Gov. Arnold Schwarzenegger
(R) on Monday proposed a system of universal health insurance for
Californians that would make the nation's most populous state the third to
guarantee medical coverage for all its residents.
"Prices for health
care and insurance are rising twice as fast as inflation, twice as fast as
wages. That is a terrible drain on everyone, and it is a drain on our
economy," Schwarzenegger said. "My solution is that everyone in
California
must have insurance. If you can't afford it, the state will help you buy
it, but you must be insured."
Appearing via video
conference California Gov. Arnold Schwarzenegger discusses his plan to
extend health coverage to nearly all Californians during a news conference
in
Sacramento
,
Calif.
on Monday, Jan. 8, 2007, as Kim Belshe, Secretary for the Department of
Health and Human Services looks on at left.
Appearing via video conference
California Gov. Arnold Schwarzenegger discusses his plan to extend health
coverage to nearly all Californians during a news conference in
Sacramento
,
Calif.
on Monday, Jan. 8, 2007, as Kim Belshe, Secretary for the Department of
Health and Human Services looks on at left. (Rich Pedroncelli - AP)
Much of the opposition to
Schwarzenegger's program, which requires legislative approval, is expected
to come from his fellow Republicans, who object that the plan will be
costly for small businesses. But the governor said
California
cannot afford not to do it. Nearly one in five
California
residents does not have health insurance -- a total of 6.5 million people,
many of whom seek expensive care in emergency rooms.
Nationwide, the ranks of
the uninsured are growing. Census figures show that a record 46.6 million
Americans, including 8.3 million children, had no health insurance in
2005, up from 45.3 million in 2004. Among those who did have coverage,
fewer were receiving it through their jobs as employers scaled back their
health plans.
Analysts say the
California proposal is illustrative of the resurgence of interest among
politicians at all levels in expanding health coverage to the uninsured
and that it provides fresh evidence that, with Congress stalled on
enacting comprehensive health-care reform, the states are beginning to
take matters into their own hands.
In the past year,
Massachusetts
and
Vermont
have passed laws requiring all their residents to obtain health insurance,
with help from the state if necessary. Other states considering expanding
coverage to reduce the number of uninsured include
Washington
,
Montana
,
Rhode Island
,
Wisconsin
and
Illinois
.
"Health care for the
uninsured is back on the agenda," said Diane Rowland, executive vice
president of the Kaiser Family Foundation, a nonprofit, nonpartisan
organization that researches health-care issues. "The governors are
trying to lead the way, but it's also going to take national action to try
to address this problem."
Schwarzenegger's plan
would require everyone living in
California
-- even illegal immigrants -- to have health insurance, at an estimated
cost of $12 billion. Individuals who refuse to carry insurance could face
reductions in their state income tax refunds or the garnishment of their
wages. All businesses with 10 or more employees would have to offer
coverage or pay a fee of 4 percent of their payroll into a fund to help
the uninsured buy health insurance.
Schwarzenegger also
recommended expanding the state's existing program for children's health
insurance to families that earn less than three times the poverty level,
or about $60,000 for a family of four.
The governor also wants to
force insurers to offer coverage to people with existing medical
conditions. Currently many insurers will not cover older people, those
with major illnesses or even people with relatively minor complaints such
as asthma or varicose veins.
Schwarzenegger also would
require insurance providers to use 85 percent of their premium proceeds on
patient care.
The state would increase
reimbursements to doctors and hospitals by a total of $4 billion. Money
for the program would come from new taxes on doctors (2 percent of their
revenue) and hospitals (4 percent), federal funds, and county funds that
now pay for emergency care for the uninsured.
In addition to objections
from small business, Schwarzenegger is sure to face opposition to taxes on
doctors and hospitals, additional regulation of insurance providers and
the extension of coverage to illegal immigrants.
"Imposing a new jobs
tax on employers of any size and expanding costly government mandates is
the wrong approach, one which will devastate our economy," the
Assembly's Republican leader, Mike Villines, said in a statement Monday.
But Schwarzenegger said
that while the plan will cost money, it will pump funds back into the
health system because of the expanded coverage. "Everyone ends up
with a better deal," he said.
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