POLICY: As Goes California, So Should Go the Nation, by Mary Kay Henry

Now I can’t claim to be an optimist about the future of California’s health reform bill. But at least someone is.  And that someone is SEIU Executive Vice President Mary Kay Henry. Here’s her take on the latest California news and why the SEIU is at least one union buying in.

ABx1 1: no, it’s not the holiday season’s hot new video game. It’s the bill name for historic legislation approved yesterday by the California State Assembly to make healthcare more secure and affordable for those who have insurance, and provide coverage to millions who don’t.

Months of intense negotiations drew on the collective creativity and wisdom of elected officials, consumer groups, healthcare professionals, and labor and business community leaders to generate the comprehensive plan. The measure has the potential to transform the healthcare reality for millions of Californians, and it will fundamentally change the healthcare debate nationally.

As the nation’s fastest growing and largest healthcare union, SEIU
has endorsed ABx1 1. Our 600,000 members in California have first-hand
experience of being stymied by the present dysfunctional system both as
workers and as consumers. We have decided to support this plan because
it holds the promise of enhanced quality, increased efficiency and
improved access to healthcare in California.

The bill improves quality of care patients will receive by offering
new initiatives focused on prevention and wellness. It increases the
rates paid to hospitals and doctors caring for patients of Medi-Cal,
California’s Medicaid program, thus discouraging discrimination in care
based on income level. Crucially, the bill also forbids insurance
companies from denying coverage to patients based on “pre-existing
conditions” like cancer or diabetes.   

The bill contains costs and improves efficiency of care by requiring
insurers, care providers and institutions to publicly disclose
information on costs and quality. It limits the amount of money that
can go toward insurance company overhead and profits. And it increases
patients’ clout by establishing a new statewide purchasing pool to
negotiate rates and benefits with insurers.

Finally, the bill contains affordability measures to ensure that
working families are not left out in the cold with a purchase mandate
they can’t afford. Subsidies, tax credits, and hardship exemptions are
written into the legislation to support Californians making below 400%
of the federal poverty level and early retirees. Those making under
250% of the poverty level will be exempt from an individual mandate but
will still receive the quality care they need. 

We see this legislation as a work in progress—a crucial step toward
the goal of quality, affordable health coverage for every woman, man,
and child in America. The plan is not perfect, but waiting around for
the perfect plan is a luxury too many Californians and Americans do not

Nay-sayers beware: if meaningful healthcare reform can happen in
California, America’s largest and most ethnically, economically, and
politically diverse state, it can—and must—happen nationwide.

4 replies »

  1. Call me a conspiracy theorist, but I’m pretty sure the SEIU and other unions support Schwarzenegger-Nuñez ABX1 1 because they know perfectly well that ABX1 1 will mess up health insurance so badly in California that the people will be so shell-shocked after a few years they’ll demand single-payer, government-monopoly health insurance – sort of a Stockholm syndrome.
    I was on the radio for a one-hour debate with Peter Harbage of New America Foundation a couple of days ago and he pretty much confirmed this. I blogged about it over at my website.

  2. I don’t give credit to California for trying to massively increase the deficit at a time of fiscal crisis. I would much prefer to see effort directed toward reallocating rather than expanding health care, both in the state and nationally. I don’t think either age or income are the best approaches to rationing. When it comes to government funded insurance, I’d prefer an approach to rationing that at least makes an attempt to get the most bang for the buck, such as by including QALY-based metrics.

  3. Sean, healthcare in this entire country is impossibly expensive. I’m not sure either how costs will be contained with so many groups seemingly on-board with their support and wonder what all the providers got during the intense negotiations. Will they really be giving up anything or is this just another attempt at recarving the same pie? We’ll have to see if the bill really will contain costs. I think designing a system with an insurance mindset is the wrong way to go but give credit to California for trying something. I hope the “work in progress” will succeed. Guess the rest of the country will wait the 10 years or so it will take for this to fully reveal itself.

  4. Sounds impossibly expensive. Massachusetts was supposed to be one of the easiest states to solve given the relatively low uninsured population (550,000 out of 6.4 million, or about 8.6%) and the preexisting hospital fund, and yet so far the plan seems to be coming up well short of its intended goals. Given California’s 6.6 million uninsured out of 36.4 million, over 18%) it is probably the last state that this should even be attempted.