What Supreme Court Decision? California’s Healthcare Reform Moves Full Steam Ahead
If the Supreme Court throws out Obamacare, in whole or in part, California will be prepared with legislation of its own. Peter Lee, the head of California’s Health Benefit Exchange, told National Public Radio that “California has been moving ahead 100 percent assuming it will be upheld.” The state isn’t doing any contingency planning “because it makes no sense to plan for what seems like an outer bounds of possibility, and rather, we’ve got a big job to do to get ready to cover what will be millions of Californians in 18 months.”
California has been working on its own bills that embrace the fundamentals of the Affordable Care Act: defining basic healthcare benefits; guaranteeing coverage for those with preexisting conditions; and at least talking about enacting a state mandate to compel coverage, if the federal mandate fails. The chair of the state assembly’s health committee, Bill Monning, said, “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. We will figure out how to do it.”
Some states have put any planning on hold as they wait on the Supreme Court. The response of Republican governors is wide and varied. In Wisconsin, Governor Scott Walker returned $37 million dollars to the federal government that his predecessor had accepted for the development of insurance exchanges. But when the law takes full effect in 2014, the federal government will administer exchanges for states that haven’t developed them. New Mexico’s Governor, Susana Martinez, wants to keep control of the guidelines for her state’s exchange, so she’s accepted federal grant money to establish it, at the same time that she has vetoed related legislation until the Supreme Court decision is known. Last year, Governor Mitch Daniels of Indiana went so far as to establish insurance exchanges in his state by issuing an executive order.
Back in California, Peter Lee isn’t worried about whether the Supreme Court throws out the national mandate because reform is going forward, regardless. “I’ve seen community groups, I’ve seen hospitals, I’ve seen health plans, I’ve seen the business community, not throwing rocks at our effort, but rather, joining in to make this thing work,” he said. His attitude is consistent with concerns expressed across the country by policy experts, insurers, doctors, and legislators about undoing the changes that have already been implemented over the last two years—like coverage for those with pre-existing conditions and for adult children up to age 26. Robert Laszewski, a health care industry consultant, told The New York Times in March that, “Many of us did not get the bill we wanted, but I think having to start over is worse than having to fix this.”
For California, the most populous state in the union, lawmakers are clear about their duty to proceed. And they have the numbers to move full speed ahead.
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