When Gov. Arnold Schwarzenegger's ambitious, but deeply flawed, scheme to provide health insurance to millions of Californians died in the state Senate early this year, it reignited the Capitol's perennial political war over who should get what care and who should pay for it.
No other political issue directly affects more people, is more complex, or generates more emotion, for obvious reasons. And no other segment of the California economy involves so much money, upward of $200 billion a year, more than 10 percent of the state's economic output.
Those factors, in combination, create a uniquely intense political atmosphere that was very evident on Aug. 31, as the Legislature faced a deadline for passing most legislation. With dozens of lobbyists for medical care interests stalking Capitol hallways, high-profile, high-dollar health care bills dominated the final hours.
Sen. Sheila Kuehl, D-Santa Monica, the foremost advocate of state-operated "single payer" health insurance, played the key role in killing Schwarzenegger's plan. And once again, the Legislature's Democrats sent to Schwarzenegger – for a likely veto – her latest version of single-payer insurance.
Beyond her bill (Senate Bill 840), the most significant health care bill to survive is one that Schwarzenegger could sign, based on his past utterances. It would make it much more difficult for health insurers to rescind customers' coverage for allegedly not disclosing details of personal health histories.
The state has fined five insurers some $15 million in recent years for canceling coverage of more than 3,000 customers. Assembly Bill 1945 by Assemblyman Hector De La Torre, D-South Gate, would allow cancellation only if customers intentionally mislead insurers, and such decisions would face regulatory reviews.
It won approval after a last-minute amendment removed language that personal injury lawyers had wanted, dealing with admissibility of cancellation approvals in lawsuits.
Another bill that made it to Schwarzenegger, Senate Bill 981 by Senate President Pro Tem Don Perata, limits "balance billing" of patients by medical care providers for costs not covered by insurers. It also provides emergency room doctors with higher fixed payments for their services and creates an arbitration system for disputed bills.
The most conspicuous final day casualty was Senate Bill 1522, which author Sen. Darrell Steinberg, D-Sacramento, argued would have overhauled regulation of individual health policies to help consumers better understand their options.
However, insurers argued that it would reduce flexibility and thus limit individual choice. It died in the Assembly, perhaps in retaliation for the Senate's sudden adjournment that left several Assembly bills in limbo.
Despite those actions, health care will remain on the Capitol's front burner. One of the major issues in the state budget stalemate, for example, is financing medical care for the poor.
Call The Bee's Dan Walters, (916) 321-1195. Back columns, www.sacbee.com/walters.
