Posted on 11/20/2007 8:49:14 AM PST by goldstategop
One twelfth of the United States is poised to adopt a sweeping healthcare reform program, making some dubious assumptions about funding along the way.
Many voters remain uncertain of the answer to the key question: "How will the proposed healthcare reforms affect me?"
On October 9th, Governor Schwarzenegger released a revised version of the healthcare reform proposal he first offered in January. There are differences between the initial proposal and the new plan, now a 220-page bill called "The Health Care Security and Cost Reduction Act." The Act carries a price tag of $14 billion and would affect millions of California families and business owners.
Funding the Governor's Plan
Governor Schwarzenegger's plan ("The Act*") levies up to a 4% payroll tax on all employers with two or more employees, depending on payroll. Only businesses with a payroll less than $100,000 would be exempt. Business owners would be mandated to either spend this on private insurance or else pay into a new government entity created to manage health coverage-"The California Health Trust Fund."
The Governor's plan carries a mandate for all Californians to buy a health insurance policy. The "minimum health insurance level" that meets the state mandate is not specified, but benefits must include coverage for medical, hospital, preventive and prescription drugs.
Catastrophic coverage plans would therefore not meet the requirement.
In addition, all Californians-working or not-would be required to spend up to 6% of their gross income on health coverage. They would be fined if they chose not to purchase health insurance and then assigned to a plan enforced through wage withholding and the tax code.
The Governor's plan expects one of the financing sources for The Act to be premiums paid when "employees, currently eligible for employer-based coverage, choose to enroll in Medi-Cal" or other government-subsidized coverage rather than keep their private insurance plans.
An additional new tax included in the Governor's plan is a 4% tax on all California hospitals, generating over $2 billion for the State. According to the Governor's 10/9/07 press release, this is justified by The Act's $500 million in additional funding for public hospitals: "California's public hospitals make significant financial gains under the new reforms."
Rising Demand and Payment Cuts
Under the Governor's plan, more than 900,000 Californians would be added to State-provided programs like Medi-Cal and Healthy Families. Government-funded coverage would be provided to all children in low- and middle-income families regardless of residency status and all residents earning less than 250% of the Federal Poverty Level (FPL). Tax credits would be offered to those with incomes up to 350% of the FPL.
Medi-Cal rates paid to doctors in California are some of the lowest in the U.S., based on 1969 data with only a single increase in the past 20 years. The Governor proposes to increase Medi-Cal reimbursements to 20% lower than Medicare rates. Medicare rates in central California are some of the lowest in the region, often 40% lower than private insurance. Medicare is currently slated for a 10% cut in 2008, followed by a 5% cut for each of the successive six years.
Federal Funds Assumed Available
This financing depends on access to federal matching funds. But the expansion of Medi-Cal and Healthy Families coverage under the Governor's Plan violates current Federal guidelines for States' eligibility for matching funds (due to the relaxed income requirements and coverage of undocumented immigrants). Therefore, according to the Governor's plan, if "federal approval is not obtained, [the Medi-Cal rate increase] shall not be implemented."
Even if the a federal exception is granted, payment to doctors who accept Medi-Cal would be conditional on at least nine "performance and performance improvement measures." These are only vaguely outlined in The Act, but include linking physician payments to the use of technology, promoting "healthy behaviors among Medi-Cal beneficiaries" and public reporting of health care data.
The Governor's plan would conform California's tax code to the federal code, eliminating California's current tax on Health Savings Accounts owned by individuals.
All employers would be required to establish "Section 125" plans to allow employees to use pre-tax income for health expenses. Failure to do so would carry a penalty of up to $500 per employee.
Redirecting Funds
Financing the Governor's plan would require increased Federal government contributions ($5.5 Billion), including the "redirection" of $5.5 Billion in safety net funds currently used to fund Trauma Centers and emergency care. County government safety net funds of $2 Billion would also be redirected to finance the Governor's plan.
Additional financing for the $14 billion plan would be derived from the new legislation's proposal to lease the California Lottery, generating up to $2 billion yearly to help pay for health care costs. The Lottery funding source for healthcare would end in 15-25 years.
The California Lottery currently funds about $1.1 billion yearly in public school education, a sum that the Governor reports would be replaced by funding from the State General Fund.
California legislators are now making decisions that will significantly impact Californians who don't enjoy the luxury of healthcare coverage provided to elected officials. It is time for those who will be affected most by healthcare reform-California's families and business owners-to let their opinions be known.
Will California be a preview of what is to come for the rest of America?
* Formally known as the Health Care Security and Cost Reduction Act
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." - Manuel II Palelologus
Linda Halderman, MD
A true medical expert! I'd rather listen to her than a politician like Arnold, who knows nothing about medicine.
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." - Manuel II Palelologus
Why don’t socialists make it easy on themselves and move to freaking Canada, and leave us alone. What a pain in the a$$. They never stop until they get full control.
But will they wipe my a$$ when I get old?
“In addition, all Californians-working or not-would be required to spend up to 6% of their gross income on health coverage. They would be fined if they chose not to purchase health insurance and then assigned to a plan enforced through wage withholding and the tax code.”....The terminator terminates the California taxpayer! Has his wifes family got him by the nuts?
The morons in Sacra-de-mento have finally gone off the deep end. They have, without success, continuosly been trying to socialize medicine in this state for decades. The voters have rejected them at every turn. No matter what the voters want, no matter how stupid, they still try.
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." - Manuel II Palelologus
deeep siigghh .. meanwhile he has outdone Davi$ on more than one front beside fundraising,, spending and borrowing... without breaking a sweat..
Another great idea from the land of ‘fruits and nuts’....The Governator maybe should take a look at what is happening to the health care plan Romney foisted upon the people of Mass..........I will just copy a few sentences of the most recent idiocy coming from there ...................................Those working to promote Massachusetts’ new health care law have been so successful in enrolling people in subsidized health plans that the state may need millions more to pay for the program.
An outreach effort by local advocates, state health officials, and hospitals has put Massachusetts on the path to enrolling as many as 180,000 people by the end of June.
That could put the program short by about $146 million.
Supporters of the law say they’re pleased more people are being insured, but are concerned about how the state will find the money to close the gap.
“It’s a good problem to have. People are getting insured and hopefully getting care,” state Sen. Richard Moore, D-Uxbridge, told the Boston Sunday Globe.....................
Only in the brain of a politician could this be described as ‘ a good problem to have’..........the shortfall was predicted before the law was enacted, but the powers that be lied to the people about the true cost, and only after the plan was enacted, did they admit it would cost about 30% more than they anticipated. This in only for the first year, the outyears will be even worse.
..............
20% of the eligible adult population has yet to comply with this violation of the Contracts Clause to the 13th Amendment. The MA Department of Revenue will be stuck in a quagmire of tracking, penalties and subsidies. Chapter 58 is an affront to Liberty.
Democrat or Republican....It does’nt matter a damn anymore!....just raise one or more taxes-problem solved!
Schwarzenegger was the prototype leftist infiltrator, Romney is the production model.
Arnold...you big dummy!...Asta la vista California, the big poor Mexican tax base can pay for this crap!
Question: have you seen or do you know of any sites that are tracking the exodus out of California? I know it’s happening because we see ever more California plates here in TexaMexico but I’ve not seen any numbers on it.
I don’t see how anyone (actual taxpayers) can live in California anyway. A million five for a cracker box house on a postage stamp lot. Plus all those taxes and even more on the way? And all that without so much as a mucho gracias gringo? No thanks.
"Show me just what Mohammed brought that was new, and there you will find things only evil and inhuman, such as his command to spread by the sword the faith he preached." - Manuel II Palelologus
Where are the freepers who supported aRINOld against McClintock? We see the same thing happening on the national scale with the true conservative getting the back of the hand treatment from party resources.
bmflr
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Why the smart money is on Duncan Hunter
http://www.freerepublic.com/focus/f-news/1926032/posts
Posted on 11/15/2007 3:43:17 AM PST by Kevmo
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