More than 1 million low-income Californians would become eligible for health care coverage through Medi-Cal under legislation proposed Monday by Assembly Speaker John A. Pérez.
The measure is meant to lay groundwork for President Barack Obama's federal health care overhaul, which requires all Americans to obtain insurance by next year or pay a penalty.
Pérez's proposal, Assembly Bill 1X-1, would provide coverage to single adults whose income is less than $15,400 per year, representing roughly 133 percent of the federal poverty level.
"California is the national leader on implementing health care reform, and I am pleased to be authoring this critical measure which will ensure more Californians have access to quality, affordable health care," Pérez said.
Senate President Pro Tem Darrell Steinberg and Sen. Ed Hernandez, D-West Covina, plan to push a similar bill in the Senate.
If Pérez's bill is signed into law, the federal government would pay the tab for Medi-Cal's expansion for three years.
State taxpayers would begin to bear a rising portion of the costs in 2017, reaching 10 percent by 2020 – but the state's share would be capped at that percentage for each year thereafter.
"This does not bind us to those out years; it begins the process, and future Legislatures can continue to adjust and address," the Assembly leader said.
Pérez, D-Los Angeles, said he did not know what the state's ultimate yearly tab might be – perhaps tens of millions of dollars, perhaps $100 million, he said.
The Medi-Cal expansion will be considered in a special legislative session on health care called by Gov. Jerry Brown.
Assemblyman Dan Logue, a Marysville Republican who serves as GOP point man on the Assembly Health Committee, said that expanding Medi-Cal eligibility by a million people without increasing the number of health care providers could exacerbate difficulties in getting timely medical care.
"The idea of getting everybody insured, that's fine," Logue said. "The problem is, do we have the personnel to be able to handle it? Is there going to be massive rationing for health care? If everybody has health insurance and nobody has health care, what good is it?"
Logue said a Medi-Cal expansion also could strain state coffers after its first three years of implementation.
California's state budget was tens of billions of dollars in debt when he was sworn into the Legislature, Logue said, and "I don't want to go back into that."
Steinberg said that California's shortage of health care providers would exist whether Medi-Cal is expanded or not.
"There are huge cost savings in covering people," he said, "because the cost of uncompensated care, the cost of emergency room care, is part of what drives health care costs up so dramatically."