The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

California Health Care Reform Timing

Posted by Alan on May 4, 2007

For a long time I’ve been saying California lawmakers won’t produce health care reform until 2008 (for example, take a look at my predictions for 2007).  This is based on my view that, when it comes to major policy issues like health care reform, the legislative process is a two-step dance.

Step One: Legislators and others are truly interested in learning as much about the issues as possible. This is especially true when term limits results in many legislators having no long term perspective on the issue. During this phase, everyone tries to be nice to everyone else. Partisan pot shots are held to a minimum. Hearings are informative and private meetings tend to focus more on policy than politics. There’s a sincere desire to gather information. I’m not naive enough to think it’s all nice and friendly. I’m simply saying this part of the dance is relatively more open minded.

In Step Two the music changes in both key and tempo. Partisanship moves to the forefront and the swords come out. Lawmakers’ positions are both more detailed and hardened. The idea is not just to get a bill passed, but to make sure it includes what “we” want — whoever that “we” might be. And if the provisions or the timing of passage works against the “other” side, all the better. Again, it’s not 100% thrown elbows and low blows, but it is more rancorous and moderates seeking compromise have a more difficult time keeping their footing.

How much time is spent in either of these steps varies based on leadership styles of the major players and from issue-to-issue. My take has been, and remains, that with 15% of the state’s economy at stake, the current leadership will strive to get things right.  Consequently, I predicted the “learning” phase would last through 2007 with the “duking it out” portion of the program kicking in (literally) in 2008.

Now I’m beginning to wonder. Word comes from an “informed source” in Sacramento that Labor has a strong interest in getting health care reform settled sooner than later. Their concern is that if the debate isn’t resolved in 2007, an initiative addressing health care reform initiative may be placed on the 2008 ballot. Yet Labor will have its plate full that year with other ballot measures, legislative elections and something about electing a new president. Labor would like to avoid having to wage a major battle on health care reform — both in the legislature or on the ballot — in 2008, according to this source. So they’ll be pushing hard for a resolution in 2007.

Governor Arnold Schwarzenegger may also desire a quick resolution to health care reform. He’s doing a phenomenal job of inserting him into the GOP presidential nomination process, not only by raising critical issues, but by moving the California primary up to February. His environmental positions have already landed him on the cover of Newsweek and into the pages of Wired. If Governor Schwarzenegger and a Democratic-controlled Legislature can deliver on health care reform, he’ll have gone a long way to defining the GOP political battleground. And making more magazine covers.

Will these agendas be enough to wrap up the first step of the legislative draft before Fall? Maybe. I don’t think we’re there yet, but my certainty is wavering. The music hasn’t shifted tempo yet, but the conductor is looking over his shoulder. And looking very nervous. 


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