California Assembly Leader Shelves Single-Payer Health Plan

The California assembly has sidelines the state Senate single-payer health care bill as California's healthcare structure enters the unknown. The US Senate may vote on its Obamacare repeal as early as this week. Covered California is trying to stabilize its insurance exchange in the face of potential upheaval. Michelle is joining me. She is a healthcare reporter. Welcome to the program. Thank you. Why did state assembly speaker Anthony Rendon say he was shelving the bill.? He is saying it's in direct response to the GOP health care bill and he says that is causing a threat to California and he needs to meet the needs of California and deal with the threat originally. He said he is encouraged by the conversation that began with the single-payer bill but he calls it woefully incomplete. He says it is not dead and that he is just holding it in the rules committee until further notice. Is that because there was no financing involved? Were not a whole lot of details. They were working on updating the bill and adding some details to it but as it passed the Senate everybody was calling it not quite done. Some people were saying half but there were different words for that. Is it too soon to know how single-payer could fair next year in California next It is not too late. It could be brought back. All of the supporters of single-payer you know I spoke to the nurses association this morning and they are saying they will put pressure on his eager to undo this action and bring it back. There is lots of mobilization because they are not happy with this. How does the ongoing federal health care legislation affect the bus -- possibility of single-payer here in our state. A lot of this conversation about single-payer in California has basically said it is a direct response to what is happening at the federal level in terms of conversation of what is going on that. Part of the problem is that what is happening in the Senate is going to mean a big cut to Medi-Cal and the Medicaid funding that comes from the federal government was intended to go into an account that would help pay for single-payer. This will be a cut in the tens of billions of dollars California and that means more money that the state would have to come up with. I think as this is being unraveled or introduced to the public it is quite confusing. The GOP Senate Bill apparently would cut federal subsidies to people on covered California exchange but President Trump has threatened to stop paying a certain kind of subsidy called cost-sharing reductions. Are they talking about the same thing? They are talking about similar subsidies to there is a plan to get rid of the cost-sharing reductions subsidies. That is the money that people pay out-of-pocket when they are going to see the doctor. Consumers on silver plans get help paying for their out-of-pocket cost. The other subsidies that they are tinkering about how they are going to pay for it is the subsidies that go to help people pay for their premiums. That is the monthly payment that people are paying they're going to be changes on both sides. Peter Lee the head of covered California said this late last week. Health plans have been uncertain if they will get paid a major part of the subsidy called cost-sharing reductions. So in California we said let's taken off the table. We have given the plans a way to build the cost into their rates and make sure the federal government still pays for it. So covered California is preparing for this possibility of the cost-sharing reductions being taken off the table. What does that mean impracticality. We talked about this last week. He said this is what he calls the least worst option as a plan B if the subsidies go away these cost-sharing reductions. That plan did not account for with Eunice -- U.S. Senate is planning. At the pass the bill as is it will throw a wrench into it because they were helping to make up for the loss in the cost-sharing reductions but up in premiums. Their idea was to hold consumers so that they would not end up paying for that because it would take care of it in the premium subsidies that they get from the federal government. Those would also go down so it creates a much bigger challenge. Allowing insurance companies to actually charge a higher premium than they would have if Obama care had stated affect to try to make it easier on the insurance companies isn't that right? Yes it is. [laughter] Let's try to do that again. [silence] Okay so here they say let's taken off the table. Is also given the insurance companies in California a carrot and that is the higher premiums you were talking about. How is that supposed to stabilize anything especially comfort -- for consumers. At the end of the day their hope was that the money that people get from the federal government in terms of the subsidies they get to pay for their premiums would cover the difference that people would be held -- helped without having to pay for it out of their own pockets. Especially the people on silver plans. It is just a really big challenge. The problem at the end of the day is that the actuaries are supposed to make sure that everybody is able to be covered and insurance rate raise enough money that people can get all the money they need. It is really hard to tell when all of these conversations and change the way it works it's hard to tell how much should be charged. Some companies are so antsy about what is happening and whether or not they will be paid they have told out-of-state exchanges. That has not happened in California so far. Is it likely to happen? It is hard to say what is likely especially since there are so many things up in the air. Insurance companies have assured me that they do not plan to pull out of the exchange. Of course that could change because California has widely been -- been considered the model for how it was supposed to work and is intended to work. Now that that is changing some of the incentives to stay in the market are also changing. What about covered California off of these Republican proposals past. Will have the same kind of clout to negotiate rates? Will it continue? That is a prediction into the future. I can tell you that there is a lot of political while in our legislature to push back against what is happening at the federal level and they are hoping that all of the politicians in this state at least the Democratic majority are hoping to maintain covered California as is to the best of their ability. I have been speaking rushed -- with Michelle fast. Thank you so much.