State Legislature

All eyes on health reform in 2008

Though 2007 ends without signed legislation, local advocates are ‘cautiously optimistic’ the governor will sign a bill this year

By Sarah Arnquist

Health care reform took center stage in California politics in 2007, raising hope that state lawmakers could compromise on a plan to help more people gain access to health insurance.

As 2007 ends without signed legislation, San Luis Obispo County reform advocates reflect on the year’s debate and the likelihood that Gov. Arnold Schwarzenegger will sign a health reform bill this year.

“I’m somewhere between cautiously optimistic and pessimistic,” said Joel Diringer, a San Luis Obispo health care consultant who works on expanding children’s health insurance statewide.

“This is the closest we’ve been in many years, but that doesn’t mean we’re close” to real reform.

Diringer is referring to the state Assembly’s passage Dec. 17 of ABX1. The $14.4 billion plan would cover an estimated 3.7 million of the 5.1 million California residents who are considered permanently uninsured.

The measure would require people to have insurance starting in 2010 and would provide subsidies and tax credits for residents who meet certain income levels.

The plan would require insurers to provide coverage to all applicants and would force them to spend 85 percent of premium dollars on health care.

It would be funded through employer contributions, a hospital tax, a tobacco tax increase and an expansion of federal funds.

Even if it overcomes its next obstacle by passing the Senate, voters have to approve the funding on a ballot measure in November 2008.

“There are a lot of potential obstacles before there’s any implementation,” Diringer said, “and then there’s the question of whether there’s enough funding.”

Senate President Pro Tem Don Perata, D-Oakland, has said he will not hold a vote until the Legislative Analyst’s Office determines the plan’s impact on the state’s looming $14 billion deficit.

One of the most controversial aspects of the plan is the requirement that all California residents buy health insurance. That worries Walter Heath, a Morro Bay resident and co-chairman of the local chapter of statewide nonprofit group Health Care for All.

“An individual mandate to purchase health insurance without knowing what the coverage is going to be or how much it’s going to cost is not productive,” he said.

Heath also said the proposal does nothing to control costs, and he said he doesn’t believe it is sustainable. He wants the state to adopt a single-payer, universal health care system.

The proposal calls for insuring all children in the state but not until 2009. And that depends on whether the state can negotiate expansions of Medi-Cal and the State Children’s Health Insurance Program with the federal government, Diringer said.

Before then, some local children could lose their health insurance, said Kena Burke, director of the San Luis Obispo County Children’s Health Initiative, a program that covers uninsured children who do not qualify for state and federal health insurance programs because of their immigration status or their family income is too high.

Still, Burke said, the progress made this year is encouraging. Looking forward, though, she worries state and local budget gaps will trump health reform as the top priority.