State Senator Sheila Kuehl’s plan, SB 921, is the only one that guarantees coverage for every Californian. It would be funded with new payroll, alcohol and cigarette and unearned-income taxes and would enable all residents to freely choose any doctor. Under single payer, a new government-run agency would replace insurance companies in collecting funds, contracting for medical services and reimbursing hospitals and doctors. Patients would receive medical, dental, vision and mental-health services as well as prescription drugs. Critics are suspicious of any program totally under government control and say demand will soar and, with the loss of open-market competition, quality of care will plummet.
Play or Pay
Sponsored by Jackie Speier (D-Hillsborough) and the state’s most powerful legislator, Senate Pro Tem John Burton, SB 2 requires employers to “play,” by providing medical benefits, or pay a fee toward creation of a publicly subsidized plan to provide basic benefits to those who need it. Private insurance would remain as an option for those who can afford it. Play or Pay is endorsed by the California Labor Federation, AFL-CIO. The plan would provide coverage for all employed Californians, including part-time workers and their dependents. In addition to medical care it would cover prescription drugs. About 60 percent of California businesses now provide health insurance for their employees. Critics say Play or Pay is harmful to struggling small businesses and would lead employers who currently provide health insurance to drop their coverage and force employees into a less-appealing government-run plan.
The Frommer Plan
Democratic Assemblyman Dario Frommer of Glendale, who chairs the Assembly Health Committee, proposes a plan that would require an initial $2 billion investment in public and private funds. After the first year every employer would be required to provide coverage. Under AB 1527 state subsidies would be available for those who could not afford coverage. All employed Californians and their dependents would qualify for insurance. The range of services to be covered has not yet been determined. No funding source has been identified.
Healthy California Act of 2003
This plan, put forward by Assemblywoman Rebecca Cohn, a Democrat from Campbell, requires every working Californian to buy health insurance. Those who cannot afford it would be subsidized. AB 1528 is backed by Blue Shield of California, whose CEO, Bruce Bodaken, calls it a “middle solution” that makes individuals bear a portion of the cost for their care. Beyond the individual contributions, no funding mechanism has been established to pay for the plan. Critics warn that many people would probably opt out as they do now with mandatory car insurance and simply take their chances on getting caught.
Under this modest plan put forward by Republican Assemblyman Keith Richman of Northridge, an estimated 2 million uninsured workers would qualify for coverage. AB 30 would cover low-income childless adults, with the cost shared by employers and employees as well as state and federal subsidies. It would also expand coverage to an estimated 300,000 uninsured parents of children enrolled in the state’s Healthy Families Program. But there is no government funding in place for the program, and, as with the other unfunded bills, the cash could be tough to come by given the current economic climate.