State officials are considering strategies for continuing health reform efforts if the U.S. Supreme Court strikes down the federal health reform law, the Los Angeles Times reports (Terhune, Los Angeles Times, 4/1).
The Supreme Court case centers on whether the federal government can require residents to purchase insurance and whether federal lawmakers have the power to pressure states to expand insurance coverage through Medicaid.
The court is expected to make a decision by the end of June.
The Kaiser Family Foundation has estimated that California could receive an additional $45 billion to $55 billion in federal funds between 2014 and 2019 if the health reform law is upheld.
Last week, California Health and Human Services Agency Secretary Diana Dooley said that California will strive to continue implementing the law regardless of the court's decision (California Healthline, 3/30).
Advancing Health Reform in California
State lawmakers already have developed legislation to further implement the federal law, and the proposals could serve as a vehicle for statewide health reforms if the court strikes down the federal overhaul.
State health reform supporters say that lawmakers must enact an individual insurance mandate requiring all residents to purchase health coverage to spread risk and lower health costs.
Assembly member Bill Monning (D-Carmel) -- chair of the state Assembly Health Committee -- said he would support the individual mandate if federal funds still are available to support residents buying health insurance.
However, he said, it "could be an uphill fight to get the political support to do that," noting that the mandate likely would require a two-thirds majority vote in the Assembly and Senate because it could be considered a tax.
According to the Times, California nearly approved an individual mandate in 2008.
Meanwhile, health policy experts said California could consider other options to encourage healthy residents to join insurance pools.
They said the state could impose an open enrollment period for health plans and incorporate penalties for people who sign up later.
California insurance industry representatives have said they will fight efforts to force insurers to accept sick residents without a requirement that healthy Californians participate in the market as well. Insurers said that premiums would rise substantially without healthy residents in the market, which could cause even more people to drop their coverage (Los Angeles Times