Dan Walters: Health plan is popular but dodgy

The plan to expand access to health care devised by Republican Gov. Arnold Schwarzenegger and Fabian Núñez, the Democratic speaker of the state Assembly, receives strong support in a new poll of California voters.

The Field Poll found that by a margin of 64 percent to 23 percent, voters endorsed a summary of the plan that was passed Monday by the Assembly on a party-line vote. The support was broad, cutting across generational, ethnic, gender, geographic, economic and partisan lines.

So it's a slam dunk, right? The Senate will pass the plan early next year, and a ballot measure containing its financial aspects, including a cigarette tax hike, will win easy voter support in November. Schwarzenegger and Núñez will go down in history as the men who solved the long-festering health care dilemma by bringing insurance to the millions of Californians who lack it.

Well, maybe. But a poll that finds strong support for something at the conceptual level nearly a year before the actual election is one thing, and getting it actually passed on Election Day is something else. The political history of California is littered with the bones of measures that seemingly enjoyed impregnable support of voters, only to fail.

The key factor is that despite strenuous efforts, Schwarzenegger and Núñez have not been able to nail down anything approaching consensus among the many "stakeholders" in the health care issue. All major factions – employers, health care providers, insurers, consumer groups and labor unions – are divided into subfactions, some favoring the plan and others opposed.

Unless the naysayers are brought into the fold, and that seems unlikely now that the legislative process has begun, there would be a well- financed and highly visible opposition campaign with plenty of ammunition.

There is, for example, the assertion of some health insurers that everyone's premiums would go up by a third or more to pay for covering those now lacking insurance. Or, conversely, there are the claims by nurses and some consumer groups that it would be a giveaway to the insurance companies.

Contradictory? Sure, but negative political campaigns are not exercises in logic; rather, they are efforts to generate fatal doubt among voters.

Another potential line of attack surfaced in news accounts this week – that language in the bill gives special health care benefits to members of the Service Employees International Union, which is its major labor supporter.

And then there's the potentially explosive fact that the Schwarzenegger-Núñez plan specifically carves out benefits for illegal immigrant children by financing them with state funds, because it would be illegal to do with federal money. As logical and humane as that may be in the abstract, it would allow opponents to tap into many voters' anti-illegal immigrant sentiment, telling them, perhaps, that their taxes and insurance premiums are being raised to support those in the country illegally.

There's no certainty that the proposed cigarette tax hike – $1.50 or $2 a pack – would be acceptable, either. The tobacco industry has demonstrated in the past that it's willing to spend many millions of dollars to beat back such tax increases. In fact, California voters rejected a $2.60 boost to underwrite health care just last year.

Finally, even if the Senate and voters were to approve the plan, there's the nagging issue of its legality under federal law since one aspect imposes health spending requirements on employers. The courts have held consistently that such requirements conflict with federal law. The only state that has them, Hawaii, had to obtain a special waiver from Congress.

Bottom line: Even with what appears to be strong voter support, this plan is a long way from becoming reality.

About the writer:

• Call The Bee's Dan Walters, (916) 321-1195. Back columns, www.sacbee.com/walters.