California Health Care: Bill's Co-Author Votes Against It

What a long, strange trip it's been for health care reform in California. After a yearlong effort ABX1-1, the health care bill backed by California Gov. Arnold Schwarzenegger and Assembly Speaker Fabian Núñez, has been voted down. The Senate Health Committee delivered a coup de grace in the form of a 7-1 vote against the measure, including a nay vote from Senate President Pro Tem Don Perata (D – Oakland) who originally co-authored the measure.

Rhonda Rundle at the Wall Street Journal talks about the factors that lead to this turnaround (page A9 if you prefer hardcopy):

Support began to erode in the senate as the outlines of the state's $14 billion budget deficit came into focus late last year.

Last week, the Legislature's nonpartisan fiscal analyst raised questions about funding for the package, further undermining its prospects. Lawmakers who had been leaning in favor of the negotiated bill began backing away in the face of uncertainty about how the state could enact an ambitious new program at a time of fiscal crisis when the governor has proposed cutting funds for established health-care programs.

ABC News 10, a California news station that covers Sacramento and the surrounding areas, brings us the view from the Chair as reported by Ayesha Thomas:

Committee Chair Shiela Kuehl said there isn't enough money to fund the program.

"There's insufficient funding there for so called subsidies, there's insufficient money there to cover the expanded Medi-Cal coverage," said Kuehl.

"If the headline is Health Committee kills reform, that's an erroneous headline. But we'll live with it...The right headline is Senate Health Committee does not pass bad bill," Kuehl added.

There's more where that came from. The News 10 article ends with a transcription of Gov. Schwarzenegger's Statement in response to the vote.

Since this is a California issue a visit to Brian Katz's blog is order. As usual Mr. Katz delivers the goods, this time in the form of this quote from Senator Perata explaining his decision:

In a letter to Governor Schwarzenegger and Speaker Nunez, Senator Perata wrote, “This bill – which is before the Senate, and the initiative, which is not – would create the third-largest program in state government, surpassed only by K-12 education and Medi-Cal. Under any circumstances, but especially in light of the state’s $14.5 billion budget shortfall, we have the fiduciary responsibility to approve a health care coverage plan that is both self financing and fiscally sound and a moral responsibility to protect from harm those who already have health care coverage.”

Mr. Katz provides our summation today, as he has stated it so eloquently.

The defeat of ABX1-1 is no cause for celebration. The reality is, while the health care system works well for many in the state, serious problems exist that need to be addressed. With the defeat of ABX1-1, pressure for change will continue to build. Lawmakers may succumb to the pressure to pass anything in order to have passed something.

SOURCE: "Health-Care Bill Fails to Pass" 01/29/08
SOURCE: "Key Committee Rejects Schwarzenegger's Health Reform Effort" 01/29/08
photo courtesy of d_vdm, used under this Creative Commons license

San Francisco Health Insurance Mandate gets Green Light from 9th Circuit Court

The Ninth Circuit Court of Appeals is allowing the City of San Francisco to move forward with its new health care plan despite the recent ruling of the U.S. Federal District Court. A few weeks ago Judge Jeffrey White ruled that the funding component of the plan violated The Employee Retirement Income Security Act of 1974 (ERISA)

Bob Egelko at the San Francisco Chronicle offers a simple summation in his analysis of the situation:

That provision requires large and medium-size companies to offer insurance to their employees or pay a fee to the city for the cost of their coverage. The court said the city probably would win its argument that U.S. District Judge Jeffrey White was wrong when he ruled Dec. 26 that local governments lack the power to force employers to contribute to a health care program. [...]

The law was challenged by the Golden Gate Restaurant Association, which represents more than 900 Bay Area establishments. Dan Scherotter, the association's incoming president, said the restaurants were disappointed but would comply with the ruling and remained confident of winning after the court hears all the evidence.

Avoidable suffering was cited by Judge Williams Fletcher as a reason for the 3-0 decision. According to Egelko's article the case has been prioritized and final written arguments are due this April with a possible decision this year.

For more detail on this topic I would advise reading the primer on the case posted yesterday on the Alan Katz Health Care Reform Blog. As usual Mr. Katz included a number of useful sources including a link to the actual court decision and some thoughts concerning the ramifications of this decision for California's proposed statewide health care plan (ABX1-1).

ABX1-1 and its companion ballot initiative create a similar funding mechanism at the state level. Opponents of the legislation claim it, too, violates ERISA. This decision undermines the argument of those critics.

Or as Speaker Nunez put it in a statement issued by his office today, in what can be considered the political equivalent of a running back's victory dance in the end zone, "Opponents of health care reform now have one less rubber arrow in their quiver as they try to stop our historic effort to fix the broken system and make health care more affordable and accessible to the people of California."

Only time will tell what impact the precedents set in this case will have on the reform of health care across the nation. One thing is certain: no matter what the final decision is, it will have a far-reaching ripple effect.

SOURCE: "Ninth Circuit Allows SF Health Plan to Go Forward" 01/09/08
SOURCE: "Appeals court allows S.F. to enforce health care law" 10/10/08
photo courtesy of tinkerroll21, used under this Creative Commons license