A mistaken autopsy…

Daniel Weintraub has his own post-mortem of health care reform in the Sacramento Bee. This should not be the last word on the subject.

First, there’s some straight-out inaccuracies: For example, he states that the Legislature’s original proposal, AB8, “would cover only employees,” when in fact it had public program expansions based on income, not employment, for both children and adults. He also stated that the final negotiated plan, AB x1 1, did not cover part-time workers (when, in fact, part-timers were covered, largely under the public program expansions–the question was whether employers would have to pay a contribution on them as a specific population).

There’s glaring omissions: the fact that consumer groups don’t get any mention at all is telling in Weintraub’s worldview. Or that the Governor only released legislative language for his proposal, not to mention make any movement on policy–a month *after* the legislative session had ended, in October. The timing mattered, since it was a crucial reason why the effort ultimately ran out of time a few short months later.

But the biggest problem is Weintraub’s thesis statement, as proposed in the final sentences of the first paragraph:

The bill died in a partisan crossfire, opposed from the beginning by conservative Republicans and ultimately killed by liberal Democrats. It was a centrist approach in a Capitol where centrism has become a dirty word.

AB8 was also opposed by Sen. Kuehl and those organizations who oppose major health reforms that are not single-payer. (This is a distinct group from many organizations who support single-payer as well as other health reforms, including Health Access.) Such attacks didn’t help AB x1 1 and are certainly part of the mix… but there are other key reasons that AB8 passed and was placed on the Governor’s desk, and AB x1 1 wasn’t. The notion that AB x1 1 died at the hands of liberal purity doesn’t make sense when AB8 passed the Senate floor a few short months earlier.

Senator Kuehl made her opposition clear early, but it would have passed without her vote. The question of whether the bill would pass out of Senate Health Committee rested on so-called “centrist” members, especially when one of them, Senator Yee, made a public pronouncement about his “no” vote.

There’s real questions about timing, the process, the salience of the proposed policy, the politics betweeen the two legislative houses, the political will in the Senate, and yes, about the influence of insurers that didn’t want to cover the sick, employers who didn’t want to cover their workers, and tobacco companies that didn’t want their product taxed.

Weintraub is right that the two-thirds vote requirement and the solid blockade of opposition from Republicans on any major health reform made it so that the Republicans marginalized themselves, but created significant procedural and political barriers for those pursuing health reform.

But the rest of the negotiations on policy and politics between the Governor, the Assembly and the Senate can’t be explained using a left-center-right axis. That’s the kind of analysis that obscures, rather than illuminates, the discussion.

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