The Alan Katz Health Care Reform Blog

Health Care Reform From One Person's Perspective

Senate Health Committee Hearing on ABX1-1 Roundup

Posted by Alan on January 24, 2008


California voters should send thank you notes to the Senate Health Committee. For the first time in the 14 month health care reform “debate,” the compromise health care reform plan worked out by Governor Arnold Schwarzenegger and Speaker Fabian Nunez, with an assist from Senate President Pro Tem Don Perata got a full and thorough vetting. Whether you support the legislation, Assembly Bill X1-1, or oppose it, you have to acknowledge the value of what the Senate Health Committee accomplished. Over the course of an 11 hour hearing they heard from dozens of witnesses on virtually every aspect of the bill.

Among the many sources describing what happened at the hearing, here are some of the most useful:

The Associated Press as published by the Monterey County Herald, “Schwarzenegger health reform bid teetering in key committee”
Kaiser Family Foundation “California Senate President Pro Tempore Delays Vote on Health Care Overhaul Measure”
California Healthline “California Senate Panel’s Vote on Health Reform Plan Delayed” 
Health Access has several valuable posts on the hearing
San Francisco Chronicle “Key vote on health care coverage delayed”
San Diego Union “Senate Democrats express doubt over insurance proposal ”
Speaker Fabian Nunez video and press release on the Legislative Analyst’s Office report and on ABX1-1 health care reform

If a vote had been taken after Wednesday’s hearing, the 11 member Senate Health Committee would have defeated ABX1-1. Democratic Senators Sheila Kuehl and Leland Yee had publicly announced their opposition to the bill. None of the Republicans had indicated much enthusiasm for ABX1-1. Senator Perata asked for a delay of the vote until Monday to give him time to find a sixth vote.

ABX1-1 has the support of the Governor, Speaker and President Pro Tem. It’s a comprehensive response to a problem a majority of Californians consider critical. Passage should be a slam dunk, yet ABX1-1 is on the brink of failing. Why?

What’s happening to ABX1-1 illustrates why it’s so difficult to pass comprehensive health care reform. Stakeholders cling dearly to their positions. The political process makes it easier to attack the most visible problems (health insurance premiums, for example) and pushes to the background initiatives to deal with the root cause of the problems (skyrocketing medical costs). A change in one area creates new issues. It’s like pick-up-sticks. Try to lift one problem from the pile and you’re likely to jostle others in undesirable ways.

For example, a lot of those testifying at the hearing yesterday want carriers to sell coverae to all applicants for coverage. Yet they were among the first to object to requiring all Californians to buy coverage. Without both of these corresponding mandates, the result is skyrocketing premiums and substantially reduced consumer choice.

Passing ABX1-1 in the best of times would be a challenge. Passing ABX1-1 as the economy whipsaws the state’s finances and has lawmakers, economists and the media warning of a recession is nearly impossible. How do you ask state legislators to support a $14 billion health care package that risks running up a $4 billion deficit in its first five years of operation (according to the report published by the Legislative Analyst’s Office) at the same time you’re asking them to cut $14 billion from the current state budget?

That’s the question Governor Schwarzenegger, Speaker Nunez and Senator Perata need to answer before the Senate Health Committee votes on ABX1-1 on Monday, January 28th.  The odds are against them.

One Response to “Senate Health Committee Hearing on ABX1-1 Roundup”

  1. Richard Figueroa said

    I always enjoy reading your columns…and we have certainly given you much to write about during this past week!

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