Bush Addresses Health Care / Health Care Overhaul in California Senate Panel

CAL/AAEM News Service calaaem_news at yahoo.com
Wed Feb 6 14:15:26 PST 2008


Bush Addresses Health Care in Final State of the Union Address
 
Source: The California Healthline ( http://www.californiahealthline.org )
Date: January 29, 2008 


President Bush on Monday delivered his final State of the Union address, in which he
focused on "extending or cementing past initiatives" and "reintroduced ideas that have
gone nowhere in the past," some of which involve health care, the Washington Post reports
(Baker, Washington Post, 1/29). 

In his address, Bush called for health care reform that involves market competition,
rather than government mandates (Kranish/Milligan, Boston Globe, 1/29). Bush advocated a
previous proposal that would provide tax deductions to help U.S. residents purchase
individual health insurance or coverage through employers and would eliminate tax breaks
for employer-sponsored health insurance in some cases. 

According to Bush, Republicans and Democrats "share a common goal: making health care
more affordable and accessible for all Americans." He said, "The best way to achieve that
goal is by expanding consumer choice, not government control. So I have proposed ending
the bias in the tax code against those who do not get their health insurance through
their employer. This one reform would put private coverage within reach for millions"
(Wolf et al., USA Today graphic, 1/29).

Bush also said that Congress should "expand health savings accounts, create association
health plans for small businesses, promote health information technology and confront the
epidemic of junk medical lawsuits," all of which would "ensure that decisions about your
medical care are made in the privacy of your doctor's office, not in the halls of
Congress" (Bush speech text, Washington Post, 1/29).

Entitlement Programs

Bush in his address avoided one of the "thorniest domestic issues that he has raised
before without success": reforms to "financially shaky government entitlement programs
such as Social Security and Medicare," the Globe reports. However, he "challenged members
of the Democratic-majority Congress to reach bipartisan solutions" on the issue,
according to the Globe (Boston Globe, 1/29).

Bush said, "Every member in this chamber knows that spending on entitlement programs like
Social Security, Medicare and Medicaid is growing faster than we can afford. Now I ask
members of Congress to offer your proposals and come up with a bipartisan solution to
save these vital programs for our children and grandchildren" (AP/Austin
American-Statesman, 1/28).

Other Health-Related Issues

In his address, Bush also called for Congress to: 

-Double the amount of funds for HIV/AIDS programs in Africa from $15 billion to $30
billion over five years; 
-Increase funds for research on "reprogrammed adult skin cells, which have the potential
and do act like embryonic stem cells" (Ward, Washington Times, 1/29); 
-Pass legislation that would ban "unethical practices such as the buying, selling,
patenting or cloning of human life"; 
-Double "federal support for critical basic research in the physical sciences"; 
-Reauthorize and reform the Trade Adjustment Assistance Act; 
-Pass legislation to implement recommendations by former Sen. Bob Dole (R-Kan.) and
former HHS Secretary Donna Shalala to "improve the system of care for our wounded"
veterans (Bush speech text, Washington Post, 1/29).

Democratic Response

In the Democratic response to the address, Kansas Gov. Kathleen Sebelius (D) asked Bush
to work with Congress "in the next 357 days to get real results and give the American
people renewed optimism that their challenges are the top priority" (Abramowitz/Eggen,
Washington Post, 1/29).

Sebelius called on Bush to support some Democratic proposals for health care reform
(Lefler/Koranda, Wichita Eagle, 1/29). Sebelius also asked Bush to sign legislation to
reauthorize and expand the State Children's Health Insurance Program as a "first step in
overhauling our health care system" (Branigin, Washington Post, 1/29).

According to the Bergen Record, her comments do not indicate that Democrats are "holding
their breath for a presidential change of heart" but that they are "aiming more for
drawing distinctions with Bush ... in an election year with the presidency and their
majorities at stake" (Kellman, Bergen Record, 1/29).

For more information, please visit:
http://www.californiahealthline.org/articles/2008/1/29/Bush-Addresses-Health-Care-in-Final-State-of-the-Union-Address.aspx?topicID=37

------------------------------------------------------------

Health Care Overhaul Plan Goes Down in California Senate Panel

Source: The California Healthline ( http://www.californiahealthline.org )
Date: January 29, 2008 
  
On Monday, the Senate Health Committee rejected compromise health care reform legislation
(ABX1 1) negotiated by Gov. Arnold Schwarzenegger (R) and Assembly Speaker Fabian Núñez
(D-Los Angeles), effectively ending any comprehensive efforts this year to overhaul
California's health care system, the Ventura County Star reports (Herdt, Ventura County
Star, 1/29). 

The committee voted 7-1 against the bill, with three Democratic members abstaining
(Chorneau, San Francisco Chronicle, 1/29). The measure received no support from
Republican committee members.

Details of Plan

The overhaul plan, estimated to cost $14.9 billion annually, would have been funded by a
variety of sources, including: 

-Employee and employer contributions; 
-A hospital fee; and 
-A $1.75-per-pack tobacco tax increase (Rojas, Sacramento Bee, 1/29).

The plan would have required about 3.6 million of the 5.1 million permanently uninsured
residents to obtain health care coverage (Zapler, San Jose Mercury News, 1/28). 

Insurers would have been required to provide coverage to nearly all applicants,
regardless of pre-existing medical conditions (Rundle, Wall Street Journal, 1/29). 

The Assembly passed the bill in December 2007 (McKinley/Sack, New York Times, 1/29). 

Aside from approval from the Legislature and Schwarzenegger, the plan could not have
taken effect without voter support of its funding mechanism. A ballot measure was planned
for November (Ainsworth, San Diego Union-Tribune, 1/29). 

Reasons Behind Defeat

Democrats who voted against the measure cited a report released last week by the
nonpartisan Legislative Analyst's Office that found the plan could leave the state with a
shortfall of billions of dollars if costs exceeded expectations (Sacramento Bee, 1/29).

Lawmakers also harbored concerns against adopting a major overhaul plan while California
faces a $14.5 billion budget deficit that could force them to cut spending for existing
health care programs. 

Schwarzenegger has proposed $2.9 billion in health care cuts over the next 18 months as
part of his efforts to rein in the budget shortfall (Rau, Los Angeles Times, 1/29). 

Senate President Pro Tempore Don Perata (D-Oakland), who advised committee members to
"vote their conscience," said the escalating budget deficit made it difficult to garner
public support for the measure. 

Schwarzenegger and Núñez had maintained the plan would generate enough money to cover its
costs without needing additional money from the state's general fund (Sacramento Bee,
1/29).

National Implications

The defeat of the measure could deal a setback for health care reform efforts on a
national level, according to the Los Angeles Times. The three leading Democratic
presidential candidates all have proposed reform plans that are similar in scope to ABX1
1 (Los Angeles Times, 1/29). 

Drew Altman, president of the Kaiser Family Foundation, said the bill's rejection "is a
significant blow, but not a fatal blow, to the growing momentum for health reform
nationally." He added, "California's failure, after coming so close, underscores the
lesson that too many states don't have the political will or resources to reform health
care on their own, and thus the need for a national solution of some kind" (Lee,
Washington Post, 1/29). 

Peter Harbage, a consultant who advised the Schwarzenegger administration on the plan and
serves as a health policy adviser to presidential candidate and former Sen. John Edwards
(D-N.C.), said, "What we really saw today is that you need national leadership" on health
care reform (Ventura County Star, 1/29).

Reaction from Schwarzenegger, Núñez

In a statement, Schwarzenegger said he would not "give up" on finding a solution to
overhauling California's health care system (Wall Street Journal, 1/29). He added, "The
problems will not disappear" and "are likely to get worse" (Los Angeles Times, 1/29). 

Meanwhile, Núñez told committee members, "I would challenge the members of the Senate to
come up with a plan that's doable, that can withstand the same type of scrutiny that
(ABX1 1) was put through in this committee" (Sacramento Bee, 1/29).

Other Reactions

Committee Chair Sheila Kuehl (D-Santa Monica) said, "The problem that we have to face is
that it doesn't matter if there are all these good things in the bill if there is
insufficient money to pay for them" (Ventura County Star, 1/29). 

Assembly Minority Leader Mike Villines (R-Clovis) praised the committee's rejection of "a
massive government-run health care scheme" (New York Times, 1/29). 

Steve Burd -- CEO of Safeway and president of a business coalition that supported the
bill -- said, "Without reform, all Californians will continue to suffer the consequences
of a failed system that leaves millions vulnerable without care" (Ventura County Star,
1/29).

Next Steps

The Senate's defeat of the measure does not leave enough time to place the financing
mechanism of a revised version of the plan before voters this year, according to the
Star. 

However, in a letter to Schwarzenegger and Núñez, Perata suggested lawmakers work to
adopt some of the reform plan's individual components. Perata's suggestions include: 

-Independently imposing a tax on hospitals to increase federal matching funds for
Medi---Cal reimbursements (Ventura County Star, 1/29); 
-Placing a cap on insurers' profit; 
-Requiring health care providers to be more transparent by publicizing costs for
procedures; and 
-Increasing the state's tobacco tax to help provide subsidies for expanding health
insurance coverage.

The Times notes, however, that Perata's proposals also would face difficulty winning
legislative approval due to Republican opposition to new taxes (Los Angeles Times, 1/29).


In his letter, Perata also said, "The significant progress we have made can assure swift
future steps when the state's budget and economic climate improves" (San Francisco
Chronicle, 1/29).

Abid Mogannam &
Brian Potts MD, MBA
Managing Editors, CAL/AAEM News Service
University of California, Irvine

The CAL/AAEM Archives are available at: http://maillists.uci.edu/mailman/public/calaaem/



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