Governor's health care bill faces long hearing, close vote

Gov. Arnold Schwarzenegger's $14 billion health care expansion bill moves to the Senate, where it will face an extended hearing this week and the likelihood of a close vote in the Health Committee.

"This is not a slam dunk," said Sen. Leland Yee, a San Francisco Democrat who could end up being the swing vote on the measure.

The bill passed the Assembly in December, but the Senate put off consideration to give the Legislature's budget analyst, Elizabeth Hill, time to report on the bill's costs.

The Health Committee will take it up Wednesday with a hearing that the chairwoman, Sen. Sheila Kuehl predicts will stretch from midmorning into the evening.

The panel will hear from Hill, take a look at health care experiments in other states, examine the bill piece by piece and take testimony from supporters, opponents and those on the fence looking for amendments.

The legislation would require employers to spend a certain percentage of their payrolls on health coverage for their workers, either by buying policies themselves or paying into a state health insurance pool.

Most Californians who couldn't obtain coverage through jobs or a government program would be required to buy insurance on their own.

The plan would be funded through employer contributions, fees on hospitals and an increase in cigarette taxes, in addition to premiums paid by consumers. Administration officials also are counting on getting additional federal funding to expand health care programs for the poor.

Supporters say the proposal would provide coverage for most of the 5.1 million Californians who lack health insurance and force insurers to take all customers instead of denying coverage because of pre-existing conditions.

"This is fundamental reform...," said Assembly Speaker Fabian Nunez, D-Los Angeles, who negotiated the legislation with Schwarzenegger and is carrying the bill.

"In the end, this is what gets us closest to universal health care. It's reform that's doable, practical, that has a shot."

But Kuehl and other critics say there are a number of problems with the bill, including lack of adequate insurance cost controls and no real minimum coverage requirements for employer-financed health insurance.

The outcome could depend on Yee, who says he is concerned about adopting a massive new health care program at a time the state is facing a $14.5 billion budget deficit over the next 18 months.

"It's rather difficult for me to vote for a health care plan that's going to cost $14 billion at the same time I'm looking at cutting $14 billion," he said.

"It's almost like telling someone who is in need of help, 'I'm going to give you food, but I'm going to take away your clothes.' At the end of the day, the person is still poor."

"I think all of us are trying to find something that's going to be of help to the people of California and not in any of the out-years find that there are unintended consequences or that it's going to shift the burden of costs to workers unfairly," he said.

Also this week, committees in both houses will step up their consideration of cuts proposed by Schwarzenegger to erase $3.3 billion in red ink in the state budget that runs through June 30.

The Senate Budget and Fiscal Review Committee has hearings scheduled Tuesday and Thursday. The Assembly has a series of budget subcommittee hearings set for Tuesday, Wednesday and Thursday.

Lawmakers are supposed to come up with a budget-balancing plan by Feb. 24 in a special session called by the governor.

From Sac Bee’s Capitol Alert:

Yee to oppose health bill – landmark legislation now one vote short

On the eve of a hearing for landmark health legislation, a spokesman for Sen. Leland Yee said the San Francisco Democrat will oppose the health care measure. The move throws into limbo whether the legislation has the necessary votes to move forward.

“The costs are a big concern for him,” said Adam Keigwin, a spokesman for Yee, regarding the $14 billion health care price tag that coincides with a projected $14.5 billion budget hole.

The 11-member Senate Health Committee is scheduled to consider AB 1X1, legislation negotiated by Gov. Arnold Schwarzenegger and Assembly Speaker Fabian Núñez, in a hearing on Wednesday.

Sen. Sheila Kuehl, a Democrat and the chair of the Senate Health Committee, has openly opposed to the measure.

With “only” seven Democrats on the 11-member committee, and both Kuehl and Yee as committed “no” votes, the measure is one vote shy of passage.

No Republican has said they will support the measure, which will require six votes to pass.

Yee has been openly on the fence about the measure. He told the AP over the weekend that the bill was “not a slam dunk.”

“It’s rather difficult for me to vote for a health care plan that’s going to cost $14 billion at the same time I’m looking at cutting $14 billion,” he said. “It’s almost like telling someone who is in need of help, ‘I’m going to give you food, but I’m going to take away your clothes.’ At the end of the day, the person is still poor.”

Keigwin said Yee conferred with labor leaders in his district over the weekend who were “almost unanimous” in urging Yee “to vote no.”

What happens next is unclear, though options certainly remain for passage.

For instance, Senate President Pro Tem Don Perata could ask Kuehl to grant the measure a courtesy vote, allowing it to proceed to the Senate floor despite her personal opposition.

In an interview Tuesday morning, Kuehl reiterated her position, saying, “I’ve been very clear with all the advocates and everybody that I do not favor the bill.”

She said she had not been contacted by Perata or his staff to support the bill. Asked if she would consider granting a courtesy vote if she was, she replied that she “can’t answer that.”

“In the Senate, we generally are equal as members,” Kuehl added.

Another option could be to seek out a GOP vote. Sen. Abel Maldonado, R-Santa Maria, sits on the committee and is the most moderate member of the Senate Republican caucus.

Maldonado, who did not immediately return a call for comment, has not had kind words for universal health care in the past. “I think universal health care is too big a jump for California. We don’t have the resources,” he said late last year, according to the San Jose Mercury News.

Another possibility for Perata is to restructure the committee itself, replacing Yee with a member more amenable to the health plan or adding members. That would break the Senate tradition of moving members off committees for particular votes, though Perata did restructure the Appropriations Committee last May, removing moderate Sens. Lou Correa and Ron Calderon.

All of those options, of course, depend on Perata pushing hard for passage of the plan.

After the bill passed the Assembly in December, Perata urged caution, saying it would be “imprudent and impolitic” to consider the measure before considering its impact on the state’s $14 billion budget hole.

He requested a study by the nonpartisan Legislative Analyst’s Office, which should be released later today, for Wednesday’s hearing.

But Perata’s reluctant tone has changed somewhat. Dan Weintraub reported on Jan. 10 that Perata said the bill would be “acted on.”

“He said the best thing about the proposal is that it allows the voters to make the final decision at the polls,” Weintraub wrote. “Sounds like he is assuming that they will get the chance.”

As Kuehl said Tuesday, “I don’t quite know what the outcome is going to be.”

Posted by Shane Goldmacher on January 22, 2008 12:35 PM

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