5 eye-popping taxes California could impose to pay for universal, single-payer health care
Here is a rundown of the 16 bills proposed by Democratic lawmakers after the Assembly's special health care hearings concluded. The hearings began following a decision last year by Speaker Anthony Rendon to shelve a controversial single-payer health care bill.
Assembly Bill 2965: Would expand Medi-Cal eligibility to undocumented adults ages 19 to 25. Currently on suspense in the Senate Appropriations Committee. The Legislative Analyst's Office estimates the expansion would cost an additional $140 million annually from the general fund. Unlikely to advance.
Assembly Bill 3148: Would have required Covered California to offer additional financial assistance to low- and middle-income people purchasing insurance through the exchange. Died in the Assembly Appropriations Committee in May. Assistance would have cost roughly $500 million annually from the general fund, according to an estimate by the University of California, Berkeley Labor Center.
Assembly Bill 2565: Would require Covered California to boost health insurance premium assistance to low- and middle-income people. Held in Assembly Appropriations Committee. Assistance estimated to cost $500 million annually. Unlikely to advance.
Assembly Bill 2416: Attempts to create greater access to care and more competition between health plans in areas with two or fewer plans selling insurance coverage through Covered California. It would require health plans with Medi-Cal contracts in underserved counties to negotiate with Covered California for potential inclusion on the exchange. Held in Assembly Appropriations Committee. Additional staff costs for Covered California of up to $300,000. Unlikely to advance, contents moved to Assembly Bill 2472.
Assembly Bill 2472: Encourages greater competition between plans, and would require Covered California to study creating a public health insurance option to compete with private insurers on the exchange. Decision expected in August. One-time costs in the range of $250,000 for Covered California to contract for the report.
Assembly Bill 2499: Would require insurers to spend a set amount — at least 80 percent — of insurance premium dollars on care instead of administrative costs and profit. Decision expected in mid-August. Additional administrative costs by state Department of Insurance and Department of Managed Health Care.
Assembly Bill 2430: Would let a larger number of low-income seniors, disabled and blind adults qualify for free Medi-Cal. Currently in Senate Appropriations Committee. Total cost for the first year would be $51.4 million, growing to $153.6 million the following year, according to a Senate analysis. Unlikely to advance.
Assembly Bill 2459: Would provide a personal income tax credit for nearly 400,000 low- and moderate-income people who purchase insurance through Covered California, equal to the amount of their health insurance premiums. Moving through policy committees in the Senate but unlikely to advance due to its high pricetag. Would cost $500 million in general fund dollars annually, and would likely grow as health care costs continue to rise. It would also cost an estimated $2.2 million per year in administrative costs.
Assembly Bill 2579: Would automatically enroll women and children whose incomes qualify them for food stamps into Medi-Cal, creating a so-called "express lane." Referred to Senate Appropriations Committee. Would cost the state Department of Health Care Services $400,000 in the first year to begin the program, and result in $200,000 ongoing costs likely paid for with federal health care dollars divvied out to the state.
Assembly Bill 2597: Seeks to increase the number of primary care doctors in the state by boosting state funding for University of California medical training programs. Referred to Senate Appropriations Committee. Cost would be $9.35 million in general fund money for the University of California system. Unlikely to advance.
Assembly Bill 2718: Expands from six months to one year Medi-Cal coverage to low-income individuals or families transitioning out of other financial assistance programs. Annual ongoing costs would be about $6 million, with roughly half coming from the state general fund. Included in budget negotiations but was not funded. Referred to Senate Appropriations Committee. Unlikely to advance.
Assembly Bill 2275: Seeks to further regulate Medi-Cal managed care plans by creating stronger care quality benchmarks. Referred to Senate Appropriations Committee. Annual costs of $3.1 million per year, covered by state and federal funds.
Assembly Bill 2427: Would increase the state's ability to regulate health plans and penalize them for engaging in anti-competitive business practices by restricting them from Medi-Cal. Referred to Senate Appropriations Committee.
Assembly Bill 2502: Establishes a database to track payments to health care providers and insurers, with a goal of increasing transparency around health care prices. Proposal included in the state budget signed last week by Gov. Jerry Brown with $60 million appropriated this year.
Assembly Bill 2517: Sets California on a potential path toward a form of single-payer health care. Proposal also included in the state budget, with $5 million appropriated this year to provide a "road map" with benchmarks to move California toward a "unified publicly funded health care system," according to the bill's authors. System could be publicly funded or a hybrid to include coverage provided by and paid for by employers. Version included in state budget.
Assembly Bill 3087: Would have created a California "Health Care Cost, Quality and Equity Commission" to control in-state health care costs and set payment rates for health plans, hospitals, physicians, doctor groups and other providers. Held by author due to staunch opposition.