Insurers have own ideas on coverage
Big health plans share Gov. Arnold Schwarzenegger's goal of trimming the ranks of the uninsured, but they have their own ideas about how to do it -- such as taxes on cigarettes and service charges on patients every time they visit a doctor.
Perhaps not surprisingly, none would limit premiums to make insurance more affordable.
Such details are likely to make it more difficult for Schwarzenegger to press his plan unveiled this month to offer everyone in California health insurance.
Blue Shield and Kaiser Permanente, both not-for-profits, broadly agree with Schwarzenegger's goal of covering everyone. WellPoint Inc., the for-profit owner of Blue Cross of California, issued its own proposal to cover more children and poor adults but not everyone.
Don't expect any endorsements from companies with the most to gain or lose until they see the fine print of Schwarzenegger's plan.
"We're encouraged by what we've seen so far," said Kathleen McKenna, a Kaiser lobbyist in Sacramento. "Everybody's anxious to see the details."
Health plans have long wrestled with how to cover more people. Blue Shield Chief Executive Bruce Bodaken called for universal coverage, including mandates on employers to provide it and on individuals to buy it, four years ago. Yet before Schwarzenegger's speech Jan. 8, universal coverage in California was widely perceived as unattainable.
Bodaken illustrated just how politically unrealistic universal coverage appeared just a day before Schwarzenegger's speech. In a Jan. 7 opinion piece in the San Francisco Chronicle, Bodaken proposed insuring all workers in a plan that fell far short of universal coverage. He wasn't abandoning his support for universal coverage, but he was indicating he was ready to start with something more politically pragmatic.
The next day, Schwarzenegger instantly shifted the debate from how to expand coverage to how to cover everyone.
"Naturally we're enthusiastic about a plan that does achieve universal coverage," said Blue Shield spokesman Tom Epstein. "The governor's plan has changed the dynamic."
A month before the governor unveiled his plan, another universal-coverage proponent, Kaiser CEO George Halvorson, described his ideas in the journal Health Affairs. His plan in many ways presaged the governor's proposal. Halvorson would expand the current job-based insurance framework by requiring employers to cover workers or pay into a fund for the uninsured.
