Regulatory Half-Measures or True Reform?
The reform “strategy” we saw with the Affordable Care Act was an extremely complex regulatory overlay that did little to change the fundamentals of our fragmented healthcare system. After investing billions of dollars to support a predatory corporate health insurance industry with government-funded marketplaces, premium subsidies and more, it is plainly obvious that the core problems of fragmentation and cost were not addressed. As a result, premiums and out-of-pocket costs continue to spiral and millions of Americans remain uninsured or underinsured.
The California Assembly Health Committee is following the same “strategy.”
Plugging Holes in the Dike
Rather than working on financing and implementing SB 562, a single bill that represents a path toward comprehensive healthcare security in California, the Assembly Health Committee has issued 14 new bills designed to plug some of the holes in our failing and broken health care system while leaving the basic mess in place.
Here is a list so far of the bills and their sponsors, as reported by 89.3 KPCC.
BILL
SPONSOR
DESCRIPTION
AB 2965
Select Committee co-chair Assemblyman Joaquin Arambula, D-Delano
Expand Medi-Cal coverage to all income-eligible adults regardless of immigration status.
AB 2472
Wood
Establish a public option.
AB 2416
Wood
Increase health plan competition by requiring plans with Medi-Cal contracts to participate in Covered California.
AB 2459
Assemblywoman Laura Friedman, D-Glendale
Provide for state subsidies and/or tax credits for those people in the individual market with incomes more than 400 percent of FPL and/or place a cap on the cost of premiums at a percentage of income.
AB 2565
Assemblyman David Chiu, D-San Francisco
Provide increased state subsidies for individual market policies for people with incomes between 138 percent and 400 percent of FPL.
AB 3148
Arambula
Limit amount of cost sharing for people in individual market plans with incomes between 138 percent and 400 percent of FPL.
AB 2430
Arambula
Increase Medi-Cal eligibility for seniors/disabled individuals whose income is between 123 percent of the federal poverty level (FPL) and 138 percent of FPL to create consistency in eligibility and expand coverage to 60,000 seniors/disabled.
AB 2499
Arambula
Limit health plan administrative costs by establishing a medical loss ratio (MLR) in statute that assures 85 percent of premium goes to care.
AB 2502
Wood
Establish an all-payer claims data base to gather information on the actual cost of services.
AB 2579
Assemblywoman Autumn Burke, D-Inglewood
Streamline eligibility to enroll uninsured individuals who are eligible for Medi-Cal, creating an
AB 2597
Arambula
Increase availability of primary care physicians by fully funding and expanding the Public Hospital Redesign and Incentives Program in Medi-Cal (known as PRIME)
AB 2275
Arambula
Increase accountability for health care quality standards and reducing disparities in Medi-Cal managed care plans.
AB 2427
Wood
Addressing profits in Medi-Cal managed care plans.
No one would argue that efforts to reduce up-front patient costs, bring transparency to treatment costs , reduce disparities and increase accountability are not worth pursuing. Obviously, these efforts bring valuable oversight to a system that has been virtually ignored by legislators, leaving corporate healthcare in the driver’s seat and Californians abandoned to their own devices to deal with it.
SB 562, An Elegant Solution
But we cannot forget that SB 562 represents an elegant solution that makes many – if not all – of these half-measures irrelevant while guaranteeing every single Californian affordable, comprehensive health care for their whole bodies from the cradle to the grave.
It would take guts and hard work to fix our healthcare once and for all. The failure of our legislators to step up with a bold vision is beyond disappointing. It is a betrayal.
Paraphrasing John F. Kennedy, and in my dreams, this is what I would have liked to hear from Speaker Rendon, Assemblymember Wood and Assemblymember Arambula:
We choose to implement comprehensive healthcare reform now, not because it is easy, but because it is hard, because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win. . . .
— Georgia Brewer
Regulatory Half-Measures or True Reform?
The reform “strategy” we saw with the Affordable Care Act was an extremely complex regulatory overlay that did little to change the fundamentals of our fragmented healthcare system. After investing billions of dollars to support a predatory corporate health insurance industry with government-funded marketplaces, premium subsidies and more, it is plainly obvious that the core problems of fragmentation and cost were not addressed. As a result, premiums and out-of-pocket costs continue to spiral and millions of Americans remain uninsured or underinsured.
The California Assembly Health Committee is following the same “strategy.”
Plugging Holes in the Dike
Rather than working on financing and implementing SB 562, a single bill that represents a path toward comprehensive healthcare security in California, the Assembly Health Committee has issued 14 new bills designed to plug some of the holes in our failing and broken health care system while leaving the basic mess in place.
Here is a list so far of the bills and their sponsors, as reported by 89.3 KPCC.
| BILL | SPONSOR | DESCRIPTION |
|---|---|---|
| AB 2965 | Select Committee co-chair Assemblyman Joaquin Arambula, D-Delano | Expand Medi-Cal coverage to all income-eligible adults regardless of immigration status. |
| AB 2472 | Wood | Establish a public option. |
| AB 2416 | Wood | Increase health plan competition by requiring plans with Medi-Cal contracts to participate in Covered California. |
| AB 2459 | Assemblywoman Laura Friedman, D-Glendale | Provide for state subsidies and/or tax credits for those people in the individual market with incomes more than 400 percent of FPL and/or place a cap on the cost of premiums at a percentage of income. |
| AB 2565 | Assemblyman David Chiu, D-San Francisco | Provide increased state subsidies for individual market policies for people with incomes between 138 percent and 400 percent of FPL. |
| AB 3148 | Arambula | Limit amount of cost sharing for people in individual market plans with incomes between 138 percent and 400 percent of FPL. |
| AB 2430 | Arambula | Increase Medi-Cal eligibility for seniors/disabled individuals whose income is between 123 percent of the federal poverty level (FPL) and 138 percent of FPL to create consistency in eligibility and expand coverage to 60,000 seniors/disabled. |
| AB 2499 | Arambula | Limit health plan administrative costs by establishing a medical loss ratio (MLR) in statute that assures 85 percent of premium goes to care. |
| AB 2502 | Wood | Establish an all-payer claims data base to gather information on the actual cost of services. |
| AB 2579 | Assemblywoman Autumn Burke, D-Inglewood | Streamline eligibility to enroll uninsured individuals who are eligible for Medi-Cal, creating an |
| AB 2597 | Arambula | Increase availability of primary care physicians by fully funding and expanding the Public Hospital Redesign and Incentives Program in Medi-Cal (known as PRIME) |
| AB 2275 | Arambula | Increase accountability for health care quality standards and reducing disparities in Medi-Cal managed care plans. |
| AB 2427 | Wood | Addressing profits in Medi-Cal managed care plans. |
No one would argue that efforts to reduce up-front patient costs, bring transparency to treatment costs , reduce disparities and increase accountability are not worth pursuing. Obviously, these efforts bring valuable oversight to a system that has been virtually ignored by legislators, leaving corporate healthcare in the driver’s seat and Californians abandoned to their own devices to deal with it.
SB 562, An Elegant Solution
But we cannot forget that SB 562 represents an elegant solution that makes many – if not all – of these half-measures irrelevant while guaranteeing every single Californian affordable, comprehensive health care for their whole bodies from the cradle to the grave.
It would take guts and hard work to fix our healthcare once and for all. The failure of our legislators to step up with a bold vision is beyond disappointing. It is a betrayal.
Paraphrasing John F. Kennedy, and in my dreams, this is what I would have liked to hear from Speaker Rendon, Assemblymember Wood and Assemblymember Arambula:
We choose to implement comprehensive healthcare reform now, not because it is easy, but because it is hard, because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one which we intend to win. . . .
— Georgia Brewer
