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States are making their own moves towards healthcare reform, now that bills are stalled in Congress. One of the states best known for trail-blazing legislation is California. Its laws regarding auto emissions and other environmental issues have been adopted nationwide. Democrats in the state believe that the health insurance system cannot continue as it currently is. Their solution is a single-payer health insurance plan.

What is single payer health insurance? It goes further than the public option that was approved by the House of Representatives, but rejected by the Senate. In effect, the government-run health insurance plan would be the only option. Their intention with this health plan is to provide affordable health insurance to all residents in a state-wide health insurance system, to be paid for largely through taxes. This is closer to Canadian and European-style healthcare than any of the proposals that have received serious debate nationally. Only a handful of staunch liberals, such as Rep. Dennis Kucinich, have called for a full-blown single payer system. To drive his point home, Kucinich voted against the House’s healthcare reform bill.

The universal health care proposal would put a newly established state agency in charge of managing the public health insurance plan. Said agency would pay claims and negotiate fees for services. State Democrats admit that their own reform has become more urgent since the special election in Massachusetts, which elected Republican Scott Brown. However, the bill’s author–state senator Mark Leno–claims that the same bill was proposed last year, but pushed back. Brown’s victory simply highlighted the necessity for it.

However, the primary reason Leno’s proposal was originally shelved was cost. The Democrats’ plan for public health insurance in California is predicted to cost about $200 billion. The worst of the recession may have passed, but California’s budget crunch is still alive and well. Governor Arnold Schwarzenegger and legislators in Sacramento have been forced to cut back on many state programs as a result. Could a state recently on the brink of bankruptcy really afford this level of spending at this time?

According to supporters of the legislation, comprehensive healthcare reform could save money that might otherwise go towards other publicly financed programs like Medicare or Medicaid. Providing affordable individual health insurance to many of the 6.5 million uninsured people in California may actually help the economy, says Christine Kehoe. Kehoe is responsible for resurrecting the healthcare reform bill, as chairperson of the state Senate’s appropriations committee. In her opinion, reform would have a positive economic impact by freeing up some of the money used on health care, by private individuals (through high health insurance rates) and the public (through taxes to cover the often minor emergency room visits of the uninsured). Allowing the state government to set and negotiate rates for services has the potential to reduce costs. Those dollars could then be used more productively within the state, by public and private industries Kehoe believes are better able to create jobs.

Republican legislators are betting that the attempt at reviving the health insurance issue will fail. They are also accusing Democrats of being out of step with the public. Several earlier proposals passed the legislature, but were vetoed by the governor. Schwarzenegger has vowed to oppose this one as well; but term limits mean that he will be out of office next year. Democrats are hoping that a new governor would be more open to the proposal, although recent signs of the current political climate make that unlikely. With enough funding and petition signatures, it is possible to get nearly any measure on a California ballot; therefore, any healthcare reform bill that manages to pass could be overturned soon after.

In addition, the state legislature has not even begun to deal with the impact undocumented immigrants would have on the bill. Illegal immigrants were specifically excluded from the federal health insurance subsidies and accompanying exchange markets in the congressional bills. California has an especially large immigrant population, including many families with mixed legal status. It is unknown what percentage of uninsured Californians are undocumented immigrants, but even many supporters of a single-payer system are leery of sparking yet another political controversy.

Ironically, Scott Brown may actually agree with certain aspects of this plan. As a state senator, he voted for healthcare reform in Massachusetts–albeit less far-reaching and more privatized than the reform California is considering. Moreover, much of Brown’s opposition to Congress’ healthcare reform bill is based on the argument that each state should make its own decisions, as opposed to subsidizing states that weren’t as prepared. For all we know, he may approve of California going its own way.

(Image: Official California Website)

Yamileth Medina is an up and coming expert on Health Insurance and Healthcare Reform. She aims to help people realize that they can find quality individual health insurance right now. Yamileth lives in Miami, FL.

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