California Assembly Committee Approves Speaker's "Near Universal" Health Care Bill and Laird's Bill to Cover All Children

The Speaker of the Assembly had a full retinue with him on the dais as he presented the bill with the Assembly Majority Leader, Karen Bass, and others in his legislative team there to support the bill.

It is almost self evident that both of these bills will eventually pass their next stop, the Assembly Appropriations Committee, and at some point later this year be approved by a party line vote in the full Assembly.

Today, President pro Tem Perata's SB 48, with different provisions, but similar to Nunez's bill, will be heard by the Senate Health Committee. Given the fact that Senator Sheila Kuehl, the chair of the committee, is a coauthor of the bill, it would be surprising, to say the least, if that measure did not pass this hurdle, and similarly pass its fiscal committee and the Senate floor.

Despite the predictability of the vote, all sides are actively engaged each step of the way, supporting and opposing, suggesting modest amendments or wholesale modifications to the different bills. This is a giant tug of war that will probably go on until September when the legislature adjourns for the year, when the steps of the Capitol will be the scene for demonstrations and large gatherings.

The Governor has not submitted a bill, or legislative language, but has fairly detailed proposals he is pushing. His aides are quoted in the press as saying he did not want to see the language of his proposal picked apart. With the possible exception of SB 840, (Sheila Kuehl's single payer plan which passed last year after extensive hearings, grillings, and amendments), the final version of these bills will most probably not resemble the shape they are in today. Nevertheless, the detailed committee analysis and the vetting of the language and concepts taking place this week will sharpen the bills and they seem to be moving forward for eventual meshing with the Governor's, picked apart or not.

You can watch Speaker of the Assembly Nunez presenting his bill to the committee online. Also Assembly Majority Leader Bass can be seen giving her testimony in support of AB 8.

Nunez Bill a Step Forward in the Health Reform Debate

Anthony Wright, the executive director of Health Access California, a statewide coalition of over 200 health reform organizations had this to say about the Nunez bill, AB 8 following the hearing:

"We are pleased the health reform debate has started in earnest. The Nunez bill would provide more security for children, for workers and their families, and for many Californians who are concerned that coverage will not be there for them when they need it."

"While the Nunez bill would take positive steps forward, there's more to do, especially in setting the standards on insurers for what coverage is. Without a strong standard for health care for working people, we will have more Californians becoming uninsured, and more pressure for those employers who pay for health benefits to scale back or drop benefits."

"Health reform proposals need to break down the barriers to on-the-job coverage, public insurance programs, and buying a plan despite so-called "prexisting conditions". The issue isn't whether Californians want health care, but making sure that it is available and affordable to get and to use."

In a letter sent to the committee, Health Access California suggested amendments and noted their support for many of the key provisions of AB 8, among them:

• providing health insurance to millions more Californians and creates the structure for providing coverage to more.
• expansion of Medi-Cal and Healthy Families to provide coverage to children, regardless of immigration status, up to 300%FPL and their parents. Health Access also supports expanding Medi-Cal to cover low-income adults without children under 18 at home.
• setting a standard for health benefits paid for by employers through requiring employers to pay a fair share for health care for their employees if the employer contribution is sufficient to create a meaningful standard for health benefits on the job.
• creation of a purchasing pool that is open to all employers that choose to participate in the purchasing pool.
• insurance market reforms that would guarantee that Californians that desire to purchase health insurance are guaranteed the opportunity to do so.
• those provisions of the measure that would encourage the use of electronic medical records and would provide partial coverage for disease management.

They concluded:

The letter Health Access recognizes that these provisions are still being developed and will be further amended in the future. Taken together, these provisions would insure millions of uninsured Californians and help to make coverage more affordable for millions more.

The Health Access letter, including their suggestions, can be read in its entirety online.

THE ADVANCE OF LAIRD'S UNIVERSAL HEALTH INSURANCE FOR CHILDREN BILL SHOULD NOT BE OVERLOOKED

On nearly any other day or week, AB 1 by Assemblymember Laird, would be heralded in the press as a major advance. His office put out a bullet point assessment of the major problem of uninsured children it would solve and how it would accomplish this:

• Nearly 763,000 children in California lack health insurance coverage, almost 7% of all California children. Approximately 447,000 of these uninsured children (58%) are already eligible for state-sponsored health insurance programs, Medi-Cal and Healthy Families.

• More than 87,000 children are enrolled in 18 different local Children’s Health Initiatives (CHIs). CHIs are local efforts that combine public and private funding to provide health insurance coverage to children who are not eligible for Medi-Cal or Healthy Families. While CHI’s are an excellent model for covering all children, most counties do not have them, and they are dependent on county general funds, foundation funding and/or private donations. Most of this funding has been given on a short-term basis thereby making it difficult to sustain programs in the counties that have CHIs. Today, more than 12,000 children are on CHI waiting lists, and this number does not reflect the total need since some CHIs do not keep waiting lists or have enrollment caps.

• AB 1 seeks to do several things that, combined, will result in coverage for all children in California:

• Expands eligibility for Medi-Cal and Healthy Families to all children in families with income up to 300% of the federal poverty level (FPL).

• Allows families over 300% of FPL to buy coverage in Healthy Families at cost.

• Increases enrollment and retention of eligible children in Medi-Cal and Healthy families by:

 Reducing required paperwork when applying for Healthy Families;
 Extending presumptive eligibility coverage to children who apply for coverage through county offices and appear to be eligible for Medi-Cal;
 Creating a seamless transition for children moving from Healthy Families to Medi-Cal; and
 Improving state electronic enrollment systems to most efficiently keep kids covered.

Conclusion

When the dog days of summer come to Sacramento, and the heat is in the triple digits, it looks like there will be three vehicles waiting for what will hopefully be a good health care advance for the state.

Dan Walters has a column in today's Bee that assesses the risks and pitfalls of all of this, including court challenges, a ballot referendum to overturn anything done that does not please those with the money to qualify one, and the other hurdles to be cleared before we will see health care changes.

Stay tuned.