The Mercury News Weekend

Bills could be the bridge to single-payer system in future

Health Access California spokesman: ‘Universal coverage within our grasp’

- By DanMorain Correspond­ent

“The leaders of California are sitting on their thumbs or taking half steps.”

California won’t be adopting single-payer health care with its $400 billion price tag anytime soon. Assembly Speaker Anthony Rendon made sure of that by opposing it.

But the health care system is ailing, and organized labor, health care advocates and several Democratic lawmakers are offering a new prescripti­on in the form of several bills. The measures could provide a bridge to a single-payer system in the future.

“Universal coverage is within our grasp,” Anthony Wright of Health Access California, the leading proponent of the package, said at a news conference at the state Capitol Thursday.

The measures are intended to rein in health care costs, fend off Trump administra­tion efforts to undermine Obamacare, provide lower- income California­ns with greater access to care, and reduce pressure on Democrats to embrace the costly single-payer concept. The overall cost is yet to be determined.

Backers say they hope to deliver them to Gov. Jerry Brown’s desk for his signature in the final months of his tenure. It won’t be easy. Measures that would cost money — and any significan­t bill would — probably would need to be approved before the deadline for adopting a new budget, July 1.

The announceme­nt comes a week after Covered California, which oversees the Affordable Care Act in this state, reported that health care premiums for some Obamacare customers could rise as much 35 percent by 2021.

Separately, a report produced earlier this week as part of an Assembly inquiry into health care said 21 percent of California­ns who have health insurance are considered under-insured, and cannot afford outof- pocket health care expenses.

— Chuck Idelson, union spokesman

There are, for example, people earning $30,000 a year who have insurance policies requiring them to pay annual deductible­s of as much as $6,000, an impossibil­ity.

The proposal includes bills to provide greater subsidies for middle- income earners who rely on Obamacare and help them pay for prescripti­ons.

Other measures would attempt to regulate health insurance company profits, including one by Assembly Health Committee Chairman Jim Wood, a Democrat from Healdsburg, to impose greater oversight when health care providers want to merge.

A bill by Senate Health Committee Chairman Ed Hernandez, a Democratic from Covina, aims to prohibit the sale in California of the low- cost short-term insurance policies, a concept that would undercut an idea pushed by the Republican- controlled Congress and President Donald Trump. Democrats dismiss such policies as junk because they failed to provide basic coverage.

Wright said the coalition, which includes organized labor, consumers, immigrant advocates and groups such as Planned Parenthood, is advocating a state- only individual mandate, intended to compel people to buy health insurance. Such a bill likely would require a two-thirds vote of the Legislatur­e. Congress abolished the federal mandate that had been part of the Affordable Care Act.

A goal would to be expand coverage to include more undocument­ed immigrants. The state already provides health care coverage for all children, including about 225,000 who are undocument­ed. Sponsors hope to extend that coverage, at a minimum, for undocument­ed individual­s up to age 26, and to elderly people.

Insurance companies and many business groups surely will oppose most if not all the bills as too costly and burdensome.

From the left, the California Nurses Associatio­n is skeptical of the package. The union is a leading advocate for replacing our existing private insurance with a single- payer system, funded by taxpayers and administer­ed by the state — and is an aggressive political force that pushes Democratic candidates to embrace it.

Chuck Idelson, the union’s spokesman, said the union supports expanded coverage for undocument­ed immigrants, but called the proposal “fragmented” and said it would reinforce an insurance-based systemthat de- pends on profits.

“The leaders of California are sitting on their thumbs or taking half steps,” Idelson said.

On Thursday, Lt. Gov. Gavin Newsom, who has made a point of backing single payer in his Democratic bid for governor, was quick to issue a statement calling the package “a step in the right direction” toward universal coverage.

Democratic politician­s worried about attacks from the left see the new package as away to show voters, who are increasing­ly concerned about health care, that they are acting. No matter what comes of the roughly 20 bills, whoever becomes the next governor will need to grapple with health care coverage, costs, and the politics of it all.

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