We’ll post our analysis shortly on the Governor’s language… but one thing…
The Governor suggested yesterday that it is just the numbers left to negotiate. Actually, it’s not just the numbers. There’s still issues about the fundamental framework. It starts with an individual mandate, without condition, exception, or limit.
Health Access supports proposals that include individual responsibility. But we believe that individual responsibility comes only after individual consumers are offered coverage that is available, affordable, and administratively simple for the consumer. After that, a mandate is mostly moot: Californian consumers want coverage, desperately, and overwhelmingly.
In AB8, which we supported, individuals are required to take up coverage that is offered through employers or a purchasing pool, if it was affordable. Affordability included affordable to get (premiums), affordable to use (out-of-pocket costs), and affordable in value (since it was negotiated by a large group). We have in the past supported other measures that included requirements on individuals to pay for or accept coverage and would do so again, but with similar protections, especially on affordability.
GROUP VS. INDIVIDUAL COVERAGE: In contrast, we are deeply troubled by a framework that is based on expanding the individual insurance market, which is the least efficient, most expensive way to get coverage.
AFFORDABILITY: Massachusetts, the only state to even enact an individual mandate (though it has yet to fully implement it), also recognized the need to have a clear statement that the mandate would be conditional on availability and affordability.
CONSUMER PROTECTIONS: They did so with a much more robust regulatory oversight over their insurance market, a much higher concentration of group coverage, and only after putting additional consumer protections in place.
If the Governor thinks that he’ll get support by just nudging the numbers, he’s mistaken. He needs to move from his January proposal.