Health care reform in California is in stall mode right now, and with each passing day the price tag for gathering signatures rises.  But between the twin fundraising efforts of the Speaker and the Governor, as long as they cancel travel for a month they should be fine.

What’s working against the proponents of health care reform, in my view, is the continuing tragedy of Nataline Sarkysian.  By November 2008 this will be out of the headlines, but within weeks the State Senate will be debating the merits of a reform measure that keeps the insurance companies in business to do this:

A Friday funeral was set for the Northridge teenager who died last week after her insurer refused to pay for a liver transplant and then reconsidered. Meanwhile, the girl’s health plan stood by its initial decision Monday.

Philadelphia-based Cigna HealthCare has a record of approving coverage for more than 90% of all transplants requested by its members, as well as more than 90% of the liver transplants, company President David Cordani said in a memo addressed to employees and distributed to members of the media.

This is definitely a time to be citing statistics.

CIGNA clearly makes decisions based on corporate profit and lawsuit threats.  They decide what treatments are “experimental” based on flowcharts and spreadsheets, not by looking into their customer’s eyes.  And their complete lack of empathy proves that they’re willing to let this continue.

Just the other day, a state appeals court ruled that insurers cannot play the game of canceling coverage because of faulty applications only when the patient actually needs to use their health care.

California health insurers have a duty to check the accuracy of applications for coverage before issuing policies — and should not wait until patients run up big medical bills, a state appeals court ruled Monday.

The court also said insurers could not cancel a medical policy unless they showed that the policyholder willfully misrepresented his health or that the company had investigated the application before it issued coverage […]

The decision came in a closely watched case involving Steve Hailey, an Orange County small-business owner whose coverage was canceled by Blue Shield of California after he had a disabling car accident. The ruling in favor of Hailey sends the case back to the lower court for trial and requires Blue Shield to pay Hailey’s appellate costs.

The types of tricks of the trade employed by CIGNA and Blue Shield are a nationwide trend.  Legislation and lawsuits have yet to stop them.  They’ll claim that they can’t do business without this kind of chicanery.  At some point, government must grant their request.

California is dragging down the rest of the country with its job performance statistics:

California gained just 900 payroll jobs last month, the state said Friday, a lackluster showing that reflects a national slowdown attributed in part to the housing slump.

The slight gain followed a revised loss of 13,500 jobs in October, the Employment Development Department said.

The slowing job market combined with declines in taxable sales and falling home prices “paint a picture of an economy that is slowing sharply,” said Stephen Levy, senior economist at the Center for Continuing Study of the California Economy

In California, a little more than 1 million people were looking for work last month, an increase of 16,000 from October and up 186,000 compared to the year-ago period.

The state’s unemployment rate was unchanged from October at 5.6 percent. It was 4.7 percent in November 2006.

Significantly, it’s the rising cost of living that is playing a part in sinking the state.  With people unable to fall back on their home equity for cash, they slash spending, and nobody’s buying any homes, which leads to declines in the construction industry.

So don’t expect payroll taxes to somehow save us from our budget woes.  And don’t expect the magic 10% across-the-board cut fix to work, either.  First of all, it’s unconstitutional.  And that’s just part of the problem.

“Can he get across-the-board cuts comprehensively? No,” said Jean Ross, executive director of the California Budget Project, a nonpartisan group that advocates for poor and middle-class families. Not only does the state have to comply with various laws and court orders, it has debts to pay, paychecks to deliver, and everything from schools to prisons to maintain.

“I could go on and on and on,” Ross added.

And this is where the recession meets up with the proposed health care reform.  Before such a program would kick in, you’re looking at a governor who may attempt to throw the health care system into more chaos than it’s in now, because it’s one of the only areas where he isn’t legally constrained against cutting:

“I think some people think that 10 percent may sound fair and it’s not that much, until you recognize what that means on a human level,” said Anthony Wright, executive director of Health Access, a statewide health care consumer advocacy coalition.

Wright said a 10 percent cut in the state’s health insurance program for the poor means 680,000 of 6.8 million recipients could be left without coverage.

If people aren’t denied coverage, Wright said the governor could slash benefits dramatically so that patients can’t get wheelchairs, prosthetic limbs or asthma inhalers.

Whether ABx 1 1 would restore all this public money or not (and the price tag is low if they think it will), the amplification of costs from two years of a lack of even the most basic care for the poor would be enormous.  Yet the Governor will claim on one day that our health care problems are solved, while on the next day slashing budgets so that they end up even worse.  This is his modus operandi, and you can’t trust someone with this track record.

Gov. Arnold Schwarzenegger won re-election in 2006 by selling himself as a problem solver who boosted California’s economy and resolved the state’s budget problems, all without new taxes.

The Republican governor declared in January that “through discipline and through new revenues that come from economic growth, we reduced the deficit over time and got our fiscal house in order.”

But less than a year into his second term, the narrative has run dry […]

“I think the problems were deeper and more structural than the governor realized when he was first elected,” said Jean Ross, executive director of the California Budget Project, which advocates for poor and middle-class families.

“There is a fundamental imbalance between revenues and expenditures,” Ross added. “Many budgets that were signed into law, including those signed by the current governor, made the problems worse, not better.”

Remember the 2004 “Performance Review,” which we were told was all that was needed to fix the budget problems (“Open up the books!  Then we’ll see the numbers!”)  Practically nothing that came out of that review was put into law.  Everything this Governor has ever said has been hype, as he plowed ahead with the same wrongheaded conservative solutions of passing off crises to future generations.

That’s why, given the fact of watching this guy operate over 4 years, it’s nearly impossible to give him the benefit of the doubt on anything.

Arnold Schwarzenegger, recognizing that you don’t build prisons as quickly as one of his movie sets, understanding that the upcoming 3-judge panel decision on the prison crisis was bound to be punitive, is planning to dismiss 12% of the prison population.

In what may be the largest early release of inmates in U.S. history, Gov. Arnold Schwarzenegger’s administration is proposing to open the prison gates next year for some 22,000 low-risk offenders.

According to details of a budget proposal made available to The Bee, the administration will ask the Legislature to authorize the release of certain non-serious, nonviolent, non-sex offenders who are in the final 20 months of their terms.

The proposal would cut the prison population by 22,159 inmates and save the cash-strapped state an estimated $256 million in the fiscal year that begins July 1 and more than $780 million through June 30, 2010. The proposal also calls for a reduction of more than 4,000 prison jobs, most of them involving correctional officers.

This seems to be as much about saving money as resolving the crisis.  Still, it’s a ballsy move.  Except it reveals the distasteful options that result when you let a problem go this long without doing anything.

Instead of releasing 22,000 prisoners who have had rehabilitation and treatment and education and the skills needed to rotate back into civil society, the Governor wants to release 22,000 prisoners who went in for nonviolent offenses, but who got caught up in a crowded system, completely lacking in the treatment services they needed, and who essentially were matriculating in Crime College.  A system as bad as California’s turns nonviolent offenders violent.  It doesn’t equip them for the real world.  And that can be witnessed by the nation’s largest recidivism rate.

This is the problem that has little in the way of good solutions.  Skimming off the top is something you can do, but its consequences are real, and the Tough on Crime folks will seize upon every offense made by these prisoners, and demonize Schwarzenegger as “Governor Pardon” (by the way, this is the END of his aspirations for higher office, this proves he’s not interested because this is such campaign fodder).  The best solution is a long-term one that doesn’t scoop out the nonviolent offenders, but fundamentally changes the sentencing guidelines so the clog becomes reduced, and taking advantage of less crowded prisons in the interim to implement real rehabilitation and treatment programs that can reverse this disappointing recidivism trend.

UPDATE: Skittish, afraid-of-their-own-shadow lawmakers predictably stand up in opposition to this plan, because the other option of having the courts mandate an even larger release is such a better idea.  I don’t think skimming off the top is such a bright idea either, but no legislator dares wrap it in a critique of the failed prison system.

I think this may end up being less of a problem in the Feb. 5 primary than people may think.  Low-information Democrats probably think this sounds like a decent idea.

ABC’s Sunlen Miller Reports: Barack Obama has often said he’d consider putting Repbulicans in his cabinet and even bandied about names like Sens. Dick Lugar and Chuck Hagel. He’s a added a new name to the list of possible Republicans cabinet members – Arnold Schwarzenegger […]

“What (he’s) doing on climate change in California is very important and significant. There are things I don’t agree with him on, but he’s taken leadership on a very difficult issue and we haven’t seen that kind of leadership in Washington,” Obama said of the California governor.

Honestly, until I see a full transcript, I wouldn’t say definitively that Obama actually suggested Arnold for his cabinet.  It sounds like, from the story, that he said he’d likely have Republicans in his cabinet (remember, even George Bush had a Democratic Secretary of Transportation, California’s own Norman Mineta), and here are a few Republicans he respects.

Of course, Obama doesn’t live here, and doesn’t see, for example, Schwarzenegger’s attempts to slow-walk the global warming law to favor business.  Or his irresponsible borrow and spend policies and refusal to address the structural budget problem.  Or his desire to bust unions.  Or his cuts to care for mentally ill homeless people.  Or… well, I could go on.

[UPDATE] by Julia  According to the transcript sent to me by the Obama campaign via email, so no link, cant verify, Obama did not directly suggest Arnold as a potential member of his administration, but rather gave his name as a person going good things on the environment.  It’s on the flip.

Questioner: When you were mentioning the list of great Democrats in the past, Presidents Roosevelt and Kennedy, by the way I hope in the future you mention Truman as well.

BO: Truman was a good one.

Questioner: Yes, but when you were mentioning those two, they were famous for having Republicans in their administration to help bring the country together. Are there any Republicans that you could tell us about tonight that you would like to be part of the Obama administration?

BO: You know its premature for me to start announcing my cabinet. I mean I’m pretty confident, but not that confident. We’ve still got a long way to go. I can tell you Republicans I respect though.  Dick Lugar who I worked with on issues of arms control., wonderful guy we traveled together to Russia we toured nuclear facilities there. Talked to Russian generals about how countries could cooperate in reducing nuclear threats. He is somebody who embodies a tradition of bipartisan foreign policy that is sensible that is not ideological that is based on the idea that we have to have to have some humility and restraint in terms of our ability to project power around the world and we have to use diplomacy as a tool. Chuck Hagel, Vietnam veteran similar approach. Somebody whom I respect in a similar fashion. You know I don’t agree with him on much, but what Schwarzenegger is doing I think on climate change in California is very important and significant. There are things I don’t agree with him on, but he’s taken leadership on a very difficult issue and we haven’t seen that same kind of leadership in Washington, but climate change should not be a partisan issue we’re all living on the same planet and there are ways of structuring an approach to climate change like a cap and trade system I’ve suggested. That can be market driven and generate investment and job opportunities that can grow the economy and that would be a very pro growth agenda over the long term.

Arnold Schwarzenegger and Jerry Brown went right to work Tuesday, preparing to sue the federal government “at the earliest possible moment” for the EPA’s denial of a waiver to let California implement Fran Pavley’s AB1493, the law regulating auto tailpipe emissions that was to begin with model year 2009.  The regulations, which sought to control greenhouse gases and not just boost auto efficiency standards, would have had the effect of an increase in MPG to roughly 43, far above the 35MPG by 2020 just mandated in the federal energy bill.  Indeed, the EPA in its decision noted the passage of the energy bill as a reason to deny California’s request, claiming that there should be one standard and that the new bill pre-empted California’s authority.  So much for state’s rights conservatives.

The lawsuit is about as close as you can get to a slam dunk.  The case law is already enormously in favor of California.  They have been granted every waiver they’ve ever requested from the EPA since the passage of the Clean Air Act in 1963, and the “compelling and extraordinary conditions” of the state’s topography, climate, and number of cars on the road has always been specifically cited.  That hasn’t changed.  In addition, federal lawsuits in California and Vermont have upheld the standards set out in AB1493 as fully legal.  And just this year, the Roberts Supreme Court has ruled in Massachusetts v. EPA that the federal government can regulate greenhouse gas emissions, writng that:

“Judged by any standard, U.S. motor-vehicle emissions make a meaningful contribution to greenhouse gas concentrations.”

Sadly, it’s true that the Bush Administration probably has the ability to put up enough of a fight in the courts to make implementation virtually impossible so long as he remains in office.  And so this is likely to come down to a decision for the next President to make.  So you would think that the media, knowing this, knowing the potential of global warming to impact all of our lives, would bother to ask a question about it.  But so far in 2007, out of 2275 questions asked of the Presidential candidates on the Sunday chat shows, 3 mentioned global warming.  Here’s a news peg, Russert, Stephanopoulos, Blitzer, Wallace and Schieffer.  Have at it!

The New York Times has more on this.

(bumped with new info. – promoted by David Dayen)

Barbara Boxer and Henry Waxman are expecting defeat in the fight to get the EPA to grant a waiver to the state so it can implement Fran Pavley’s landmark tailpipe emissions law.

In a gathering with reporters Tuesday, Sen. Barbara Boxer, D-Calif., said she has “very little hope” that the EPA will grant the waiver, which would open the door to California and more than a dozen other states imposing emission standards more stringent than federal requirements […]

Asked whether she thought the decision would be made by the EPA or at the White House, Boxer said: “If you look at everything done on the environment, a lot of this leads back to the vice president’s office.”

“Politics is alive and well in relation to this waiver,” said Boxer, chair of the Senate Environment and Public Works Committee.

It’s difficult to understate how abnormal this would be.  The EPA has never denied a waiver to California allowing them to regulate their own emissions.  

The EPA Administrator, Stephen Johnson, has claimed there will be a decision on the waiver by the end of the year, but he’s ducking requests for meetings with Boxer, and ignoring letters from Waxman.  The handwriting is on the wall.  I don’t know if the lawsuit prepared by the state demanded that a decision be made on the waiver or that the waiver be granted.  Either way, expect some legal recourse as a result of the expected denial.  And expect little movement on implementation of a law central to California’s efforts to curb emissions until the swearing in of a new President.

UPDATE: They denied the waiver.

The Environmental Protection Agency on Wednesday slapped down California’s bid for first-in-the-nation greenhouse gas limits on cars, trucks and SUVs, denying a request for a waiver that would have allowed those restrictions to take effect.

“The Bush administration is moving forward with a clear national solution _ not a confusing patchwork of state rules _ to reduce America’s climate footprint from vehicles,” EPA Administrator Stephen L. Johnson said in a statement.

Expect a flurry of lawsuits.

UPDATE II: Waxman:

EPA’s decision ignores the law, science, and commonsense.  This is a policy dictated by politics and ideology, not facts.  The Committee will be investigating how and why this decision was made.