• Universal health coverage bill, SB840, clears Assembly; Will go to Gov after Senate re-vote
  • Health care-related rallies on Wednesday
  • Prescription drug discount bill expected to be heard in Senate on Tuesday, August 29th.
  • UPDATE on bills of interest to health advocates

In a historic vote, the California Assembly voted to support a universal, public-financed health care system, the California Health Insurance Reliability Act (CHIRA), to guarantee health coverage to all Californians, with comprehensive benefits, and the right to choose one’s own doctor, and save on health care costs.

The plan would be funded by drawing in current public spending and replacing all premiums, co-pays and deductibles paid to insurance companies with premiums paid to the system. As amended, the bill creates a blue ribbon panel of health, finance and technical experts to lay out the mechanics for an affordable premium structure using information gathered in available funding studies. Because this structure, the bill needed a majority vote to pass, not the two-thirds vote needed for fiscal measures.

Supporters of the plan argued that SB 840 saves the state of California, businesses and working families nearly $8 billion in the first year, through a streamlined claims and reimbursement system reducing administrative costs, and using the state’s combined purchasing power to negotiate better rates for prescription drugs and durable medical equipment.

The bill will now return to the State Senate for concurrence and is expected to reach the Governor’s desk by September 1st. Four years after Sen. Sheila Kuehl first introduced her “single-payer” health coverage legislation, and after major organizing around the state by a broad coalition of groups, the proposal is now on its way to the governor’s desk. The Governor is expected to veto it, although advocates are organizing to support it, starting on Wednesday with rallies in Sacramento and Los Angeles.

Despite the potential veto by Governor Schwarzenegger, the vote is historic in having the full California legislature go on record in support of a universal healthcare system, and for the desired direction of our health care system. The California legislature has voted on and passed other major health care coverage expansions in recent years, most notably with an expansion of employer-based coverage in 2003 (SB2) which was narrowly repealed by referendum and a full expansion of coverage to nearly all children in 2005 (SB774), which was vetoed. With the vote on SB840, the California legislature has continued to make health care coverage a priority, puts forward a vision, and sets an even higher marker for the coming debate next year.

ASSEMBLY DEBATE: The Assembly passed the bill Monday afternoon on a near party-line vote. Assemblywoman Barbara Matthews, D-Tracy, was the only Democrat to vote against the measure. In the preliminary 43-30 vote, four other Democrats were counted as “not voting”: Dario Frommer, of Glendale, Paul Koretz, of Hollywood, Joe Nation of San Rafael and Nicole Parra, from Bakersfield.

Republicans, as expected, resoundingly opposed the measure. Assemblymember Greg Aghazarian railed against a “government-run” health care system, and several members made comparisons to the Department of Motor Vehicles as an example of inefficient government bureaucracy.

“The reason our health care system is messed up is because of government,” opined Republican Assemblyman Ray Haynes, of Murrieta. He blamed the rising costs of health care on 23 mandated benefits that have been added on in recent years. (He didn’t mention that the California Health Benefits Review Program has studied recent mandate legislation and determined that spending increases as a result of mandated benefits range from .006 to .2 percent.) He and Assemblymember La Malfa read off the list of boards and agencies created under the plan. La Malfa called the proposal “son of Hillary care” and “socialized medicine.”

But in comments praising the bill, Assemblyman Merv Dymally said that with all the money that goes into California’s health care system, there would be more than enough to cover all its citizens –“you take the consumer contribution, you take the insurance contribution, you take the government contribution, you have enough money to pay for a health care system, with a little change to go to Brazil.” Assemblywoman Goldberg mentioned, “I’m tired of talking about DMV… that’s a ridiculous argument. We are talking about Medicare. Medicare functions very well. Almost all of us, if we are lucky to live long enough, will see how well it functions.”

Using a business argument, Democrat Assemblywoman Fran Pavley of Santa Monica , argued that auto companies were moving across the border to Canada because manufacturers in that country, which provides universal health care to all citizens, don’t have to spend money on those benefits. Democrat Assemblyman Juan Arambula of Fresno relayed a personal story from his son, an emergency room physician who saw a patient saddled with a $4,000 hospital bill because they could not afford the $40 inhaler. That story convinced him to vote for SB840, he said.

Assembly Speaker Fabian Nunez, in his closing argument as the bill’s floor jockey,challenged detractors to come up with a different plan that would help cover the uninsured and drive down health insurance costs “We know the health care system in place today is teetering on the brink of collapse. We need to do something in the affirmative to fix it,” Nunez said, adding that small businesses and employees are all struggling to pay to keep health benefits. “This is not just about the 6.5 million that don’t have health insurance; this is also about those that do.”

“This is what we are bringing to the table,” said Assembly Speaker Nunez. “If you don’t like this, give us something else. Show us how you are going to fix a system… the broken health care system… This is our solution. We feel strongly that this is the right direction to move in.”


While advocates expect SB840 to clear the Senate in the concurrence vote, obtaining a gubernatorial signature will be a struggle. Two rallies are scheduled on Wednesday, August 30th for noon, sponsored by the many supporters of SB840:

* SACRAMENTO: Wednesday, August 30, 12:00 Noon, Sacramento. State Capitol, Steps on South Side of the State Capitol, 11th and L Street.
* LOS ANGELES: Wednesday, August 30, 12:00 Noon, Los Angeles. California State Building 300 South Spring Street.

WAKE-UP WALMART RALLY: With a related message, there will another rally on WEDNESDAY in SACRAMENTO, also at the state Capitol on the West Steps, one hour earlier at 11:00am, featuring the “Wake Up Walmart” bus, which is on a 35-city, 35 day tour. Part of the message is to spotlight the health care benefits of the nation’s largest retailer. A featured speaker includes gubernatorial candidate Phil Angelides.


While health advocates wait for universal coverage, another bill would make it easier for low income families and seniors without coverage to get a fair price on their medications. AB2911(Nunez/Perata) could be taken up on the Senate floor as early as Tuesday morning.

The bill authorizes the state to negotiate for the best possible price for up to 6 million Californians. The first three years, the program is voluntary, allowing the drug companies to fulfill their promises made last year to make a voluntary program work. However, after August 1, 2010, if drug companies are not participating or their discounts are still insufficient, the state may use the purchasing power of its Medi-Cal program to steer some business to those drug companies that do participate.

The program would be available for 5-6 million Californians who earn less than 300 percent of the federal poverty level ($60,000 for a family of four); or who have high un-reimbursed medical expenses and incomes below the state’s median family income ($68,310 for a family of four); or whose drugs are not covered by Medicare may qualify.

In anticipation of this week’s vote, advocates and a giant, walking pill bottle distributed 600 pro-prescription drug leaflets to Capitol staff, lawmakers and lobbyists arriving at work Monday morning.

Members of Gray Panthers, Older Women’s League, Congress of California Seniors, Latino Coalition for a Healthy California, Health Access California, California Alliance for Retired Americans and Health Care for All showed up to paper the Capitol.


Voted on Assembly Floor Monday:

  • SB840 (Kuehl) PASSED 43-30. Returns to Senate for concurrence. Called the California Health Insurance Reliability Act, creates a universal, publicly financed (single-payer) health care system for the state similar to Medicare.
  • SB1405 (Soto) PASSED 45-24. Returns to Senate for concurrence. Creates a Task Force on Reimbursement for Language Services to recommend actions for achieving linguistic access to care.

Pending on the Assembly Floor

  • AB1840 (Horton) Requires the state to disclose names of employers who, rather than providing health coverage, have their workers and their families on Medi-Cal and Healthy Families. ( on concurrence)
  • SB437 (Escutia) Streamlines enrollment into children’s insurance programs. Support local children’s health insurance programs and expansions.
  • SB452 (Alarcon) Requires Medi-Cal to report to Governor on whether Medi-Cal prices are higher than prices for federal programs.

Voted on Senate Floor Monday:

  • AB2889 (Frommer) PASSED 37-1. Now returns to Assembly for concurrence. Allows patients in the individual market to transfer to similar health plans without underwriting that would lead to denial of coverage based on “pre-existing conditions.”
  • AB1948 (Montanez) PASSED 25-13. Now returns to Assembly for concurrence. Creates a feasibility study on simplifying application for Medi-Cal and Healthy Families using CHDP Gateway and electronic application.

Still pending on Senate Floor:

  • AB71 (Chan/Frommer) Establishes a clearinghouse for information about the safety and effectiveness of prescription drugs that are advertised on television
  • AB774 (Chan) Provides consumer protections against abusive hospital billing and collections practices, including those that charge uninsured patients multiple times what insurers pay for the same service.
  • AB1971 (Chan) Extends the sunset for the Managed Risk Medical Insurance Program (MRMIP), which covers patients with “pre-existing conditions” unable to get coverage elsewhere.
  • AB2667 (Baca) Allows the state to monitor Part D prescription drug plans in the same way it monitors health plans.
  • AB2877 (Frommer) Establishes a website listing sources that are safe for purchasing more affordable drugs from other countries.
  • AB2911 (Nunez/Perata) Allows the state of California to use its Medi-Cal purchasing power to negotiate discounted prescription drug prices for uninsured and underinsured Californians.
For more information, contact Health Access:

Sacramento · (916) 442-2308 · 1127 11th Street Suite 234 · Sacramento · CA · 95814
Los Angeles · (213) 748-5287 · 3655 South Grand Avenue · Los Angeles · CA · 90007
Oakland · (510) 873-8787 · 414 13th Street Suite 450 · Oakland · CA · 94612
Health Access California promotes quality, affordable health care for all Californians.
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