HEALTH ACCESS BUDGET CUTS UPDATE
July 19, 2002
ADDITIONAL CUTS PROPOSED BUT REJECTED
Conference Committee Has Major Discussion on Health Care: “Bread, Water and Shelter vs. A Wise Investment for California”
MORE CUTS CONSIDERED: Budget conference committee met earlier today June 19 to review further potential cuts. They re-opened a number of items looking for additional cuts. Health care items reconsidered for cuts included trauma care funding, the increase in the DSH administrative fee, the frequency of pediatric dental care, Medi-Cal co-payments, and CHDP periodicity, and provider rates.
By the end of the night, in the items of most concern to health care advocates, the Committee voted to sustain the decisions they have made in earlier sessions, and prevent further cuts, with the Republican members often dissenting.
DISCUSSION: The following is NOT a verbatim transcript: it is from notes taken by Beth Capell, Health Access legislative advocate, on Wednesday morning. Health Access has ordered the videotape and will make a verbatim transcript of key passages. With that disclaimer, what follows is a debate that goes to the core of the fight to provide health care to working people.
Conference committee was reviewing a list of health items that the conference committee had added above the Governor’s May Revise proposal. Last on the list was the proposal to start Healthy Families coverage of parents. Steinberg asked what the federal match on this program was and got confirmation that it was $2 federal dollars for every $1 dollar in state general fund.
Assm. John Campbell, R-Irvine: Is this really needed? That’s like saying that if you go to the store and need one thing, but if you buy two, you get one free, then you should buy two even though you only needed one.
Assm. Darrell Steinberg, D-Sacramento: 164,000 parents would be eligible under this program. There is a huge need. This is a wise investment for California to make up front. If we don’t invest in health coverage, people think we’ll get off scot-free and that’s not true. We spend it in emergency rooms.
Campbell: I disagree. The people of this state are not interested in increasing their taxes to fund programs that don’t exist. This program is not so vital that it was needed before now.
Assm. Jenny Oropeza, D-Los Angeles: I don’t agree that our citizens who pay taxes do not need health care
Campbell: We cannot provide all of what everyone wants free of charge. We have to draw the line somewhere. You choose to tax people for something that in some cases the people you are taxing don’t have themselves.
Oropeza: We are making up for a past wrong that we just take care of half the family. It is heartless and inhumane not to take care of the entire family.
Campbell: A Rand study shows that 80% of these families have access to employer sponsored coverage.
Steinberg: You know it is not just Democrats that support this. Keith Richman (R-Simi Valley) spoke very eloquently for this (in the Assembly budget subcommittee). And the Bush Administration is funding it.
Campbell: This is about what you need, what you really need. The standard is bread, water and shelter.
Steinberg: If that’s the line, I am ready to engage in that debate.
Campbell: Bread, water and shelter is what people really need.
Sen. Steve Peace (D-San Diego): My doctor tells me not to eat bread.
Steinberg: Mr. Campbell, you need to prove your supposition that people can get coverage because I don’t believe it.
Oropeza: This is $27,000 for a family of three–what job offers coverage at that level?
Campbell: Well, I offer coverage to my employees regardless of what they make.
Peace: Health insurance is more expensive and fewer options. My employees were in the HIPC but they just chose to go with a single insurer because of costs. But in this universe of folks that employers do not offer coverage, what are we to do?
Peace: Are we saving the taxpayers money because the counties pay this without state and federal costs?
My notes fade here but Peace pursued this point about counties paying to support county hospitals and their requirement to be the provider of last resort. Department of Finance and Legislative Analyst talked about how difficult it is to determine what counties spend. They also mentioned hospital charity care and emergency rooms. Peace then talked about how the cost of care for the uninsured is cost-shifted to the insured. (Health Access believes that the real problem is that the uninsured just do not get care and thus are sicker.)
Peace talked about the ideological divide between the Republicans and Democrats on universal coverage and why the business community should support universal coverage. (Peace’s solution was vouchers through refundable tax credits and medical savings accounts to allow people to participate in a single state system with list of providers similar to that offered by PERS Choice, a loose PPO. It is possible that this concept would need further elucidation to be understood in its full glory.)
Peace pointed out that there has been a shift in expectation from his parents’ generation when health insurance was for catastrophic costs to a sense among the public that health care should be free. There was brief further discussion.