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Health Care Reform Efforts Taking Shape

This month could be the beginning of the calm before the storm, the storm itself or both.

Ordained “the year of health care” by Gov. Arnold Schwarzenegger (R), 2007 is shaping up to be a busy year for politicians in California but not for voters. Voters have no statewide ballots this year, but legislators and the governor have a full agenda ahead of them.

However, voters will have ample chances to make their opinions known next year. There is a possibility of three statewide elections in California in 2008. In addition to the June primary and November presidential election in 2008, California voters might be asked to vote on term limits and redistricting in a special election in March. Some Sacramento sources say the March 2008 election might be among the first items of business when the Legislature goes back to work this month.

Depending on what happens in Sacramento this year, those three ballots in 2008 could be full of health care-related propositions ranging from single-payer state-run health care to food, including restriction of trans fats in restaurants. If the governor and Legislature talk themselves into political stalemates as they have in recent years, this year might provide a few squalls along the way, but the real storms will come in ballot showdowns in 2008. If, however, politicians actually can come to agreements on statewide policies, this might indeed become “the year of health care” in California and beyond.

California Shaping Other Efforts

Regardless of the outcome, the rest of the country will be watching carefully this year as California grapples with what almost everyone now agrees is a broken system. In addition to being the country’s most populous and richest state, California also has become a health policy trendsetter over the past few decades.

The Wall Street Journal, calling California a “leader in addressing national issues,” predicted that Schwarzenegger’s focus on health care this year is likely to boost national attention on one of the most intractable policy dilemmas facing the entire country.

“I think a successful health care plan in California would begin to be the catalyst to change the country’s health care system,” Andrew Stern, president of the Service Employees International Union, told the Journal. “People look at California as almost its own country, with all the complexities any state could find,” Stern said.

Lawmakers Offering Proposals

As the new year begins in Sacramento, state legislators already have pitched more than two dozen bills dealing with health care policy, including a couple of broad sweeping approaches to California’s growing uninsured population. The state’s 6.6 million people without insurance are the focus of Schwarzenegger’s much-anticipated health care plan, expected to be unveiled Jan. 9 in his State of the State address.

Assembly Speaker Fabian Núñez (D-Los Angeles) and Senate President Pro Tempore Don Perata (D-Oakland) both have introduced plans to require employers to provide health insurance for workers or pay a percentage of their payroll into a state insurance pool that would provide coverage. The plans also call on workers to pay a share of their health premiums.

Perata’s plan would require employees to show proof of health insurance on their state tax returns, mirroring a similar new law in Massachusetts.

In addition to the large-picture bills competing for attention with the governor’s plans and perhaps ultimately providing a framework for compromise, several other bills already in the works address a variety of health issues ranging from insurance premium relief for small-business owners to a new tobacco tax.

And there most assuredly will be more as the year progresses.

Depending on the fate of these bills — especially broad-picture proposals such as those from Schwarzenegger, Perata and Núñez — California voters might be asked to take things into their own hands in 2008. If substantive changes aren’t in the works in the Legislature by this time next year, and even if they are, there’s a very good chance ballot propositions will be in the works.

Even if the governor and Legislature do reach compromises, voters may get opportunities to weigh in on the big picture. At least two sweeping initiatives are possible for 2008 ballots.

Kuehl a Strong Influence

Sen. Sheila Kuehl (D-Santa Monica) in 2006 offered a proposal for a state-run universal health system. The Legislature approved the bill, but Schwarzenegger vetoed it. Kuehl has said her proposal could be retooled as a statewide initiative and put directly to voters.

“I continue to think it is the best long-term solution for California,” Kuehl said. She also might reintroduce the bill this year, despite its track record with the governor.

Kuehl is poised to play a key role in shaping legislation this year as chair of the Senate Health Committee.

In addition to the possibility of seeing Kuehl’s proposal on a ballot, California voters might see similar initiatives from health advocacy and labor groups exploring the possibility of statewide campaigns for a single-payer system.

However, before any petitions start to circulate, before senators and Assembly members cast any votes, the governor gets the spotlight in a few days to kick off his “year of health care” in California.

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