RNs Say Latest Health Bill Even More Flawed - Still A Boondoggle For Insurance Companies While Affordability Provisions Are Eroded, California

Main Category: Health Insurance / Medical Insurance
Article Date: 17 Dec 2007 - 4:00 PDT

email to a friend   printer friendly   view / write opinions   rate article

With a healthcare vote presumably scheduled for Monday on the California Assembly floor, the California Nurses Association/National Nurses Organizing Committee criticized the latest revised deal between Gov. Arnold Schwarzenegger and Assembly Speaker Fabian Nunez as a further erosion of even the Speaker's prior bill.

"What started out as a promising year for major reform of our broken healthcare system is sadly ending with a deeply flawed, patched-together package that will leave the insurance companies in control of our health with millions of California families struggling to pay their medical bills," said Zenei Cortez, RN, member of the CNA/NNOC Council of Presidents.

Among the major problems, said CNA/NNOC, under the bill now known as ABx 1 1:

- Insurance companies can continue to deny medical care they brand as "not medically necessary" or experimental, deny access to specialists, and deny tests - even when those care options or treatment are recommended by a physician.

- Insurance companies can continue to charge whatever they want. The bill has no limits on escalating premiums, deductibles, co-pays, or other rising costs.

- Individuals are still forced to buy insurance without guarantees of what they are buying or whether they can afford it.

- Fails to include the much discussed requirement of employer contributions which are left to a separate initiative to go before voters next November. "Without an employer mandate, the concept of 'shared responsibility' is out the window, and it just becomes an individual mandate bill, with all the onus and burden on individuals and families," said CNA/NNOC legislative director Donna Gerber.

Escalating costs and the lessons of Massachusetts

Among the changes from the prior version proposed by Speaker Nunez, the new bill:

- Eliminates an exemption to the mandate that all uncovered Californians must buy insurance if the cost of the minimum plan exceeds 6.5 percent of your income.

- Cuts financial assistance for families over 400 percent of the poverty level - roughly $40,000 for an individual, $82,000 for a family of four.

By failing to rein in skyrocketing premiums and other rising costs the bill will sharply escalate financial insecurity for California families or cause greater financial crisis for the state which already has a $14 billion deficit and a governor who today declared a fiscal emergency.

Massachusetts, which is the model for the Schwarzenegger-Nunez deal, is already learning the lessons of its failure to control insurance costs. As reported today in the Boston Globe, facing costs next year that could climb 14 percent, state officials are considering sharp increases in co-payments and other out-of-pocket costs for Massachusetts families, fewer choices for consumers, and cuts in payments to doctors and hospitals.

Uncertain and limited medical coverage -- health insecurity, self-rationing of care

ABx 1 1 creates a multi-tier system of health coverage for those forced to buy insurance. Some will be in a public purchasing pool with a minimum insurance plan similar to what is now required for HMO plans. Others, such as the self-employed, part timers or those employers' policies are too expensive, will be forced to buy insurance on the private market with no standards set for what the plan will include (such as maternity care) and no limits on costs, co-pays, and deductibles.

For both groups, many essentials will cost extra, including dental, vision, mental health, long-term care, and other coverage. And with no controls on costs, many Californians are likely to buy the cheapest plans with high deductibles and other out-of-pocket bills that will discourage them from using the insurance they pay for. Tax credits are presented as a major source of affordability protection for middle income Californians - but tax credits hardly make up for costly monthly premium payments, deductibles, and co-pays.

A hurried process - is this a return of energy deregulation?

With language of the latest 150-page bill only released today, giving Assembly members little time to read, review, and analyze it prior to being called on to vote the bill up or down on Monday, Gerber called the process "son of energy deregulation."

"Just as with the energy deregulation fiasco, legislators are being rushed into voting in the dark on a sweeping bill with massive loopholes and serious financial ramifications that no one has adequately reviewed."

"The result last time was we nearly bankrupted the state, and let Enron pick the pockets of consumers while plundering our state coffers. That experience should be a warning to those who are demanding we pass a bill no matter how flawed and uncertain the consequences."

"With thousands of California children facing the cutoff of coverage due to the president's veto of the children's health program, and the governor expected to propose new healthcare budget cuts, we should focus on guaranteeing continued coverage for the children and protecting current programs rather than rushing through a bad plan that could just exacerbate the crisis for California families and the state," Cortez said.

California Nurses Association