Steve Wiegand: Health bill ready for trip to ER

The sign below state Sen. Sheila Kuehl's chair in a Capitol hearing room Wednesday read, "Do No Harm."

It was a bit incongruous, seeing that it was addressed to members of the Senate's Health Committee, who are California legislators and generally ignore such admonitions.

Still, it played perfectly into the rhetoric of what seemed like hundreds of people who spoke for, against and around the edges of ABX1 1, which is the formal name for a bill that, in essence, would overhaul California's health insurance system.

Backed by arguably the two most powerful politicians in the state – Republican Gov. Arnold Schwarzenegger and Democratic Assembly Speaker Fabian Núñez – the bill would provide coverage for most of the state's poorer residents who currently lack medical coverage. It would require insurance companies, in most cases, to provide coverage to applicants no matter what their prior health problems had been.

And under a companion initiative that would go before voters in November, it purports to pay its $14 billion costs through fees imposed on employers, workers and medical care providers, and a $1.75-a-pack tax hike on cigarettes.

Because supporters are facing a deadline to gather initiative signatures for the November ballot, there is a need to get something passed. And because the current version of the bill is the result of a very fragile compromise among the politicians and various special interests, there is precious little room to tinker with it.

Wednesday, Núñez acknowledged the bill, which has passed the Assembly, wasn't perfect.

"(But) keeping the status quo does do harm," he said. "We cannot let the perfect stand in the way of the good."

He was echoed by Kim Belshé, Schwarzenegger's health secretary. "The status quo is not an option," she said.

Actually, it's not only an option, it's looking like a distinct possibility.

In a 27-page letter to Senate President Pro Tem Don Perata, the Legislative Analyst's Office said that if one or more of a combination of financial factors go south, the reform could find itself billions of dollars in debt by 2014.

Those factors include higher monthly premiums for the poor, more uninsured Californians than anticipated, a drop in the amount of money provided by the federal government and higher inflation rates.

Representatives of the speaker and the governor disagreed with the analyst's conclusions. (These are the same people who told us the $14.5 billion-deficit-ridden state budget was balanced, so take that for what it's worth.)

The analyst's numbers could provide extra ammunition for some Democratic senators to vote against it. (No GOP senator has expressed support.) Sen. Darrell Steinberg, D-Sacto, for example, said determining the program's future costs "is the heart of the issue for me."

When Sen. Elaine Alquist, D-Santa Clara, suggested it would be a cruel trick to begin providing coverage for poor folks and then stop it if the state couldn't afford it anymore, and that people might die, Belshé shot back: "People are dying today … people are dying for lack of the state failing to move forward on comprehensive reform."

Then Sen. Leland Yee, D-S.F., who has already made it clear he doesn't like the bill, said he resented the implication that opposition to the measure would cause people to die.

And so on. Realizing the bill was probably doomed if it came to a vote Wednesday, Perata got Kuehl, who also opposes it, to put off a vote until next Monday afternoon. That might give the governor, the speaker – and the Senate president if he so chooses – the time to do some arm-twisting.

Without it, ABX1 1 looks doomed. And as disheartening as that might be, it's at least consistent with the Legislature's true mantra:

Do Nothing.

About the writer:

• Call The Bee's Steve Wiegand, (916) 321-1076. Back columns, www.sacbee.com/wiegand.