On monday, a sweeping proposal to reform the health insurance system in California and provide coverage to the millions of Californians currently without health insurance was defeated in the Senate Health Committee.
I was the only committee member to vote in favor of the measure, which would have required nearly all Californians to obtain insurance and subsidized the premiums of those who could not afford it. I would like to explain why I supported this proposal when my 10 colleagues abandoned the effort, and why I think we lost a rare opportunity to provide healthcare to millions of people who will now continue to go without.
ABX1 1, authored by Assembly Speaker Fabian Nunez and co-sponsored by Senate President Pro Tem Don Perata, was the end product of Gov. Arnold Schwarzenegger's "Year of Health Reform," which began early last year. It was not a perfect bill, as both its author and the governor would be quick to tell you.
But it was a proposal that produced a large and unlikely coalition of backers. Support came from labor unions, consumer groups, ethnic and minority organizations, local governments, senior citizen advocates, provider organizations, hospitals, business groups and even some insurance companies. The chief executive of Los Angeles County, as well as the director of the county's Department of Health Services, made impassioned pleas in support of the bill.
In choosing to vote against the bill, or abstain from voting on it altogether, many of my colleagues cited an analysis of the bill provided by the legislative analyst's office, a nonpartisan and highly respected advisor to the Legislature. The primary risk identified by the analyst's office was the possibility that premium costs for health insurance plans would exceed the bill's projected cost of $250 per member per month. The analyst's office figured -- based on the possibility of a more costly benefit package -- that if the average premium cost were $300, the purchasing pool would have a deficit of more than $4 billion by 2015.
How, you might ask, could I justify voting for a bill with that much downside risk? The short answer is, because there was so much upside potential, it was worth the risk. But more than that, I believe the risk was overstated. The projected cost was based on what Medi-Cal pays for its managed-care products. The increased provider rates in this bill were added to the Medi-Cal numbers, and the result was just $187 per member per month. The authors of ABX1 1 added 30% to allow some leeway, which resulted in the $250 projection.
