A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

California Rambling

California Rambling

August 5, 2006

I took a trip this week to California, land of the Governator, to give a varied audiences details and perspective on MA health reform. Lots of interest, lots of strong opinions, pro and con, informed and otherwise. San Francisco and Sacramento. My hosts were Len Nichols of the New America Foundation and Crystal Hayling of the Blue Shield Foundation. Len’s an economist who taught at Wellesley College in the ‘80s (a good ole boy from Arkansas). He’s did stints in the Clinton Administration and at the Urban Institute and the Center for Studying Health System Change. Now he’s working to promote bipartisan universal coverage nationally and in states like California. I’m going to try to get him up here in the fall to meet the part of Red Sox nation that can’t get enough health reform. Crystal’s a ball of fire and worth watching.

Back to CA. Health reform is hopping out there. A ballot question coming in November would raise tobacco taxes about $2.60(!) a pack to expand kids coverage from 200 to 300% of the poverty line. Right now it’s ahead in the polls (between 55 and 70%, depending on the poll), and big tobacco is getting ready to drop big money to kill it. Lots of support – and worth watching.

Last week, Governor Arnold held a five hour health summit in Sacramento. According to eyewitnesses, he said he was amazed when he first came from Austria because everyone there has health insurance and nobody had it in his body building community in the 70s. He said he didn’t know how to fix it, and he wanted everybody there to tell him how to do it and he would try. Unclear whether he cares more about access or costs.

Arnold’s running for re-election against Dem. State Treasurer Phil Angelides, and despite some polls showing a close race, the consensus among those I met was that Arnold’s got it in the bag. Bill Clinton showed up last week and raised $4 million(!) for Phil

Single payer is hot among the advocacy community. Sen. Sheila Kuehl’s singe payer bill is scheduled to come up in the legislature this month and may have the votes to pass – but it’s clear if it gets through, Arnold will veto and there are not enough votes to override. The bill sets up a single payer structure and leaves the issues of how to pay for it punted to some future date. Reminds me of what Vermont was trying to do in the spring of 2005. Beats me, but a health bill without financing seems like a car without an engine. Looks nice, going nowhere fast.

Our friends at Health Access California are getting ready for another push on employer responsibility. You may remember in 2003, just before Gray Davis’ recall, the legislature and governor agreed on pay-or-play for employers with more than 200 workers, and the law got narrowly repealed by voters in 11/04 by about 51-49%. They’ll be back.

Lots of very smart people out there. Like other states, the attention created by the MA reform law has been an energy jolt for reformers. The details of our plan don’t matter a whole lot to them. They’re hungry to get something done, and worth watching.

By the way, had a briefing with Gov. Arnold's staff. Saw Arnold's smoking tent (from the outside). It's real.