The nation's re-election of Barack Obama means California lawmakers will have a much busier and more productive special legislative session in December, according to state lawmakers.
Gov. Jerry Brown (D) called for the December special session as a way to make sure California is fully on board with implementation of the Affordable Care Act. The governor vetoed several bills and policies because of uncertainty about who would be in the White House next year, according to Assembly member Bill Monning (D-Carmel), last session's chair of the Assembly Committee on Health.
"This [re-election of Obama] helps define a much more positive scenario for special session," Monning said. "The governor was appropriately cautious, not wanting to sign onto some bills and not being able to forecast the outcome of this election. Now the special session will take a very positive tone."
Anthony Wright, executive director of Health Access California, said "We're full steam ahead, and getting ready for enrolling people starting in 2013."
The Affordable Care Act goes into effect at the start of 2014. Open enrollment in California's new insurance exchange will begin in the fall of 2013, with coverage starting in 2014.
Issues to address in the special session, Monning said, include reform of the individual health insurance market. That includes AB 1461, authored by Monning and vetoed by the governor, which would align individual health insurance market rules with the ACA. When he vetoed it on Sept. 30, Brown said "a state-level mandate on insurers alone" would place the state in a vulnerable position if the federal subsidies were not there to back the plan.
"The governor was exercising caution," Monning said, "but that question is now answered."
Passage of Proposition 30 by California voters also will change the tenor of the discussion during the special session in December, Monning said. For instance, the feds have a pot of $10 billion to distribute to states for health promotion and disease prevention, and in a few cases, programs would need continued funding from California to access some of those federal dollars, Monning said.
If Prop. 30 had not passed, he said, the state budget would have continued to be the central topic of discussion in Sacramento.
"A lot of California programs will be eligible for federal support, but there are some state dollars that could determine how much federal money we can capture," he said.
Richard Pan (D-Sacramento), the incoming chair of the Assembly Committee on Health, said the long-range, big picture is becoming more clear after the election.
"What this election means is there is more certainty going forward about the Affordable Care Act," Pan said. "There was concern about what Romney would do, or could do, what would he try to take apart. This will allow us to move forward with the implementation with more certainty."
Coming up in December, Pan said, "there are certainly things to get done. Medicaid expansion, maybe putting vision on the health plan, individual market reform, there are still a lot of things that need to be worked out in the ACA to come out with the best possible product."
All of those details are important, Pan said, but he said he's more focused on the overall impact of the ACA on patients and society. "These reforms are important," Pan said, "and in the long run, I think we're going to have a better, more efficient health care system."
If Romney had been elected, according to Wright, the effort to implement health reform in California would have become "more of a salvage operation," he said, "to see what could be saved here in California. I mean, we have to take the governor at his word, that if he were elected, he would repeal the ACA on his first day, on Day One."
Wright pointed out that Prop. 30 funds will have no direct effect on the special session. "This is an expansion that is entirely federally funded," Wright said. "The special session is basically a legislative procedural move to allow bills to get through quickly."
But the indirect effect of Prop. 30 passage is undeniable, he said. "Obviously Prop. 30 has an impact on health care. If we don't have a stabilized budget, that has an impact on health and human services," Wright said. "It does matter, but it shouldn't have an impact directly on implementation, because that's almost entirely federally funded."
The next state legislative session begins Dec. 3.