The Year of Health Care Reform: The Sequel
By: Laura Mecoy Source: AARP Bulletin Date Posted:
Sequels rarely deliver as big a box office as originals. But Gov. Arnold Schwarzenegger and leaders of the California legislature are banking on voters to turn out in droves for "The Year of Health Care Reform II."
They plan to ask residents to go to the polls in November 2008 and approve new tax recommendations to pay for reforms, including extending health coverage to uninsured residents. Although health reform proponents had been wary of going to voters, it became a logical step after the Republican governor vetoed the Democrats' health insurance legislation in September because it failed to meet his goal of covering all of California's uninsured.
Californians could avoid a ballot fight if Schwarzenegger can persuade Republican legislators to accept a new tax to fund reforms. But GOP lawmakers remain adamantly opposed, so the governor and Democratic leaders have resumed negotiations on reforms that would cover all residents. "By default," says JoAnn Lamphere, AARP's national coordinator for state health and long-term care, "legislators opposing these efforts are not supporting any health care reform."
Despite the setbacks, Assembly Speaker Fabian Núñez, D, thinks a compromise bill is possible this year or next. "It's not going to be easy, but I believe ... in the strength of people working together when you have the same goals," he said.
Schwarzenegger, after announcing his veto, called the legislature into special session to adopt as many health reforms as possible without having to raise taxes, and to write the ballot measure. He continued to insist on insurance for all Californians—which the Democrats had previously rejected—and proposed subsidizing those who couldn't afford it. He insisted, too, that people not be denied insurance because of their medical history.
"The governor and the legislature have picked up where they left off on health care reform and are continuing to work," says Casey Young, AARP California's advocacy manager. "The momentum is there."
Schwarzenegger had vowed to enact reforms this year. AARP and other organizations rallied supporters to march on the Capitol. They aired TV ads and launched websites to urge action. Presidential candidates and Congress watched closely in case California set the course for the rest of the country.
But a contentious budget stalemate soured relations in Sacramento. When Republicans refused to consider new or increased taxes, Democrats were deprived of the votes needed to fund the governor's call for coverage for all uninsured. Schwarzenegger's veto of the Democratic plan, whose funding depended on business fees, disappointed the bill's supporters. Even so, they say the legislation has laid the groundwork for the work ahead.
"We can't dismiss what has already happened," says Anthony Wright, executive director of Health Access California, a nonprofit reform advocacy group. "The bill the legislature approved would have been the biggest expansion of public health care since the creation of Medicaid and Medicare 42 years ago."
How to finance reforms is probably the biggest hurdle. The governor wants hospitals and doctors to pay as well, not just businesses. The California Hospital Association agreed to contribute 4 percent of hospital revenues, but doctors balked at paying more. The governor and the legislature are considering several financing schemes, including a sales tax that business interests proposed.
"We're still optimistic," says AARP's Young, "that our campaign and the work of other advocates will keep the pressure on to enact health care reform."
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