Update: AB 8 Passed the Senate and the Assembly

(Note: I work for the It’s Our Healthcare Coalition which includes member organizations in support of both SB 840 and AB 8).

This morning, Assembly Speaker Fabian Nunez and Senate Pro Tem Don Perata held a press conference about AB 8. 

They were joined by supporters of AB 8 such as Count Dracula, the CEOs of all of the major health insurance companies in California, the honorary co-chair of the Schwarzenegger for Senate 2010 committee, and a bunch of people who like to drown kittens. Oh wait, that’s not what happened at all. 

Yet that’s what you might have expected given the rhetoric coming from some quarters. The rhetoric has gotten well beyond ridiculous, and it’s time to stop engaging in bizarre fantasies and the shrill invective and start talking seriously about the healthcare reform debate in California. 

When it comes to debating the merits of AB 8 and SB 840, it’s easy to bash insurance companies and  it’s easy to believe that politicos are about to sell us out on something so vitally important.  But none of that deals with the fact that large elements of the progressive movement are supportive of AB 8 for very legitimate reasons. 

Reasonable people can disagree.  Nobody is compelled to support AB 8.  But to ignore these stakeholder groups and their legitimate interests in seeing healthcare reform this year (much less to demonize them as some have done) is not only bad politics, it’s wrong.

[More on the jump]

First, let’s look at some of the groups who have come out in support of AB 8:

• The California Labor Federation
• SEIU
• AFSCME
• the Unitarian Universalist Legislative Ministry of California
• AARP-California
• California ACORN
• the Latino Coalition for a Healthy California
• Congress of California of Seniors
• AFTRA
• Health Access California

They’re not exactly the Legion of Doom. 

Were AB 8 to pass, it would represent the single largest expansion in health coverage in decades.  It would extend coverage to literally millions of Californians. AB 8 would cover approximately 70% of the uninsured, a tremendous increase over SB 2 (passed in 2003), which would have covered approximately 20% of the uninsured had it not been repealed via referendum (Prop 72) in 2004. 

There is no denying that AB 8 is not universal healthcare.  But there is nobody who is seriously arguing that true universal healthcare, much less single-payer healthcare, will be signed into law in California this legislative session. 

And so those who argue that we ought to withhold support for AB 8 in favor of waiting for something better (e.g. SB 840) are actually saying that it is better to continue to allow people to suffer now and take the risk that nothing substantial will happen for years instead of helping those we can in the interim.

For the 4.9 more than three million Californians who would get coverage under AB 8, the issues are real and urgent, and asking them to wait even another year is asking them to endure the risk of incalculable harm: bankruptcy, preventable sickness and death, harm to themselves and their loved ones.  It is fine to argue that AB 8 does not represent a complete solution to the healthcare problems we face, and I would agree with that.  But absent a strong argument (one that shoulders the burden of proof) it’s simply callous to ask that others be martyred and denied protection based on some abstract political calculation. 

And make no mistake about it, a political calculation is what undergirds all of the arguments against AB 8 from those who will not tolerate anything less than a jump from the status quo to a single-payer system in one fell swoop. 

There is no reason that I have seen offered by supporters of SB 840 to oppose AB 8 in its current form except that a) AB 8 putatively helps the insurance companies by expanding health insurance coverage to more people and b) passage of something now might stymie a change to a universal or a single-payer system. 

THE MOMENTUM ARGUMENT

First, let’s deal with the issue of momentum.  Opponents of AB 8 like the California Nurse’s Association have (amazingly) pointed to the enactment of Medicare as an example of gradualism gone awry, thereby killing momentum for fundamental reform.  RoseAnn DeMaro, the Executive Director of the California Nurses Association, in an article with the inflammatory title of Whose
Life Doesn’t Count? writes:

With public frustration over the collapse of our healthcare system mounting, we have the greatest opportunity in years to achieve fundamental reform. Yet the gradualist approaches would undercut the momentum and squander that opening.

Our most successful national health program, Medicare, also provides one of the best arguments against incremental steps. When Medicare was enacted 40 years ago many contended that the dream of a full national health system was right around the corner.

Four decades later, Medicare has not been expanded. Most of the changes have been contractions – higher out of pocket costs for beneficiaries and repeated attempts at privatization by the healthcare industry and its champions in the White House and Congress.

 

You follow that logic?  Medicare is “our most successful national health program,” which demonstrates that we ought not to take incremental steps like…the enactment of Medicare.

We know we can help millions of people now. We don’t know whether it is even possible, much less likely, that we will be able to enact more meaningful reform in the next couple of years.  I don’t think that this means we pack up and settle for something short of a solution.  But taking one affirmative step towards a solution does not mean that you can’t take another step later on.  Does anyone really think that enacting Medicare seriously made us worse off? Would any progressive, if they could go back in time, argue against its enactment because of our current situation? Bueller? Bueller? 

THE ROLE OF INSURANCE COMPANIES ARGUMENT

Anyone who’s concerned about the role of insurance companies in our healthcare system would be perverse to oppose AB 8. Here’s why: AB 8 substantially reforms the role of insurers in our healthcare. It sets a floor for the percentage of premium dollars that must be spent on healthcare (85%). It creates a public insurer to change the playing field and guarantee that there’s real competition with low overhead and driving the market in the right direction. Finally, it bans denial of insurance for pre-existing conditions and actually requires health insurance plans to help fund a real, adequately-funded, high-risk pool.

Many of the things we hate about insurance companies are now completely and utterly legal.  It boggles my mind that anyone who supports single-payer healthcare wouldn’t, while we still have the current system, want insurance companies to be better regulated.

(Disclosure: I work for It’s OUR Healthcare.)

The state legislature is down to its final days of the session and Blue Cross alerted their list of insurance agent supporters that current reforms on the table are “unhealthy.” (And the status quo isn’t?)

The fact of the matter is that Blue Cross, and like-minded groups, are adamantly opposed to real healthcare reform in California: creating astroturf front groups (with a laundry list of insurance agent supporters) and running print and radio advertisements stressing “responsible” reform as part of a scare-tactic campaign.

But what’s really irresponsible is standing in the way of meaningful healthcare reform.

Below is a video parody of the Monty Python’s The Life of Brian, specifically, “Always Look on the Bright Side of Life.”

With that, I give you Blue Cross’ “Always Look on the Bright Side of Death.”

(Dude must have been hot in that suit. – promoted by Julia Rosen)

In Los Angeles yesterday, Blue Cross was brought before the Department of Managed Health Care (DMHC) following 4,100 calls and complaints in the last three years. The Sick of Blue Cross petition drive turned in more than 1,600 in only one week’s time.

The hearing gave Californians a great opportunity to hold the state’s largest for-profit health insurer accountable for dangerous business practices such as only covering the healthy and denying coverage to the sick. Blue Cross is also notorious for raising rates however and whenever it chooses.

Find out more and see pictures of Mr. Sick of Blue Cross below the fold…

For years, Blue Cross has treated California like an ATM machine and recently shipped $950 million in profits to its corporate parent, WellPoint, based in Indiana.

But yesterday’s hearing is just the beginning – and there’s still much more work to do to get Blue Cross to clean up its act because these practices are simply unacceptable.

Health advocates gathered outside with signs and placards saying “I’m sick of Blue Cross” and repeating chants of “Hey Blue Cross you can’t hide — we can see your greedy side.” (Check out video courtesy of NBC-TV San Diego.)

Once inside, past and present Blue Cross policyholders told their stories of premiums going up and benefits going down, rejected claims and denied coverage — all this conducted by a health provider that claims it supports “access to all Californians.“

Now our work shifts from the Los Angeles hearing room to the Capitol in Sacramento, where the Assembly and Senate must keep their promise to enact meaningful healthcare reform when they return later this month.

Blue Cross is leading the opposition to healthcare reform in California – and we’re going to need your continued help to fight back and pass real reform this year. Earlier this year, Blue Cross committed $2 million for a campaign to stop healthcare reform in California under the auspices of “responsible” reform. This campaign to stifle change already includes print and radio ads criticizing reform efforts, using fear-mongering tactics to make Californians afraid of change in the healthcare system.

Sick of Blue Cross is a project of the It’s OUR Healthcare! coalition

Health Advocates Take on Blue Cross

(I love me some liveblogging. Just so everyone is clear: SB 840 is Keuhl’s single payer bill and AB 8 is the Nunez/Perata bill that stays within the private insurance model. – promoted by juls)

Things are about to get underway as It’s OUR Healthcare! will be liveblogging from the John L. Burton Hearing Room where the Senate Health Committee chaired by SB 840 author, State Senator Sheila Kuehl (D-Santa Monica), will meet at 1:30pm.

Senator Kuehl is setting the ground rules for the hearing. (No cheering, clapping or booing.)

Scheduled to speak are the Speaker of the Assembly Fabian Nunez (D-Los Angeles) and Senate President Pro Tem Don Perata (D-Oakland).

Check for updates below the fold.

Speaker Nunez has just arrived and will start the discussion on AB 8. Senate Pro Tem seated right beside him.

In front of Senator Kuehl is a white sign with black text: “DO NO HARM.”

Speaker Nunez says that he and Perata are pleased to be here to make a major step in ailing a system that is broken.

Nunez: [Kuehl] You are a champion of healthcare for all Californians.

Nunez: AB 8 built on the idea of shared responsibility between employers, government and individuals. These measures will not fix the entire healthcare market, but improve it. This is a rare opportunity to fundamentally improve our healthcare system. We need to act now; take advantage of this opportunity.

Nunez: All of the uninsured children in California will be covered by this legislation. It will move 3.4 million (of the 6.5 million) under coverage.

Nunez: This is not a perfect plan, but will help pave the way for “real healthcare reform.”

Senator Perata now at the podium.

Perata: “[Bills merged because] we got tired talking to each other. We wanted to talk to the Governor.” Says we should have a national healthcare program. “Scandalous” that the U.S. is “woeful” on healthcare. California must provide the leadership [for the country].

Kuehl: In MA, they just added “affordable” to the name.

Witness: (Speaking of SB 840 support) “It seems like Kuehl’s gang were all over the place.” Kuehl replied jokingly, “Kuehl’s angels, we call them,” and the room chuckled.

Angie Wei, California Labor Fed acknowledged the huge number of IOH supporters that have traveled from across the state today. Provisions supported: Creation of statewide purchasing pool; establishment minimum of healthcare spending requirement; subsidies and discounts for families below 300% poverty level.

Concerns: issue of cost containment (union members have been able to hold on to their healthcare but pay a dear price for that; early retirees face risk of losing their healthcare; current system is unsustainable); affordability (we need to protect families from maximum exposure out of pocket).

Beth Capell, Health Access California: [Legislators] have been receiving healthcare Stories of the Day. Retells her own personal healthcare story involving her husband. “Never once did we worry we whether we could pay for his care. It should be that way for everyone.”

Number of studies released today on employer-based coverage. AB 8 would have a modest, yet positive, impact on California’s economy and not cost jobs.

Capell: We can do something this year that will improve the economy and help with people’s care.

Witness: AB 8 would improve healthcare for low-income Californians.

Mary Hernandez, SEIU: We support AB 8 if amended to control healthcare costs.

Gary Passmore, Congress of California Seniors: Add amendments on two issues for support; truly a work in progress; “we like what we see”

Consumers Union: support if amended; transparency a must;

AFSCME: We want to make sure this bill includes cost controls.

California Medical Association: support if amended; refinement of cost control efforts; inclusion of fiscal transparency

CNA voiced opposition to AB 8, instead favoring SB 840.

Senator Sam Aanestad (R-Grass Valley) suggested to the Speaker that he work with the chair, put a hold on the bill and work on it through the fall.

Kuehl: “I don’t like your bill as much as I like my bill.” (The assembled crowd laughed.)

Kuehl: If we had the right Governor, we’d have it (SB 840). But my responsibility, is to now. Responsibility to push as hard as I can to hammer on the issues at hand. I am going to support this bill today (AB 8). It must keep moving to have a vehicle better than the Governor’s plan.

Nunez: Your bill (SB 840) is not only a bill that I not only support, but enthusiastically support. AB 8 is not perfect but will help a lot of people — 3.4 million.

Kuehl voted in favor of AB 8, vote is currently still open.

(Cool new site, even though the graphics make my eyes freak out. – promoted by juls)

For far too long, Blue Cross of California’s standard operating procedures of policy cancellation and denial of coverage have gone on unchecked and unregulated. With healthcare reform a top priority in Sacramento, Blue Cross dropped $2 million on an astroturf “coalition of one” to stifle necessary reform this year.

Today, It’s OUR Healthcare, a coalition of consumer advocates, seniors, health advocates, communities of faith, and labor comprising more than 10 million, says no more and is asking Californians everywhere to stand up and fight back.

We are launching an aggressive online, public information campaign to uncover the real Blue Cross at www.SickOfBlueCross.com.

From our press release this morning:

It’s OUR Healthcare! has been advocating for a number of reforms that would fundamentally change the way Blue Cross and the healthcare industry do business in California:

* Banning the practice of denying coverage for “pre-existing conditions,” including minor conditions such as yeast infections, ear infections and seasonal hay fever.

* Requiring that a fair percentage of every premium dollar be spent on healthcare. There’s no minimum now, and a proposed requirement that at least 85% of every dollar charged be spent on healthcare, would be a radical shift (and increase) for Blue Cross.

* Requiring approval and justification for rate hikes. Because uncontrolled increases in the cost of health insurance have hit businesses and families hard in California.

Blue Cross sent nearly $1 billion in profits back to their corporate headquarters in Indiana last May. Their “coalition of one” — Blue Cross — are using scare tactics with their radio and print ads.

Blue Cross is putting money into stopping reform this year, because real reforms are on the table. It’s OUR Healthcare! and legislative leaders are taking a hard look at how our healthcare needs to be fixed, and those changes will force Blue Cross to make serious changes to its business model, which relies on:

* Spending hundreds of millions of dollars that Californians pay for health insurance each year on high salaries, slick marketing and “dividends” to out-of-state corporate headquarters

* Cherry-picking: denying coverage for pre-existing conditions  and instead seeking to insure only the healthy

* Selling insurance designed to provide limited benefits, coupled with high deductibles and co-pays

* Raising rates however and whenever it chooses

Their slogan says, “Get the power of Blue working for you.” The fact is that it ain’t working and they want to keep it that way.

Don’t let them. Stand up.