On Tuesday, Gov. Arnold Schwarzenegger (R) and Assembly Speaker Fabian Núñez (D-Los Angeles) vowed to continue seeking a plan to overhaul California's health care system, one day after their reform bill (ABX1 1) failed in the Senate Health Committee, the Sacramento Bee reports (Furillo, Sacramento Bee, 1/30).
Background on Vote
The Assembly passed the measure in December 2007, but the Senate committee voted 7-1 against the bill, with three Democratic members abstaining. The legislation received no support from Republican committee members.
The plan would have required about 3.6 million of the 5.1 million permanently uninsured residents to obtain health care coverage.
Aside from approval from the Legislature and Schwarzenegger, the plan could not have taken effect without voter support of its funding mechanism. A ballot measure was planned for November (California Healthline, 1/29).
Governor Remains Steadfast
Schwarzenegger said that "just because the Senate has missed this golden opportunity to pass our health care reform doesn't mean that we should walk away from reforming our broken health care system" (Sacramento Bee, 1/30).
The governor added, "I'm as determined as ever" and the "issue is not going to go away" (Christie, Reuters, 1/29).
In a news conference with Núñez, Schwarzenegger pledged to "regroup" with the speaker and various stakeholders to devise a successful health care reform plan.
Speculation on Why Bill Failed
The governor said he will work with Núñez and other proponents of the measure to "find out exactly" why the bill failed. He suggested that there was something "underneath" the reasons given by opponents of the plan who argued that it would affect state spending over time.
However, Alicia Trost, spokesperson for Senate President Pro Tempore Don Perata (D-Oakland), said the only motivation for rejecting the bill was the $14.5 billion budget deficit (Sacramento Bee, 1/30).
Perata said that if Schwarzenegger "wants to spend his energy working with leaders around here, he ought to spend it on the budget," adding that the governor's proposed spending plan to reduce the deficit would include cuts to health care services for low-income residents (Yi, San Francisco Chronicle, 1/30).
Meanwhile, Núñez speculated that Democratic support for a state-run, single-payer health care system undermined ABX1 1.
In 2006, Schwarzenegger vetoed legislation (SB 840) to create such a system. The bill -- by Sen. Sheila Kuehl (D-Santa Monica), chair of the health committee - was reintroduced last year and is pending in the Assembly.
Núñez said he thinks "it's time for us to have an honest conversation about" the single-payer bill, adding that lawmakers "cannot create a false sense of hope that we can do something better if it hasn't been tested and put through the same type of scrutiny that [ABX1 1] was put through" (Sacramento Bee, 1/30).
Health care analysts maintain that the defeat of ABX1 1 is a setback for state-level health care reform efforts and demonstrates that national reform is more feasible.
Marian Mulkey, senior program officer for the California HealthCare Foundation, said states lack the "policy levers in their arsenal to do that kind of fundamental reform, when you consider how much of health care is driven by federal financing."
Mulkey added that mechanisms to control rising health care costs can only be imposed by the federal government through Medicare because it accounts for such a large portion of overall U.S. health care spending (Rundle, Wall Street Journal, 1/30).
Gary Lauer, president and CEO of eHealthInsurance, said, "A lot of other states were looking to California as a trailblazer, a model." He added, "Part of the fallout might be more consideration will be given to implementing change on an incremental basis" (Fernandez, San Francisco Chronicle, 1/30).
Summaries of opinion pieces and editorials regarding health care reform in California appear below.
- Sen. Mark Ridley-Thomas (D-Leimert Park), Los Angeles Times: "This bill was the best chance I've seen since I've been in the Legislature of providing significant new funding" for expanding health insurance coverage, Ridley-Thomas, who provided the sole vote in favor of the bill on the Senate Health Committee, writes in a Times opinion piece. The Legislature had "a rare opportunity to take a chance on a bold vision, crafted by Democratic legislators and a Republican governor working together. I hope we get another chance," Ridley-Thomas writes (Ridley-Thomas, Los Angeles Times, 1/30).
- Timm Herdt, Ventura County Star: "The senators were clearly put off by the political situation of having only the options of embracing or rejecting the plan," Herdt writes in a Star opinion piece. "The timing was such that they couldn't tinker with it, a reality that collided with their senatorial sense of self-importance," Herdt writes (Herdt, Ventura County Star, 1/30).
- Los Angeles Daily News: "Shame on Perata and the senators ... who soured this deal," a Daily News editorial states. "They failed the public, which consistently ranks the growing inaccessibility of health care as a top worry," the editorial states (Los Angeles Daily News, 1/29).
- Orange County Register: If "a plan constructed over the course of a year at the state level proves to be unworkable once people start crunching the numbers and considering the implications, a national plan is likely to have similar problems on a much larger scale," a Register editorial states. "Moving toward a more free-market approach rather than heavier government involvement just might move us toward the objective of having affordable health care available to more people more quickly," according to the editorial (Orange County Register, 1/30).
- Sacramento Bee: "The demise of health care reform in the California Senate is a crushing setback for the 6.7 million Californians who lack health insurance," a Bee editorial states. The committee's vote "hurts the Legislature's standing and leaves Californians wondering if lawmakers can ever deliver on the promise of health care reform," the editorial states (Sacramento Bee, 1/30).
- San Diego Union-Tribune: The "first step" for the governor and Núñez "when they do the inevitable and once again offer a health insurance expansion bill ... should be to ask the [Legislative Analyst's Office] to examine its financial assumptions," a Union-Tribune editorial states (San Diego Union-Tribune, 1/30).
- San Francisco Chronicle: "Whatever the real politics behind the committee's decision are, we urge the Senate not to take up ... Perata's suggestions to pass piecemeal elements of" the bill, a Chronicle editorial states. "Picking this bill for the bits the senators like wouldn't just be an act of bad faith, it would be bad policy, even if it were politically possible," according to the editorial (San Francisco Chronicle, 1/30).
Three broadcast programs recently reported on reaction to the failure of the bill. Summaries appear below.
- American Public Media's "Marketplace": The segment includes comments from Richard Brown of the UCLA School of Public Health; Democratic presidential candidate Sen. Hillary Rodham Clinton (N.Y.); Chris Conover, a health policy analyst at Duke University; and Peter Harbage, a health care adviser to former Sen. John Edwards (D-N.C.) (Marshall Genzer, "Marketplace," American Public Media, 1/29). Audio and a transcript of the segment are available online.
- KPBS' "KPBS News": The segment includes a discussion with Sacramento political consultant Leo McElroy about the bill (Brown, "KPBS News," KPBS, 1/29). Audio of the segment is available online.
- KQED's "The California Report": The segment includes comments from Harbage, Kuehl and Perata (Varney, "The California Report," KQED, 1/29). Audio of the complete program is available online.
In addition, the governor's Web site includes video of his comments about health care reform at an appearance with Núñez
on Tuesday, as well as comments about health care at an appearance at the Sacramento Press Club