It’s good that the Assembly Republicans have agreed there’s a need to fix the problems in health care, even if we disagree with many of the solutions. Some of their proposals—like raising Medi-Cal rates—make sense and are necessary. But many of the proposals would serve to undermine consumer protections and ultimately take the health out of health insurance.
We need to reduce costs, but not at the price of reducing care and coverage. As even insured Californians grow concerned that their coverage won’t be there when they need it, these proposal go in the wrong direction, providing less security for families.
The entire section on “maximizing choice” is focused on offering what many would consider a bad choice: watering down coverage by either reducing benefits or increasing deductibles. They find an impressive number of ways to accomplish the goal:
On benefits, one proposal would allow out-of-state plans, not subject to California’s consumer protection laws, to be able to operate here unregulated. (Would you like a plan regulated by the Alabama Department of Insurance?) Or they would allow plans sold without any minimum benefit standards, without covering cancer screenings, pap smears, or diabetic supplies. (The point of insurance is not having to guess what disease or ailment you might have, but to be covered regardless.)
They also have several bills to encourage high-deductible plans, through tax credits for Health Savings Accounts (which can only be used with plan of $5,000 deductibles or more). While even some proponents have said that such plans only work for the “healthy and wealthy” (and opponents sometimes question that, these proposals would encourage such “underinsurance” for public employees (through CALPERS), low-income families (through Medi-Cal), and even more stunningly, those with “pre-existing conditions.” This would actually serve to make coverage worse for many Californians.
There are other ways to contain costs, other than simply shifting them to consumers. Here’s a whole list, on the Health Access website…
There are things worth looking at in the Assembly Republican proposal, even if one or two of them seem to already be in existing law. For example, allowing small businesses to band together to get better rates on coverage makes sense: California had a purchasing pool for small employers, unfortunately this privatized program shut down last summer with little notice and less explanation. Similarly, increasing the number of nurses is a good idea: there have been several efforts to do this but more could be done. And there are things worth exploring like allowing employers to buy coverage that is both health insurance and the medical side of workers compensation.
And while we don’t think that high deductible plans make much sense for most people with pre-existing medical conditions, we agree that guaranteeing coverage is available for people with health conditions is the right step to take.
So we welcome the Assembly Republicans to the debate, even if consumer group disagree on key points.