The first shots in the fight over California Gov. Arnold Schwarzenegger’s health care reform proposal were fired last week. The Los Angeles Times reported that a team of advisers is working to develop the proposal, which will probably be unveiled during Schwarzenegger’s state of the state address in January. The news had led to a pretty serious hoo ha.  Liberals are worried that the plan will look a lot like the helpful proposal drafted by America’s Health Insurance Plans. Conservatives, on the other hand, are concerned that Schwarzenegger could get carried away in his enthusiasm to appeal to moderate voters and end up producing something that could hurt California’s businesses.

What should we expect? The backgrounds of the advisers who are helping Schwarzenegger produce the plan may give us some hints. As it turns out, three of the four are Democrats. One recently left his position at McKesson government relations. In his piece this week, the California Health care Foundation’s George Lauer described the makeup of the team:

Richard Figueroa, former
legislative director for Insurance Commissioner John Garamendi and
former aide to former Gov. Gray Davis (D).

John
Ramey, former executive director of the Managed Risk Medical Insurance
Board, deputy secretary and assistant secretary of the Health and
Welfare Agency, and chief of staff for the Department of Health
Services. Since 2000, Ramey, a Republican, has been principal and
partner of Ramey, Macomber & Associates a Sacramento firm
specializing in health care and health insurance contracts.

Herb
Schultz, former deputy director of the state Department of Managed
Health Care, most recently vice president of government programs at
McKesson Health Solutions. Schultz also served as acting director of
the California Employment Development Department and acting secretary
and undersecretary for the Labor and Workforce Development Agency.

Daniel Zingale, chief of staff for first lady Maria Shriver and former director of the Department of Managed Health Care.

A lot of people have focused on the possibility that the plan will look a lot like the proposal produced by former Massachusetts Gov. Mitt Romney. The critics say the idea probably wouldn’t replicate well in California for many reasons. (Short explanation: California is a lot bigger than Massachusetts.)  Adopting a variant of the Romney proposal would also be a form of endorsement for Romney, who plans to run for the White House in 2008.

It also seems unlikely that the Governor will make the mistake of
embracing the insurance industry’s proposal. Arnold took a lot of heat
during his fist term when he lent his support to pharmaceutical
and insurance company backed ballot initiatives.  (One of the reasons
he’s now coming back with a health care plan of his own). As his
advisers keep reminding us, Schwarzenegger is no George Bush. He’s
unlikely to make the same mistake again. He also knows how to change
tack, as he did last year when distancing himself from the White
House. 

The wild card may be the illegal immigration issue, which looks like
it is going to become a tempting target for those on the right opposed
to any real reform. Schwarzenegger has promised to find a way to
provide some form of coverage to all of California’s six million
uninsured. This week we saw evidence of what that’s likely to lead to: attacks by Republicans who are afraid that tax dollars could go to pay for health care for illegal immigrants. The end result, they argue, will be more illegal immigration.