Special Session: Where to Start?

Monday, October 8, 2007

* AB8 (Nunez/Perata) would be largest expansion of public coverage since Medicare
* Governor has threatened to veto AB8; Special Session on health reform to continue
* ACTION ALERT: AB8 & its Affordability Standards Should Be Basis of Negotiations
* Other Special Session Updates, Including “Working Draft”

New on the Health Access WeBlog: SCHIP Updates; Rep. Watson’s Vote; Humor from Tragedy; Override Strategy; Sec. Leavitt’s Blog; Veto’s Impact in California; Other Clips; Special Session Gossip; Analysis of the “Unowned” Legislative Language on Health Reform

All eyes are on Sacramento in the next few days, as Gov. Arnold Schwarzenegger has approximately one week to sign or veto over 500 pieces of legislation.

BILL LIST: Up for consideration before this deadline is a handful of bills tracked by health consumer advocates, on everything from protecting consumers from insurance companies rescinding coverage, to broadening coverag to include mental health services; to expanding coverage for the working disabled.

For a list of bills of interest to health advocates, visit the Health Access California legislative tracking page (with a companion printable flyer), at:


By far the most far-reaching proposal on the Governor’s desk in health and likely any other issue is AB8(Nunez/Perata), a comprehensive health reform package that would expand health coverage to over 95 percent of Californians in the state — the most sweeping coverage expansion in four decades.

The bill was passed last month in the final days of the 2007 legislative session and would accomplish many of the goals Schwarzenegger laid out last year when he declared 2007 would be the “Year of Health Reform.” Unlike the Governor’s plan, which requires a 2/3 vote, AB8 can be passed and financed as a majority vote, allowing it to get to the Governor’s desk.

Instead of embracing AB8, though, Schwarzenegger has vowed to veto it.

ANOTHER VETO? Schwarzenegger’s fervor for health reform this year represents his own concession to a challenge, issued by the Legislature and health advocates over the past five years, who had passed significant and historic health coverage expansions, including an employer mandate, children’s coverage expansions and single-payer universal coverage measure, all of which he had opposed saying he wanted to find a “comprehensive’’ solution. If he follows through with a veto on AB8, it would be the fourth time he has blocked a major health care expansion effort.

SPECIAL SESSION CONTEXT: The Governor has called a “special session” of the Legislature to consider a compromise health care reform.

Recently, legislative language was released in Sacramento–unowned by anybody, but reflecting a proposal very similar to what the Governor announced in January. The Health Access WeBlog has a short description of the language, and how it compares with the Governor’s original concept paper, both positively and negatively.

Instead of this trial balloon, AB8 is made up of legislative language that has gone through the public legislative process. Short of the Governor signing the bill, AB8 should be the basis of negotiations.


* Tell the Governor that he should sign AB8.
* Tell the Governor that health care negotiations should start with how he would amend AB8.
* Tell the Governor that any health care negotitations should include the types of affordability protections that are in AB8.

Contact the governor at:
Gov. Arnold Schwarzenegger
State Capitol
Sacramento , CA 95814
FAX: 916.445.4633
To view the letter Health Access sent to the governor on AB8, click here.


AB8 would make significant strides toward universal health coverage. Once enacted, 95 percent of Californians would have health coverage.

Read the bill here, or read Health Access’ fact sheet on AB8 here.

Here are the high points of AB8:
· Expands Medi-Cal and Healthy Families to cover all children, up to 300%FPL and parents who are citizens/legal residents also up to 300%FPL.
· Creates a statewide purchasing pool initially for employees and dependents of employers that choose to use the purchasing pool. A new, affordable option for employers to cover their entire workforce, the purchasing pool would cover an estimated three to four million people.
· Establishes a minimum employer contribution to spend 7.5% of payroll on health benefits, either by paying into the purchasing pool or buying health insurance or other health benefits.
· Establishes a ceiling – at 5 percent of income – for what consumers are required to pay annually for health costs (including premiums and out-of-pocket costs).
· Reforms the individual insurance market so that coverage is available to anyone who wishes to purchase, by limiting insurers ability to deny people based on “pre-existing conditions,” and providing better funding coverage for those that are denied.
· Brings in new federal dollars to California ’s health system, through these expansions of public programs and employer contributions.
· Offers workers tax savings, by providing the ability to pay premiums, or share-of-premiums, with pre-tax dollars, for a savings of 15-40%.
· Places other rules and oversight on insurers, including limiting the percentage of premium dollars that go to administration and profit, rather than patient care.
· Provides modest reforms of job-based coverage to make it more accessible and affordable for employers.
· Encourages use of health information technology and disease management.
· Encourages cost savings through a bulk purchasing of prescription drugs, transparency of medical cost and quality information and creates a public insurer to compete with private insurers to help keep premiums low.


AB8 (Nunez/Perata) is a comprehensive approach to both expand health coverage, and to secure coverage for those who have it, but are concerned that it won’t be there for them when they need it.

It seeks to make health coverage more available, affordable, and automatic in each of the three ways that consumers now get coverage: through employer health benefits, public coverage programs, and the individual market. Health Access’ analysis of the current barriers for consumers in getting coverage, and how AB8 and SB840 would address those issues, is available on our website, here.

Passage and enactment of AB8 would be historic, as it would be the biggest health care expansion of since the creation of Medicare 40 years ago; it would set a minimum employer contribution for health care, as significant as the establishment of the minimum wage 70 years ago.

The proposal includes “shared responsibility” financing from employers, workers, state and federal government, and insurers. As a majority vote bill, it can be enacted into law with simply the Governor’s signature, without the need for additional financing or special federal waivers.


AB8 is now sitting on the governor’s desk awaiting action. It’s time to act. Please write Gov. Schwarzenegger, advising him of AB8’s import. The Year of Health Reform should not end with a vetoed bill.

If the governor wants something different or include different elements that would improve the bill, such as the Medi-Cal rate increase, he should start with the framework of AB8.

Again, contact the governor at:
Gov. Arnold Schwarzenegger
State Capitol
Sacramento , CA 95814
FAX: 916.445.4633

BONUS ALERT: The coalition Having Our Say, made up of groups representing communities of color, is seeking 1,000 signatures for their online petition, calling for health reform this year that reduces health disparities, increases access, and ensures affordability. The petition is at:

To view the letter Health Access sent to the governor, click here.

To view other resources from the Year of Health Reform, visit our website http://www.health-access.org/advocating/2007_healthdebate.html.

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