The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Governor’s Health Care Reform a Bill at Last

Posted by Alan on September 19, 2007

Cue the music (not sure if it should be the theme to “Jaws,” “The Twilight Zone” or “Happy Days,”). Rumor has it Governor Schwarzenegger’s health care reform plan will emerge in legislative form as early as Friday, September 21st. Several spot bills have already been introduced in the special session called to consider reform proposals. (A spot bill is one introduced initially with little, if any, substance awaiting a later date when the complete text  is “dropped into” the bill).

For months the Governor has forcefully outlined the principals he believes must be a part of any health care reform package. For the first time the public will how the Governor and his staff translate these principals into the detailed place where devils dwell.

There are unlikely to be many surprises. It will contain an individual mandate, create the California Cooperative Health Insurance Purchasing Program (“Cal-CHIPP”), a state-run purchasing pool for individuals receiving premium subsidies, require carriers to spend 85 percent of premiums on health services, promote wellness and preventive programs, and speak to containing health care costs.

It will not include any funding for the above. That will be left to an initiative the Governor and his allies will qualify for the November 2008 ballot. This means the bill could be passed on a majority vote of the Legislature. Including taxes and/or fees means it would need a two-thirds majority in each house.

A couple of tea leaves to look out for:

  1. Is there anything in the bill Republicans can get behind? Leaving out taxes and fees is a good start, but he’ll need to do more to capture any GOP support. My guess: it offers Republicans something from their reform package. Including a few of the Republican proposals would be a show of good faith to his own party. And  even if the Governor doesn’t really support those provisions, he can count on the Democrats to be the bad guys and eliminate them later.)
  2. Does it reflect the compromises the Governor has already reached with Speaker Fabian Nunez and Senator President Pro Temp Don Perata or does it take a few steps back towards the Governor’s original proposal? If it’s the former, it’s a sign a final deal is close; if the latter then there’s more than cigar smoke filling up the Governor’s tent. My guess: they’re close to a final deal and this bill will reflect their progress.
  3. Does it specifically spell out how the reforms would be structured or does it leave the nitty gritty to regulators? It will be easier to pass a bill that avoids contentious specifics for now. My guess: it will include a lot more detail than we’ve seen before, but regulators will still have plenty to do.

Seeing the Governor’s proposal in bill form is a huge step toward acheiving comprehensive health care reform. It also will invite everyone and their cousins to start a new round of sniping. However, there’s something the Governor said when he unveiled his plan back in January, “The status quo can no longer be everyone’s second choice.” He’s right. There will be plenty to argue about as the Governor ratchets up the specificity of his vision. But the goal should not be to defeat any health care reform. The goal should be to come up with the right reforms.


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