California health care reform goes to the wire

Facing a mid-September deadline for action during the Legislature’s regular session, California’s Democratic legislative leaders and Republican Gov. Arnold Schwarzenegger have intensified negotiations for a health care reform bill that can be passed and signed this year.

Some 6.8 million Californians, or nearly one-fifth of the population, were uninsured at least part of last year. The figures reflect the national trend shown in statistics released last week by the U.S. Census Bureau.

Three proposals have been considered: state Sen. Sheila Kuehl’s SB 840 single-payer bill to replace private insurance with coverage for all Californians; AB 8, a compromise bill by state Sen. President Pro Tem Don Perata and Assembly Speaker Fabian Nuñez to broaden and improve coverage under the present system; and reforms proposed by Schwarzenegger. SB 840, an earlier version of which passed the Legislature last year only to be vetoed by the governor, is now being held over to the next legislative session.

In a Labor Day briefing, the California Labor Federation backed the national AFL-CIO’s recently announced drive for quality health care for all and urged state health care reform in the current legislative session. The federation’s reform goals include making health care affordable to all Californians, controlling costs, and protecting health benefits provided through pension funds.

Though current negotiations focus on AB 8, a Field Poll released Aug. 22 showed 36 percent of California voters favor a state-administered single-payer health care program, up from 24 percent in December. At the same time, voters who back reforming the current system dropped from 52 percent to just 33 percent. Some 69 percent of those polled are unhappy with current health care in California, up from 44 percent in December.

A study released last month by the Having Our Say coalition of over 30 California organizations found that historically underserved communities of color would benefit from all the reform proposals, and emphasized that reaping these benefits requires culturally and linguistically appropriate health care services.

The report, “Health Care Reform Proposals Hold Promise for Diverse Communities: Getting California Ready,” points out that while all Californians would benefit, communities of color would see a big increase in the number of insured, up to 2.5 million under AB 8 or the governor’s proposal, and 3.4 million under Kuehl’s single-payer bill. People with limited English proficiency would see a 28 percent increase under AB 8, 26 percent under the governor’s proposal, and 38 percent under SB 840. Coverage of lower-income Californians would also increase greatly, especially under SB 840, which would cover everyone regardless of employment or immigration status.

“This is a historic time, when we can make a huge difference in addressing the racial-ethnic health disparities that we see too often, and that our communities of color face even when people have insurance,” Ellen Wu, executive director of the Oakland-based California Pan-Ethnic Health Network, told an Aug. 16 press conference.

Report co-author Ninez Ponce of UCLA’s School of Public Health said, “We see that the insured population will begin to reflect California’s diverse demographics and the changing composition,” including racial and ethnic diversity, limited English proficiency and income, “will require that we lay a foundation for a health care system to meet the needs of all Californians.”

Dr. Alice Chen told how patients she has seen at San Francisco General Hospital continue to return there even after they have insurance, because they know they’ll get culturally and linguistically appropriate care. She emphasized that public health facilities “have been responding to community needs for decades, and need to be part of the solution.”

mbechtel @pww.org