Tuesday, November 18th, 2003


* Appointments from the Gubernatorial Transition: Health Care Hints

* Continued Work Needed to Expand Health Coverage: Nov 6th Advocates Mtg to Implement SB 2

* Medicare Debate Set for Showdown: Will Privatization Pass?


Since Governor-elect Arnold Schwarzenegger rarely mentioned health care in his campaign, and he has no public record on the subject, very little is known about his positions on the key health policy issues of the day. His appointments have been scrutinized to figure out how he will deal with health care issues. His transition team of more than 60 people, while notable for the wide breadth of experience and diversity, was sorely lacking in major leaders from the health world, either from industry, academia, or advocacy circles. However, his two most important important appointments–transition finance director and chief of staff–raise serious concerns.

TRANSITION FINANCE DIRECTOR: Schwarzenegger asked Donna Arduin, on loan from Florida Governor Jeb Bush’s finance staff, to conduct an overall audit of California’s budget and make recommendations. According to Florida advocates, Ms. Arduin is known for advocating major cuts to health and social services.

* Under her direction, Florida has made cuts that have been rejected here in California, including lowering the eligibility for adults on Medicaid from 100% to 88% of the federal poverty level, and eliminating Medicaid coverage for adults for such benefits as dental care, vision care, and hearing aids.

* Other cuts made in Florida by Ms. Arduin have not even been proposed here in California. Florida has capped enrollment in their Child Health Insurance Program (called KidCare), which has so far denied coverage 60,000 children who are now on a waiting list; increased co-payments on prescription drugs, medical transportation, and non-emergency use of the emergency room; and increased premiums on families in KidCare. She also proposed to eliminate medically needy program in Medicaid, but this last suggestion was rejected.

CHIEF OF STAFF: Last week, the Governor-elect announced that HMO senior executive Patricia Clarey would be named as his chief of staff. Clarey worked in the first President Bush’s Administration and then as deputy chief of staff in Governor Wilson’s Administration. She then went off to Transamerica Insurance before becoming vice president for governmental affairs at Health Net, one of the large California HMOs. Her appointment, combined with the dominance of the Wilson team that opposed HMO reform, raises serious questions about the future of HMO reform and the Patients Bill of Rights, including the continued enforcement of these important consumer protections.


With the signing of SB 2 (Burton), to extend health coverage to over one million uninsured workers and their families, advocates for the uninsured have significant work to do in order to make the promise a reality. Here’s some work to defend, implement, and expand SB 2.

* DEFEND: The Chamber of Commerce and a few other business organizations are beginning a petition drive to get a ballot referendum to repeal SB 2. They are paying $2 a signature to collect the more than 373,816 signatures needed to qualify the referendum for the ballot, either on the March or November 2004.

Most voters get their health coverage through their employer, and polls have shown that voters are strongly supportive of the concept of SB 2, even after opposition arguments are read. Especially with the increased coverage of health care labor disputes in Southern California, voters may very well want the protections in SB 2 to preserve the coverage they have. However, the campaign to repeal SB 2 is likely to rely on misinformation and scare tactics, as the name of the campaign–Californians Against Government Run Healthcare–suggests. More information on this effort will follow.

* IMPLEMENT: The bill has a two-year implementation process that includes multiple agencies. Last Wednesday, the Managed Risk Medical Insurance Board (MRMIB) started its deliberations on how to implement SB 2, including putting out a list of issues for consideration regarding implementation that they are seeking comment on. They will finalize the list of issues at their next meeting.

MEETING FOR ADVOCATES: Advocates for the uninsured are invited to a planning meeting on SB 2 implementation on Thursday, NOVEMBER 6th, 2003, at 2:00PM in SACRAMENTO. This “Faces of the Uninsured” convening will be a strategy session to plan and figure out all the ongoing work that will be needed to make the promise a reality, including the policy work of implementation at six agencies, especially given the new administration. Location to be announced. Please RSVP to Anthony Wright, Health Access, at Transportation subsidies are available for those organizations who need them.

* EXPAND: Even as SB 2 is defended and implemented, the work toward universal coverage needs to continue. SB 921 (Kuehl), to establish a universal health care system, is currently awaiting a hearing in the Assembly Health Committee with a probable hearing date in March. Continued advocacy is needed to expand the organizations in support of universal health care, and to urge Assembly legislators to support this proposal.


The U.S. Congress continues to debate the particulars of a Medicare prescription drug bill, now pending in conference committee. Over 40 Democratic and Republican Senators have expressed serious concerns about the details of the final product, over a number of key issues. Health Access California has opposed both H.R. 1 and S. 1. Both bills provide little relief to many seniors, and actually would cost hundreds of thousands of seniors more than they pay today for prescription drugs. More disturbingly, the bills–particularly the House legislation–would lead to the privatization of Medicare. Several other issues and problems have been raised by senior and consumer advocates with the content of the bill.

It is likely that the Congress will make a decision and vote on a proposal in the next two weeks. Health advocates should contact Senator Barbara Boxer and Senator Diane Feinstein to urge them to OPPOSE any proposal that does not provide real relief to seniors, and that leads toward the privatization of Medicare.

For more information, see the following websites:

Campaign for America’s Future:

Alliance for Retired Americans:

Families USA:

Anthony E. Wright

Health Access

1127 11th St., #234, Sacramento, CA 95814

Ph: 916-442-2308, Fx: 916-497-0921

Health Access California promotes quality, affordable health care for all Californians.
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