Governor Schwarzenegger signed AB1422 today, which along with increased premiums, increased copays, and contributions from First Five provide the resources to prevent loss of Healthy Families coverage for over 900,000 children. Anticipating this signature, the Managed Risk Medical Insurance Board has already started processing the nearly 90,000 children that have been left uninsured on a waiting list for the last month or so. We should have never have been in this situation, but this is good news that such a major crisis was averted.
Health Access California joined the 100% Campaign, the community clinics, Western Center on Law and Poverty, and other organizations in supporting AB1422 by Assembly Speaker Karen Bass which creates a gross premium tax on managed care organizations that can be used to draw down federal match to fund Healthy Families. But it was our frequent adversaries, the HMOs and health insurers themselves, that provided essential support for the bill.
We here at Health Access California go head to head with HMOs and insurers day after day, year after year. HMOs and insurers are among our most frequent adversaries and only rarely on the same side with us. So it is a rare day when we give them credit for helping to get something good done. They had their own interest in supporting the measure, but it still was a good thing to do.
Particular credit is due to John Ramey, who now heads the association that represents the local initiatives, California’s home grown public options for Medi-Cal and Healthy Families. John Ramey was one of the first staff at MRMIB when it was created. We know him more recently from his work with the Chamber of Commerce opposing an employer mandate ballot measure in 2004—and in working with Governor Schwarzenegger for health reform in 2006-07. John was committed to avoiding the destruction of the Healthy Families program as a result of the devastating cuts done in the July budget: he revived the notion of reconfiguring the existing provider fee for HMOs into a gross premiums tax that could draw down federal match.
I know the lobbyists who are on staff with the various insurers and HMOs as well as the trade association lobbyists and the very highly paid contract lobbyists from some of the highest billing lobbying firms in Sacramento. I spend a lot of time in the halls of the Capitol with these folks. The lobbying firms included Lang Hansen O’Malley and Miller as well as Sloat Higgins, both firms that bill a million dollars or more a quarter (http://cal-access.sos.ca.gov/Lobbying/Firms) One of these contract lobbyists once accused me of wanting government-run health care because of the modest reforms to label products in our AB786! So the gulf that exists between their world and mine is not just about who their clients are and how much they charge but their perspective on issues.
I watched over the last few weeks as these lobbyists sweated vote by vote to pull out the victory that looks easy from the vote totals but was very much a day by day effort. These lobbyists assured Republican legislators that there was no official opposition, even from many conservative tax groups, and that at the last critical moment, the Chamber of Commerce senior lobbyist came to lobby on our side of the fight. It is the tradition on the corporate side to hire both conservative Republicans and former Democratic staff: it meant that the face of this fight was often a HMO trade association lobbyist who used to lobby for the Chamber of Commerce or a HMO staff lobbyist that is a former Republican staffer well known for his conservatism.
Credit is also due to Sumi Sousa, Speaker Bass’ staff; David Panush, staff to Pro Tem Steinberg and Jennifer Kent in the Governor’s office. The three of them worked in tandem to make this happen. While their bosses get the public credit (after all Bass, Steinberg and Schwarzenegger were elected, not the staff!), the staff does a lot of the day to day, hour by hour work to get things done.
Of course, thanks are also due to the many advocates who supported this effort as well—but for once, we had the easier assignment.
In a year when we have seen such devastating cuts in health and human services, it is good to have averted the worst of the cuts to Healthy Families.