As State Bill Dies, Activists Turn to Single Payer Bill

By J. Douglas Allen-Taylor
Tuesday February 05, 2008

Advocates of single payer health insurance in California are saying that the collapse of the Nuñez-Perata-Schwarzenegger health care bill is a good thing and are moving forward with reviving their own single-payer legislation. 

“We were opposed to the Nuñez bill,” Vote Health representative Kay Eisenhower said by telephone this week. “We considered it a step backwards.” 

Vote Health is an Alameda County-based health care activist organization. 

Eisenhower said statewide single-payer health care advocates will be holding a two-day conference in Los Angeles later this month to talk about ways to put State Senator Sheila Kuehl’s (D-Santa Monica-Los Angeles) SB 840 single-payer health care bill back on track. “SB 840’s not dead,” she said. “It’s only on ice.” 

Two years ago, it seemed dead. After SB 840 passed the state legislature in 2006, Gov. Schwarzenegger vetoed it. 

Kuehl revived her single payer bill a year later, and the bill passed the Senate on a 23-15 vote and the Assembly Health Committee on a 12-5 vote last summer, but it stalled in the Assembly Appropriations Committee as attention in the Assembly turned to a compromise bill being put together by Assembly Speaker Fabian Nuñez. 

The bill’s summary says it “would establish the California Universal Healthcare System (CUHS) under which all California residents would be eligible for specified health care benefits. The CUHS would, on a single-payer basis, negotiate for or set fees for health care services provided through the system, and pay claims for those services.” 

The year 2007 began with promises from many legislative sources to expand health care coverage in California, with State Senate President Don Perata (D-Oakland), Assembly Speaker Fabian Nuñez (D-Los Angeles), Gov. Schwarzenegger, and State Senate Republicans all putting up individual bills or proposals. Eventually, Perata and Nuñez consolidated their two bills into one, ABX1 1, which won Schwarzenegger’s backing. 

In contrast to Kuehl’s single-payer system, which would set up a state agency through which all insurance premiums and claims payments would be funneled, ABX1 1 would have required that all California residents “enroll in and maintain at least minimum creditable health care coverage … for themselves and their dependents,” but would continue to allow independent insurance companies to manage the actual coverage itself. 

ABX1 1 passed the Assembly 46-31 late last year, but after the economic downturn led to proposed steep cuts in the state budget, Perata withdrew his support, and the Senate Health Committee, which Kuehl chairs, voted 1-7 to hold the bill in committee, refusing to send it to the full Senate. 

Despite Perata’s abrupt about-face and ABX1 1’s defeat in committee, Schwarzenegger said he was not giving up on health care reform in California, telling the Sacramento Bee late last month that “just because the Senate has missed this golden opportunity to pass our health care reform doesn’t mean that we should walk away from reforming our broken health care system.” 

Eisenhower said among the biggest objections to ABX1 1 were the bill’s consumer mandates. 

In a statement entitled “Pledge to Continue Work for True Healthcare Reform” posted on her website shortly after the Senate Health Committee vote, Kuehl wrote: “As Senators [Leland] Yee [D-San Francisco] and [Elaine] Alquist [D-San Jose] indicated in their statements, explaining why they could not now vote for this bill, the bill as it is currently written does nothing to protect working class and middle class people from being burdened, to the point of breaking, by the individual mandate that requires each Californian to buy health insurance without adequate protection against unaffordable premiums and escalating out-of-pocket expenses. Furthermore, as Senator [Darrell] Steinberg [D-Sacramento] reminded us, we must conclude, especially after seeing the report from the legislative analyst, that this bill’s proposed revenues and expenses do not balance out and will leave the state exposed to increasing deficit costs as well.” 

And the California Nurses Association (CNA) put up a fact sheet on its website which read that the Nuñez bill “had serious failings on access, quality, and cost that were especially dangerous for working people,” among them that “employers would have had strong incentives to drop or sharply reduce union-negotiated benefits,” the bill “forced individuals to purchase insurance policies without knowing the real cost or what coverage they would have received,” and the bill provided “no restrictions on increases in premiums, co-pays, or deductibles.” 

The single-payer health care campaign in California is being coordinated through the One Care Now Organization (www.onecarenow.org), a coalition of California unions and health care advocate groups.