Health care deal benefits insurers, not Californians-CNA Director
|Health care deal benefits insurers, not Californians
By Rose Ann DeMoro
Article Launched: 01/28/2008
AS THE SENATE Health Committee votes on the flawed health care deal today, the critical question is not the cost of "doing nothing," as the Mercury News suggested in an editorial last week. It's whether the Legislature enacts a badly crafted bill that puts the state in further fiscal free-fall and exposes more families to health insecurity and financial risk.
The bill is faltering precisely because, after being rushed through the Assembly, it received a full public airing in a Senate hearing last week - and is collapsing on its merits on access, quality and cost.
Several moments of that hearing especially stand out.
As the Legislative Analyst's Office revealed, the bill is colossally underfunded and could leave the state billions of dollars in the red. Further, the LAO estimates use the author's undercount of the uninsured in California who would receive subsidies under the bill. Federal surveys show much higher numbers - which would make the budget shortfall far greater.
A "recession similar to the one California experienced in the early 1990s," the LAO adds, "could result in hundreds of thousands of Californians losing access to employer-provided health care," throwing more into the subsidized pool and exacerbating the shortfall.
In response, the proponents essentially argue: "Give us a multibillion-dollar unfunded mandate and trust us."
The Massachusetts law, the California bill's model, is instructive. In a state with far fewer
uninsured, the state is finding the subsidies cost hundreds of millions of dollars more than expected - a $400 million increase just for next year.
With insurers projecting a 14 percent increase in premiums next year, Massachusetts is considering further reducing the benefits covered by the subsidized plans or slashing payments to providers.
Which raises another notable moment of last week's hearing. Sen. Gloria Negrete McLeod asked Department of Health Secretary Kim Belshé if she'd want the coverage offered to Californians under the bill. Belshé admitted she'd have to wait to see what the proposed benefits are - a reminder that the proponents want to force Californians to purchase insurance policies without knowing what they cover or how much they will cost.
No wonder supporters of the bill include several of the state's biggest insurers: Kaiser Permanente, Health Net, PacifiCare, Blue Shield, Cigna and Molina Health Care.
The authors' failure to establish any meaningful cost controls on insurance company price gouging compromises its intent. As a result, many Californians will see the grand promises of this bill morphing into unaffordable, junk insurance plans.
Even with the public subsidies, the lowest-income Californians will likely see substantial out-of-pocket costs for deductibles and co-payments, and have to pay extra for dental, vision, mental health and other essential care. The draconian choice for many could be meeting their housing costs in an imploding economy or paying for needed care.
There are plenty of other problems.
While individuals who fail to buy insurance could see their wages garnished or liens on their homes, there are no penalties on employers who fail to comply with their obligations or evade the supposed protections for employees through the many gaping holes in the bill's language.
Companies like Wal-Mart, for example, could dump their low-wage hourly workers into the public pool without paying a cent for their health care, further overwhelming the fund, a point made by Barry Broad, director of the California Teamsters Public Affairs Council, one of the many unions now opposing the bill.
Neither corporate welfare nor forcing people to go into bankruptcy for an insurance product they can't afford should be considered universal health care.
Those are just a few of the reasons that the list of those opposing ABX1 also includes the League of Women Voters, California Association of Retired Americans, Gray Panthers, Church Impact (the legislative arm of the Council of Churches), United Food and Commercial Workers, California School Employees Association, Communications Workers of America and others.
One final moving moment of the hearing came with the testimony of the family of Nataline Sarkisyan, the Southern California teenager who died after Cigna denied her a liver transplant recommended by her bedside physicians. Insurers can continue to deny care under ABX1.
"I want to have Arnold Schwarzenegger's level of coverage and care," Nataline's father, Gregor Sarkisyan, told the Senate. Everyone should, which is exactly why CNA has fought for genuine reform, such as the expanded and improved Medicare-for-all approach of SB 840.
ROSE ANN DEMORO is executive director of the California Nurses Association/National Nurses Organizing Committee. She wrote this article for the Mercury News.
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