subsidize low-income families,' is terrific. But if you're a family of four making $60,000 a year -- which is beyond the subsidy threshold -- how are you going to pay $10,000 for insurance?"
California Chamber of Commerce President Allan Zaremberg said requiring employers to provide health insurance would "kil[l] the economy by driving jobs out of California." Zaremberg advocates a plan that would improve the "clinical structure" in the state and expand "first-dollar coverage," or health insurance without a deductible. He said, "First-dollar coverage, for many low-wage uninsured, through the clinics, and maybe a real catastrophic policy, is the way to go."
Health and Human Service Agency Secretary Kim Belshe said Schwarzenegger has not endorsed a proposal but added that the administration has "been talking to research organizations -- think-tank groups like the New America Foundation that have come forward with some very innovative thinking."
Belshe said that Schwarzenegger is "open to a number of approaches for closing the gap for people who are uninsured" but added that "he has been very clear that an employer mandate is problematic to the extent that it imposes costs on businesses that they can ill afford" (Rojas, Sacramento Bee, 1/12).