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New California Health Marketplace Moves Forward, Despite Uncertainty

Aired 6/11/12 on KPBS News.

California health planners say even if the high court overturns the federal mandate to buy insurance, their effort will move forward.

California was the first state in the nation to start a new health insurance marketplace, following the passage of President Obama's health law. A staff of thirty-six is now part of what's called the Health Benefit Exchange. It's contracting to create a web portal that would eventually help consumers shop for insurance online. Exchange managers are discussing how, not whether, to use tens of thousands of people to help new enrollees navigate the system in the coming years. Peter Lee is heading up the effort.

"California has been moving ahead 100% assuming it will upheld, we believe it will be, and we aren't actually doing anything in the way of contingency planning because it makes no sense to plan for what seems like an outer bounds of possibility. And rather, we got a big job to do to to get ready to cover what will be millions of Californians in 18 months," said Lee.

Lee said his mission won't change even if the Supreme Court overturns the individual mandate to buy insurance, stating "the reason the exchange is going to have - we project - over 2 million people in it after a few years, is it's very little to do with the mandate. It has to do with we're a place where people can get subsidies for care, and can make informed choices."

But Patrick Johnston who speaks for California insurers said the federal law wouldn't work without a requirement to buy insurance.

"We need to have a group of people that is big enough and has enough people who for the most part are healthy to make sure that the insurance costs will be shared and not high," said Johnston.

Johnston said health insurance is like car insurance. It can't just include high risk clients. He said the federal law is like a three-legged stool that can't be pulled apart.

Johnston said, "states that decided to say 'Everybody gets insurance at the same price but you can buy it whenever you want,' found that prices just went way up and people dropped out."

California lawmakers have been moving forward with parts of the federal law since 2010. But would they - and the marketplace - keep pushing for a state health overhaul without the federal requirement that people buy in? Bill Monning said yes. He's the Chair of California's Assembly Health Committee.

"I'm going to remain fully committed to figuring out how do we preserve and protect what was the vision of President Obama, to replicate that in California by any means necessary," said Monning.

Monning and his counterpart in the state senate Ed Hernandez are hesitant to say they'd propose a state health insurance mandate, without knowing the court decision. But Hernandez said California should implement parts of the law that could be overturned, and he'd author bill that would address the issue of compelling people into the market. Still he said funding a new state marketplace without federal help, would be difficult.

"The state just doesn't have any money," said Monning. "And my biggest fear and concern is that we lose those federal subsidies, I just don't know how we can make it happen…work here in California."

But even Republicans like Assemblyman Dan Logue think the Democratic majority in California would propose and pass a state mandate in the absence of a federal one.

"They're trying to implement Obamacare right now," said Logue. "They're putting everything in place, and I think it's because they believe that if it is shifted to the states, that they'll already be ready to go."

Logue said President Obama's health law would lead to rationing and a mass exodus of business. If a state mandate were proposed, he'd take it to the voters.

"I think once they realize the dynamics and the cost and how it would put California at risk financially with the rest of the country, that it would go down in flames easily. But it will be a difficult fight," said Logue.

In a recent survey by the Public Policy Institute of California, more Californians supported the health law than opposed, but a majority were against the mandate.

While political will has already set changes to California health laws in motion, the scope of the new system will largely be shaped by the U.S Supreme Court decision.

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Avatar for user 'Peking_Duck_SD'

Peking_Duck_SD | June 11, 2012 at 5:21 p.m. ― 4 years, 9 months ago

Republicans are draconian on healthcare.

We are the only industrialized country on the planet that does not view healthcare as a basic human right.

Anyone who has studied healthcare models globally knows that there are four basic models seen today:

The Entrepreneurial Model (examples: **The U.S.**, Thailand, The Philippines, South Africa, Ghana, Bangladesh, Nepal)

The Bismark Model (examples: France, Germany, Japan, The Netherlands, Austria)

The Beveridge Model (examples: Great Britain, Canada, Sweden, Norway, and Spain)

The State Controlled model (examples: former Soviet Union, possibly Cuba and North Korea).

Look at health statistics for the countries that use the same model as we do.

They are not good.

They are far below the countries utilizing other methods.

Republicans like to fearmonger and mischaracterize other systems as being like the former Soviet state controlled model, an antiquated argument more appropriate for the 1950s than now.

We must stop down this path of 3rd world health statistics.

An unhealthy population equals an unproductive population, and yes - this includes the working poor.

If the right-leaning Supreme Court harms out country by ruling against Obama's Health Care Reform, then I hope states like California enact our own.

We can then compare health statistics by state and see which system works based, and I know from my studies in this arena that the health statistics won't be on the conservative's side.

Let political nit-wits like Assemblyman Logue threaten dragging our health through the flawed ballot initiative system so superpacs can throw billions trying to keep us in 3rd world status.

People are wising-up to the ploy here.

Our country needs to function well as a whole, not simply as a plutocracy where wealth, healthcare, good wages, and the American Dream are condensed into a small but very wealthy 1% ruling elite as Republicans want.

In fact, the countries that subscribe to our system that Republicans want to continue are:

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Avatar for user 'josezwing'

josezwing | June 12, 2012 at 12:02 a.m. ― 4 years, 9 months ago

This could be ideal for someone who nobody wants to cover. It's an opportunity to get coverage subsidized by your fellow American. Learn more about it at "Penny Health" online

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