SACRAMENTO — Dave Dunlap is a Kern County trucker with a failing liver. Like about 600,000 Californians, he is too sick to qualify for private insurance on the open market.
"I'm trying to fight to get a transplant," he said. "Everyone's waiting for me to have a way to pay for it. I can't even get on the donor list until I have a way to pay for it."
California is supposed to have a solution for people like Dunlap. It is one of 35 states that arranges health coverage for people rejected by commercial companies because they have blemished medical histories.
This group -- known as "medically uninsurable" -- accounts for about an eighth of the 5 million Californians who lack health insurance. Most are self-employed, work for companies that don't provide insurance or don't have a job.
But California's publicly subsidized high-risk pool, long one of the least generous in the country, has atrophied over the tenure of Gov. Arnold Schwarzenegger -- even as the governor put the plight of the uninsured at the top of his political agenda.
Rising premiums and limited subsidies have made the Major Risk Medical Insurance Program either unaffordable, unavailable or ineffective for many of those who most need health insurance.
The program now covers about 13,000 Californians -- about 2% of the medically uninsurable.
Enrollment has dropped by almost a third since Schwarzenegger became governor.
Schwarzenegger last month vetoed a measure that would have expanded the 17-year-old pool, overruling the bill's endorsement by the pool's own governing board, most of whom he appointed.
The governor said "the only solution for our healthcare crisis" is a complete overhaul of the state's healthcare system along the lines of his $14.9-billion plan that the Legislature rejected last January as too expensive.
"We supported wholesale health reform, but this is a population that has nowhere else to go, and he's leaving them high and dry," said Elizabeth Landsberg, legislative advocate for the Western Center on Law & Poverty, a Los Angeles nonprofit.
Subscribers pay two-thirds of the pool's cost and the state about one-third. The insurers that voluntarily participate -- primarily Blue Cross of California and Kaiser Permanente -- break even.
Unlike most other states, which finance their programs either directly with tax dollars or with assessments on insurers, California's subsidies have come only from the state's tobacco tax.
