|
California
Governor is hoping to develop a plan to extend
health care to 6.5 million uninsured
Californians, but to do so, he will have to
find common ground between groups that often
are at odds.
Union leaders
quickly balked at a requirement that all
Californians have insurance, calling it a tax
on the middle class. A demand that all but the
smallest businesses offer their workers
insurance upset many of Schwarzenegger's
business allies.
"I look
forward to everyone now having those
debates," Schwarzenegger said via
videolink to a panel of health care
stakeholders who assembled Monday to hear his
plan. "There are a lot of people around
the table."
Under the
proposal, all Californians must have
insurance, although the poorest will be
subsidized. Those who go uncovered will be
subject to tax penalties.
Businesses
with 10 or more employees will have to offer
insurance to their workers or pay 4 percent of
their payroll into a state fund. Smaller
firms, which the governor's office said make
up 80 percent of California businesses, will
be exempt.
Insurers
would no longer be allowed to deny coverage to
people because of their medical problems. All
children, regardless of their immigration
status, will be covered through an expansion
of the state and federal Healthy Families
program.
"If you
can't afford it, the state will help you buy
it. But you must be insured," said the
governor, who presides over a state with more
uninsured people than any other. "That is
number one."
Schwarzenegger
said his plan will save $10 billion a year by
cutting costs and redirecting money already in
the health care system.
Many
applauded the breadth and ambition of the
Republican governor's plan, which a special
team of advisers spent six months developing
in secret.
Several
experts said it went even further than
Massachusetts, which last year became the
first state to require everyone to have health
insurance.
"This
plan one-ups Massachusetts," said Peter
Harbage, a health care consultant with the New
America Foundation. "The governor has
gone further and added doctors, hospitals and
health plans" to those who must help pay.
The state
will subsidize the estimated 1.2 million
low-income people who do not currently qualify
for coverage. They would be able to buy
insurance through a state-run pool and will
have to make a small contribution toward their
premiums.
Kim Belshe,
Schwarzenegger's health secretary, said an
additional $10 billion to $15 billion will go
to health care providers under
Schwarzenegger's plan. The state will increase
reimbursement rates to help doctors and
hospitals.
But in turn
they will have to pay into the new system.
Hospitals will be assessed 4 percent of their
revenues, while doctors will pay 2 percent.
Insurers,
seeing the possibility of 4 million to 5
million new customers, praised the proposal,
despite the new restrictions it places on
them, such as limiting administrative costs.
"The
governor's plan is bold, comprehensive and
visionary," said Bruce Bodaken, chairman
of Blue Cross of California. "Taking each
part separately, there's something for
everyone to hate. But taken as a whole,
there's a lot to like."
But employers
and doctors said they were being taxed to fund
it, while unions protested that low-income
workers would bear the brunt of the costs
because they will be forced to buy insurance.
"This is
all going to be on the backs of the
individual, the workers," said Angie Wei,
a lobbyist with the California Federation of
Labor.
Schwarzenegger's
decision to include an employer mandate is a
blow to his business allies, who waged an
expensive fight against a similar requirement
just three years ago -- with the governor's
help. Republicans reacted negatively.
"Imposing
a new jobs tax on employers of any size and
expanding costly government mandates is the
wrong approach, one which will devastate our
economy," Assembly Republican leader Mike
Villines said in a statement.
Democrats
said they were open to the governor's ideas.
But Assembly Speaker Fabian Nunez, a Democrat,
said if all workers are required to buy
insurance, insurers will raise their prices
"and ultimately make health care less
affordable."
Nunez and
Senate President Pro Tem Don Perata, a
Democrat, have put forth their own health
reform ideas. They and the governor now begin
what may be a long process of trying to
achieve a compromise.
Republicans,
who are in the minority, may have less of a
say in whatever plan emerges unless it
involves raising taxes, which requires a
two-thirds majority.
|