A Healthy Blog

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

If You’re Going to Sa-Cra-Mento, Be Sure to Wear – A Flak Jacket and a Helmet

If You’re Going to Sa-Cra-Mento, Be Sure to Wear – A Flak Jacket and a Helmet

January 24, 2008

Sacramento: It was a dicey scene at California’s State Capitol on Wednesday as about 500(?) gathered at a public hearing of the State Senate’s Health Committee to testify for and against the health reform bill advanced by Gov. Arnold Schwarzenegger and Assembly Speaker Fabio Nunez, and approved by the State Assembly late last month. Schwarzenegger and Nunez have already started the process to certify an initiative for the 11/08/08 state ballot to approve financing for the scheme, which includes a $1.75 cigarette tax, payroll assessments as high as 6.5% on employers who don’t cover their workers, a hospital revenue tax, and more.

Today, it was the Senate’s turn, starting with the Health Committee chaired by Sen. Sheila Kuehl, the highly respected and term-limited senator who has been the legislature’s leading single payer advocate for more than a decade, and the former adolescent TV actress who played Zelda Gilroy on the show Dobie Gillis (boy, am I dating myself!).

There are seven Dems and five Repubs on the Committee; all Repubs plus Kuehl plus at least one other Dem have declared their intention to vote against the bill, which needs at least six votes to move to the full Senate. The Senate Pres, Don Perata, collaborated with Schwarzenegger and Nunez early, turned negative in late December, and has now restated his support – though unclear to what avail. He opened up the hearing with a short statement indicating his continuing support.

The MA health reform law is a bit of an obsession out here – legislative analyses of the CA bill are full of references to our law. I was asked by our colleague organization, Health Access California, to come out and testify to give information about what’s actually happening with Chapter 58.

Armies of organizations support, support with changes, and oppose. Just about every constituency has supporting and opposing organizations, including consumer advocates, labor unions, provider groups, and insurers. I had to leave in the early afternoon – and it seemed the hearing would go on well into the evening.

Overshadowing the process is a $15 billion budget deficit which coincidentally equals the estimated cost of the health reform plan when fully implemented, as well as gathering recession clouds. Kuehl promised a committee vote at the end of the hearing – and the Senate has scheduled a debate for Monday, though if it fails to get out of committee, it’s unclear what they will debate.

Like it’s most famous industry, California health policy debates never fail to excite for drama and action: major ballot initiatives for single payer and pay-or-play in 1992, 1994, and 2003 all went down to defeat. California can generate big excitement – it has yet to show it can get something big done. We’ll keep watching and keeping our finger crossed.
John McDonough

Kaiser UPDATE -- 1-24-08: California Senate President Pro Tempore Don Perata (D) has decided to delay until Monday a vote on compromise health care reform legislation (ABX1 1) negotiated by Gov. Arnold Schwarzenegger (R) and Assembly Speaker Fabian Nunez (D), state Senate Health Committee Chair Sheila Kuehl (D) announced on Thursday during a hearing on the bill.

Perata's decision to postpone the committee's vote came one day after Sen. Leland Yee (D-San Francisco), a member of the panel, announced he would not vote for the bill. Kuehl previously has stated her opposition to the measure. Perata has the option of replacing committee members to secure enough votes for passage of the bill. However, Perata on Wednesday said he is pessimistic about the prospects of passing the plan. He said that "it's very hard for people to come to grips with" the idea that the timing may not be right to pass the bill. "When you have to explain all those nuances to people who are losing their jobs and their homes," Perata said, "it's not a good position to be in".