The Assembly and Senate yesterday voted to approve two similar bills that would reform the individual health insurance market and ban pre-existing conditions as a reason for denying health insurance.
They are the first bills from the special session on health care reform to pass legislative floor votes.
The bills now must pass a procedural vote by both houses of origination before heading to the governor’s desk. The governor’s office has expressed support for the bills, so both are expected to be signed into law.
The Senate yesterday approved ABX1-2 by Assembly member Richard Pan (D-Sacramento), and the Assembly voted for SBX1-2 by Sen. Ed Hernandez (D-West Covina). Both bills aim to ban pre-existing conditions as a means of denial for health coverage, establish community rating and require guaranteed issue and renewal of health insurance in the individual and small group market.
The two bills are almost identical, but have slight differences: ABX1-2 includes language clarifying insurance code and SBX1-2 has additional health and safety language.
Both floor votes went along party lines, for the most part. Sen. Ted Gaines (R-Roseville) did say he supported ABX1-2, with some reservations. “I’m voting for it, but with the caveat that Congress may not fund the Affordable Care Act,” Gaines said. “Our budget’s going to be in a mess if we don’t see federal dollars come through.”
Hernandez said that the individual market changes are just that — market changes — and are not funded directly by government dollars, unlike Medi-Cal expansion, which is a program fully funded by the federal government.
Other Republicans, though, had stronger words against the two bills, and health care reform in general.
“I have had a group of doctors coming through [the Capitol offices] on a regular basis, and ⦠what all these doctors are saying is, we’re scheduled to see 30 patients a day — i.e., this doesn’t work now,” said Assembly member Diane Harkey (R-Dana Point). “We are rushing through these policies. ⦠We’re going to have practitioners fleeing the state, we’re going to have long lines. Everybody’s going to opt out and settle on national health care, and we won’t have choices anymore. We will not have choice. ⦠Your children will be waiting in line, and getting care from pharmacists. We have to be sure we are doing the right thing.”
Assembly member Steve Fox (D-Lancaster) disagreed, and said the problem is not just what might happen, but what is happening already.
“The sky is not falling,” Fox said. “It fell a long time ago. And we’re trying to fix it.”Â
Assembly member Shannon Grove (R-Bakersfield) said the Democratic rhetoric about doing what’s right for low- and middle-income Californians is misleading.
“This is about insurance,” Grove said. “This is not about services. Right now people can go to any emergency room and get services.”
That set off Assembly member Holly Mitchell (D-Los Angeles). “It is true, all of us can appear at an emergency room and receive care. Is that the preferred method of care? I would say no. Is it free? I would say no. Do the people who receive those services pay for the higher cost of those ERs? I would say no,” Mitchell said. “To suggest that the preferred method of care is the emergency room, that is not logical and is not fact-based.”
Assembly member Tim Donnelly (R-Twin Peaks) said the debate is more fundamental than where people get care: “Do we truly want to move from a free market system to a government market system?” he asked. “We are taking all the incentives of a rational market and making it an irrational market. In this country, we have the greatest health care system in the world. And we are destroying it.”
Assembly member Richard Pan (D-Sacramento), author of the version of the bill up in the Senate yesterday, said he appreciated the debate on the legislative floor, but that the discussion has been a long, thought-out process.
“When people talk about hearings, we’ve had many of them,” Pan said. “This is not a government-run system, we’re creating a marketplace. A free marketplace.”
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