Sen. Kuehl tries again for universal health care system in California

By Aurelio Rojas
Sacramento Bee
July 17, 2008

Six years after launching her effort, state Sen. Sheila Kuehl made a final pitch Wednesday to a legislative committee for a government-run universal health care system.

Senate Bill 840 would establish a single-payer system in which the state would assume the role that private insurance companies now play.

Gov. Arnold Schwarzenegger vetoed a earlier version of the legislation in 2006, calling it "socialized medicine," and has vowed to do so again.

That did not stop Kuehl, now in her last year as legislator because of term limits, or the Democrats who control the Assembly Appropriations Committee from praising a single-payer system during the overflow hearing.

"This plan would cover every California resident with comprehensive, affordable health benefits," Kuehl, D-Santa Monica, told the committee. "Once put into place, it would seriously contain the growth in health care spending and improve the quality of care that's provided."

Earlier this year, the Senate Health Committee that Kuehl heads rejected a health-care expansion plan negotiated by Schwarzenegger and then-Assembly Speaker Fabian Núñez. SB 840 then became the only option left in the Legislature.

Donna Gerber of the California Nurses Association, a sponsor of the bill, testified Wednesday that a single-payer system is "the only effective approach to reining in (the) insurance industry and solving the state and national health care crisis."

But Assemblyman Doug La Malfa, R-Oroville, said he opposes the bill because it would expand government's role.

"I hope that at the end of this debate … we can address some of these issues (with) more of a free-market approach," La Malfa said.

Marti Fisher of the California Chamber of Commerce testified that SB 840 would create "a huge, new underfunded bureaucracy while imposing new taxes and not addressing escalating medical costs."

The measure's supporters cited studies predicting that the legislation would drive down health care costs.

Opponents pointed to other studies concluding that costs would escalate.

An earlier version of the legislation called for the plan to be funded by a 12 percent hike on payroll taxes, with employers picking up 8 percent and employees the remaining share.

SB 840 does not say how the plan would be funded. Instead, it would create a task force "to design the funding that would meet the needs of the program and to figure out what that would be," Kuehl said.

While all the Democrats on the Assembly panel have signed on as co-author, no vote was taken because of the state's $15.2 billion budget deficit.

The bill, which cleared the Senate last year, could still be resurrected before the end of the current session and sent to the governor, depending on the outcome of internal discussions among Assembly Democrats.

But Assemblyman Mark Leno, the San Francisco Democrat who heads the Appropriations Committee, predicted "this will ultimately be decided at the ballot in some coming year."

California voters defeated a single-payer proposal in 1994, 73 percent to 27 percent. But supporters cite polls showing that backing for the concept has increased dramatically as health care costs have escalated.

After Wednesday's hearing, Kuehl said she hopes the Assembly will send her bill to the governor.

Another veto, she said, "essentially means that the executive branch under this governor doesn't have the vision that we have to help people with health care in this state."

Schwarzenegger supports a more limited state role. His plan would have provided coverage for 3.7 million of the 5.1 million permanently uninsured Californians by mandating employer and employee contributions, imposing a fee on hospitals, hiking cigarette taxes and leveraging the money to increase matching federal funds.

Kuehl and other Democrats who joined Republicans in voting against the governor's proposal cited a report by the Legislative Analyst's Office that concluded the plan could be underfunded by billions of dollars.

The senator, who estimated she probably made 30 presentations in the Legislature on behalf of her proposal, said support has grown in the past six years.

Kuehl cited 700 organizations, including most of the state's unions, that now support the idea, which she said will live on after she leaves the Legislature.

"There will be a new author," she said. "It will be re-introduced in January, (and) this is going to keep going until we get it."