What’s my quick take on the new proposal?
While we have yet to see legislative language, the framework of the new proposal provides more help to more people to help them get affordable health care than either the Governor’s plan or the legislative leaders’ previous proposal.
* The new proposal would expand public program coverage not just to children and parents, but low- and moderate-income adults without kids as well. It’s the biggest public program coverage expansion since Medicare, maybe even including Medicare.
* It would raise Medi-Cal provider rates, to benefit the health system on which we all rely, and to expand access for those on Medi-Cal.
* It would allow for subsidies up to 450% of the federal poverty level, and provide a statewide purchasing pool, so that people get coverage that is both affordable, and negotiated by a group purchaser.
* There’s a minimum benefit of a broad benefit package (Knox/Keene plus prescription drugs), and that it can be defined upwards from there.
* The proposal combines the good prevention and cost containment elements of the Governor’s proposal (e-prescribing, health information technology, prevention on obesity and tobacco use) with the strong cost containment elements of AB8 (trasnparency, bulk purchasing of prescription drugs, a public insurer option).
In addition to providing more benefits to more Californians, the proposal seeks to spread the risk and cost more broadly, with multiple funding sources. While we are still looking at the details, this is a fair framework, making coverage more available and affordable in each of the ways that people get coverage, through public programs, on-the-job benefits, or the individual market.
ON INDIVIDUAL RESPONSIBILITY: Perhaps the biggest philosophical issues for consumer groups was the individual mandate. The questions was never individual responsibility… people want coverage, desperately.
The question and concern was about the affordability and value of coverage, and the new proposal takes major steps in answering those questions. The affordability protections in the new proposal is a major step, and sorely lacking in the Governor’s proposal. We still have questions about how this would work, and so are looking to the legislative language.
ON THE POLITICS: The legislative leaders moved much more signficantly toward a deal than the Governor did when he modified his proposal a few weeks ago. This proposal meets all the issues the Governor raised when he vetoed AB8, and then some. It’s now time to see if the Governor is willing to meet the promise of his rhetoric, of making sure that people can get affordable coverage, by adopting this framework.