Posted on 02/15/2005 3:07:21 PM PST by swilhelm73
SAN JOSE - A sweeping, bipartisan health reform plan that would require all Californians to purchase basic health insurance -- or have their wages garnished -- is drawing a lot of attention in Sacramento, but insiders say the plan in its current form doesn't stand much of a chance.
Assemblymen Joe Nation, D-San Rafael, and Keith Richman, R-Granada Hills, on Thursday unveiled their Universal Healthcare Act of 2005, which aims to help California's 6.4 million uninsured people, control costs and improve health quality. The legislation is expected to be formally introduced next week.
The centerpiece of the reform package, an "individual mandate" to purchase health insurance, is a drastic change from the current American system of delivering health insurance through employers and government programs like Medi-Cal and Medicare.
The idea of individual mandates surfaces periodically in health-policy circles, but no state has ever adopted it, said Alan Weil, executive director of the National Academy for State Health Policy.
"If we're going to be serious about a mandate, we have to be very serious about subsidizing a lot of people to make it affordable," Weil said. "Once you start looking at the numbers, it's very hard to make it work."
Still, the concept is trendy in some Sacramento circles, particularly after the narrow defeat of Proposition 72 appeared to dim the chances of a statewide employer mandate to provide health insurance. The influential California Medical Association's board of trustees is floating early support for individual mandatory health insurance and Gov. Arnold Schwarzenegger has expressed interest in it.
The Nation-Richman legislation is modeled on concepts developed by the New America Foundation, a centrist think tank that espouses mandatory health insurance for all Americans. It's dramatically different from the "universal health care" legislation recently re-introduced by State Sen. Sheila Kuehl, D-Los Angeles, which would scrap private insurance entirely in favor of a government health insurance program covering everyone.
The Nation-Richman reform package would:
• Require citizens and legal residents of California to purchase basic health insurance, maintaining at least a catastrophic policy with a maximum $5,000 deductible. Californians would be required to submit proof of coverage with their state tax returns. Those who don't could be automatically enrolled in a health plan and either lose their tax refunds or have their wages garnished to pay the premiums.
• Establish purchasing pools to help reduce risk to insurers and the cost to individuals. Small employers would receive subsidies to provide insurance for low-income workers.
• Improve enrollment in Medi-Cal and Healthy Families, government health programs for the poor.
• Require hospitals, insurers and health plans to have electronic medical records systems in place by 2010, and doctors to do the same by 2012.
• Allow Medi-Cal, the state's health insurance program for the poor, to dispense only generic drugs unless it can be shown that a brand-name drug is medically necessary.
• Limit the amount employers can deduct on state taxes for their health insurance premiums paid for employees.
• Levy a premium tax on health insurers.
The proposal already appears to be a tough sell among lawmakers.
"I welcome their entry into the debate," said Assembly Majority Leader Dario Frommer, D-Glendale, "but an individual mandate without a mechanism to provide affordable health insurance means many people will not be able to afford it. Many employers will stop offering it. We'll see a race to the bottom. As written, it's a very dangerous plan."
Frommer, former chair of the Assembly Health Committee, also said Californians aren't ready for Kuehl's proposal of a government-run health care system.
So are there any health reform proposals that try for the middle ground? Frommer would allow only that "there's a lot of discussion" about how to proceed, noting that he and other legislators will soon introduce a plan to expand health insurance coverage for children.
"An individual mandate has a really high bar to reach politically," said Larry Levitt, a vice president and health policy analyst with the Kaiser Family Foundation, a Menlo Park think tank. "It's hard to sell the notion that the way we're going to solve the health care problem is by making you buy health insurance."
Are they going to force me to eat beets too?
I'm so glad I moved. Sold my condo for a ridiculous price and got the heck out.
Mexifornians.?... (Eddie Murphy laugh)...
california er's and hospitals are going broke servicing illegals. the democrats give illegals a free ride.
i think everyone, including illegals, ought to be required to purchase health insurance >>>> the result being that it would bring down the price of insurance for all.
LOL We'll trade you Debbie Stab-em-now for anybody you got!
I would almost guarantee the opposite would happen.The mandate to acquire health insurance would result in the insurance companies raising rates to meet the guaranteed market.
Look at auto insurance.That is mandatory and the rates keep pushing higher.
Ok...I'll take Debbie and you can have Miss,Ms or whatever Kuhl.
Kuhl=Kuehl or whatever.
Universal Healthcare?? What's up with this?
Just the dims?
One thing is for sure. If California passes this, they'll get alot more of them.
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