Right before heading off to our Calitics Q3 Quarterly tonight, Russ Warner sent off this press release about David Dreier’s vote against children’s health:

David Dreier stood with George Bush and Big Tobacco and voted against reauthorizing the State Children’s Health Insurance Program (SCHIP).  As a result of this vote, hundreds of thousands of California families will likely lose health insurance for their children in the coming months. 

  “At a time when we are spending $450 billion on the war in Iraq, David Dreier’s unwillingness to invest in California’s kids shows how out of touch he is with the priorities and concerns of people in the 26th district,” said Russ Warner, Democratic candidate for Congress in the 26th district.

Currently 850,000 children in California receive health care coverage through the SCHIP program in California, called Healthy Families.  Dreier voted along party lines against the reauthorization of the program and a proposed expansion that could have extended health care coverage to another 650,000 children in California currently without health insurance.

David Dreier said this legislation, which is supported by groups such as AARP, the American Medical Association, and Easter Seals – is an “expansion of the welfare state.”

“After 27 years in Congress, all David Dreier has to offer are outrageous comments and unwavering support for George Bush’s failed policies,” said Warner.

“The money invested in covering children’s health today will save California money tomorrow, in identifying and catching illnesses earlier and in eliminating unnecessary emergency room visits.”

  “The people of the 26th district are ready for a representative who will fight for their interests – not the interests of George Bush and Big Tobacco,” continued Warner.

Me likey the rapid response.  This will be a defining issue in a lot of campaigns next year.

The other day, while arguing with someone who claimed that SCHIP benefitted families who make too much money, I realized something profound.

Thanks to tax policy, SCHIP costs the government less per child than private health insurance for high-tax bracket individuals.

(Adapted from a diary at Daily Kos)

SCHIP serves 6.6 million children for $5 billion a year. It sounds like a lot, but when you do the math, that’s only $758 per child per year.  (The actual total cost per child is slightly larger, because some families pay a small premium, while others pay nothing.) If you’ve done any shopping for individual health insurance, you’ll know that for a bargain, largely possible because the state can bargain very hard with the private companies who run it (in California, the most popular plan is Blue Cross), and because it’s a large risk pool of mostly healthy individuals.

Great.

But, we wouldn’t want to provide this subsidy to richer children. They’d leave private health insurance, sending the government’s burden up… right? Make the rich pay their own way!

Well, for the SCHIP money pool, maybe.

But here’s a fun fact. Health insurance is tax deductible if it is purchased by the employer or by a self-employed individual, which is the majority of American health insurance. If we say my daughter’s portion of my health insurance policy is $2400, and I’m in the 25% tax bracket + 15% for social security/payroll/self employment tax, then the Federal Government is picking up $960 of her annual premiums.

That’s right. My private health insurance costs the government more than if we were to enroll her in SCHIP. (Not to mention how much more it costs out of my pocket.)

If I made more money, and popped into the 35% bracket, the government would pay even more, and I’d pay less. (I guess that’s because if I made enough for the 35% bracket, money would be tight with the high price of yacht fuel.)

But thank goodness we’re not benefitting from that large state risk pool!

UPDATE: This will take place at 3:30pm PT today.

Russ Warner’s campaign has informed me that he’ll be participating in a liveblog here later today about S-CHIP and children’s health care.  Health care is maybe the most pressing domestic issue in California and the nation, and I’m pleased to see one of our Democratic Congressional candidates engage us on this issue.  He’ll post a diary and then stick around in the comments to answer questions.  It should be a good way to get a sense of his policy ideas.  When I get an exact time I’ll update.

Any legislator or candidate can do this simply by posting a diary, and I’m hopeful that this will be the first of many of these live chats.  Rather than supporting anyone with a D in front of their name, it’s important to really engage and understand the views of those who wish to represent us.  On the endorsement front, I can say little other than the Hoyt Hilsman campaign has contacted the editorial board and decisions are in the process of being made.

Seems like a great deal of things are happening on the health care front, but I don’t think any of them point to significant reform in this legislative session.  In fact, people are trying to scramble for alternatives.

Dan Weintraub has a feature on Fabian Nuñez’ attempts to get through to the Governor that the other side of the aisle is simply not interested in compromise.  As Julia noted the other day, Nuñez will put the Governor’s plan up for a vote tomorrow, and nobody will vote for it.

The speaker says he intends to package the governor’s plan as legislation and present it to the Assembly, where it will surely die. In fact, Núñez said, his own vote for the bill, which he will cast as a “courtesy,” will likely be the only support the governor’s plan receives.

“I’m going to take him from the stratosphere, and I am going to ground him,” Núñez told me in an interview in his Capitol office. “He needs a little grounding. Nobody likes his plan.”

I don’t know how the Governor is going to respond to this, but clearly observers aren’t thinking it will end in sweetness and light.  They’re making other plans.  over…

State Sen. Darrell Steinberg is floating a plan to cover all children as a fallback reform should nothing else materialize.

“We ought to achieve comprehensive health care reform, but our first priority must be children,” Sen. Darrell Steinberg, D-Sacramento, said Wednesday at a Capitol news conference to tout children’s health care.

Steinberg’s Senate Bill 32 and a companion bill, Assembly Bill 1 by Assemblyman John Laird, D-Santa Cruz, would expand the children’s Healthy Families Program by increasing the household income limit from $51,625 for a family of four, or 250 percent of the federal poverty level, to $61,950, or 300 percent.

But there’s currently no funding in the legislation, which would require the state to spend $225 million more annually to cover the estimated 800,000 children without insurance in California.

Any legislation would have to be approved before the Legislature adjourns Sept. 14, unless Gov. Arnold Schwarzenegger calls a special session.

“If our bills become the vehicle (for health care changes), they will be amended to include a funding source to either fund the full amount or at least a significant start for year one,” Steinberg said.

Obviously, there’s no chance of this happening without S-CHIP expansion, which the Governor is trying to get the President to authorize.  Children’s healthcare is cheap and saves the state money in the long run, along with being simply the right thing to do.  But it’s a small step, not the big change that Californians want.  The Governor is opposed to a piecemeal approach, for the record, but could he really veto children’s health care?

To that end, a couple unlikely partners are looking to the ballot box for an eventual answer.

In 2004, the California Restaurant Association led the successful effort to repeal SB 2, which would have required employers to provide health insurance to their employees. On the other side of that multimillion-dollar battle was the California Medical Association and organized labor.

Labor and the CMA are both heavily engaged in the ongoing Capitol negotiations, while business groups have rejected both the Democrats’ and the governor’s proposal as untenable. But the restaurants’ proposal may serve as a starting point for negotiations for a possible November 2008 ballot initiative, just in case a deal cannot be hammered out this year.

“We are not ready to give up on current legislative proposals, but are interested in hearing what CRA has to say,” said CMA’s top lobbyist, Dustin Corcoran. “As a longtime proponent of universal health care, CMA welcomes any serious effort to reform health care and looks forward to further discussions.”

But Jot Condie, president of the California Restaurant Association, said his members are “moving forward as if the Legislature has already concluded its business.” Condie said, “It appears the Legislature is incapable of producing needed reform, so we decided to look to the initiative process.”

I don’t know whether this is serious or just an attempt to put pressure on the Legislature to get something done.  The CRA is floating an 1% increase in the sales tax to cover the cost of health care, that’s really all the details that have come out.

This might be just chaos before everything actually fits into place and a deal is brokered.  I’m not seeing that, however.

Without a health care plan of his own that any legislator would back, Arnold Schwarzenegger is left to mold the Democratic leadership plan in his image.  He came out strong yesterday in the opening salvo in the negotiating process:

Gov. Arnold Schwarzenegger took a firm stand Wednesday against the Democratic healthcare proposal moving through the Legislature, saying for the first time that he would not support an expansion of medical insurance if it were financed solely by new requirements on employers.

The Democratic proposal would require employers to spend at least the equivalent of 7.5% of their payroll on their workers’ health. The governor insisted that the plan also must require all Californians to have insurance, an idea at the core of his January proposal.

Democrats omitted that concept, believing that many people would be unable to afford the premiums.

Schwarzenegger’s program would have given employers the option of providing insurance or paying into a state fund that would offer it to uninsured workers and those who couldn’t afford individual policies. It also would have spread the responsibility of paying for expanded healthcare to doctors and hospitals, an idea that was rejected by Democrats as politically infeasible.

Schwarzenegger essentially wants MassCare, with its individual mandate, along with a buy-in from doctors and hospitals along with individuals and employers.  This is what he calls a fee but is probably a tax, which means Republicans would have to get involved because it would require a 2/3 vote.  But that doesn’t matter; he’d rather have no health reform at all than one without an individual mandate:

Schwarzenegger has said repeatedly that all parts of society — including healthcare providers, individuals and businesses — must make sacrifices if all Californians are to be insured. Nearly 5 million residents lack coverage at any given time. The Democratic proposal would cover 69% of them. Schwarzenegger’s comments were even more pointed earlier in the day, when he told the Sacramento Bee editorial board that he would veto a bill that failed to spread the costs around.

“If anyone over there thinks that I will sign a bill that . . . has only employer mandate, they shouldn’t,” he said, according to an account posted on the newspaper’s website.

“I won’t sign it. It won’t happen,” he said.

My favorite part of the article is the part where Schwarzenegger just ignores reality.

The idea of scrapping private insurance altogether and enacting a state-run program — an idea championed by Sen. Sheila Kuehl (D-Santa Monica) in the Legislature and Michael Moore in his film “SiCKO” — has gained support: The poll found that 36% of Californians now prefer this approach, up from 24% nine months ago.

Schwarzenegger, however, reiterated his opposition Wednesday.

“It’s very clear people don’t like government running their healthcare system,” he said.

Yes, so clear that it’s the most popular proposal before the people.

This is bluster from an action hero, and I’m not sure it should be taken seriously by Don Perata and Fabian Nuñez.  Schwarzenegger wants a ready-made market for the insurance industry, and his plan had no floor on coverage and no ceiling on costs.  That individual mandate starts to look like a gun barrel under those circumstances.  And I’d rather see nothing enacted than something that holds up California’s indigent and forces them to pay through the nose. 

The guaranteed issue part of his proposal, whereby nobody could be denied insurance, should be retained.  As we move toward an eventual not-for-profit system, setting up some public framework, as the new AB8 is rumored to strengthen, is crucial.  And clearly, the Governor shouldn’t be saying a word about healthcare until he fights the callous Bush Administration proposal to deny coverage to children by tightening S-CHIP eligibility.

UPDATE: The California Budget Project released a report detailing what California families could actually afford for health care, and according to their assessment, a family making twice the poverty line would be unable to contribute ANYTHING toward their own health care given the cost of living in the state.  Even those making 300% above poverty would require some help.  If you like feeding your inner wonk, it’s a good report.