States Struggled To Enact Health Care Reform In 2007, Uncertainty For Reforms Remains

Main Category: Public Health
Also Included In: Health Insurance / Medical Insurance
Article Date: 03 Jan 2008 - 12:00 PDT

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"A year that began with great ambition for major expansions of health insurance" in California and other states, ended "with considerable uncertainty, as a second wave of change runs headlong into a darkening economy and political divisions over how to apportion the cost," the New York Times reports. California, Illinois and Pennsylvania each proposed wide-ranging health care proposals, but none "finish[ed] 2007 with bills passed and signed," according to the Times. The Times reports that the proposals "confronted entrenched opposition from insurance and other business lobbies that made it far more difficult to build a consensus for change" in these large states than in the smaller New England states that have been successful with reform.

For example, in California, Republican Gov. Arnold Schwarzenegger and Democratic state Assembly Speaker Fabian Núñez (D) were successful in crafting a plan that aims to achieve near universal coverage in a state with one of the country's highest rates of uninsured residents. The state Assembly approved the measure, but state Senate President Pro Tempore Don Perata (D) has expressed concern about the cost of the plan at a time when the state faces a massive budget shortfall (Sack, New York Times, 12/25/07).

Despite potential problems in the California bill's final passage, the health proposal impressed some experts "by finding compromises where earlier efforts ended in logjams," according to the Washington Post. Karen Davis, president of the Commonwealth Fund, said, "For a long time, [health care reform] was seen as too big, too complicated, too costly, too many interest groups," adding, "Where you get action by a major state like California that has a very high level of the uninsured, it just becomes realistic and pragmatic: This is doable. What is really needed is leadership" (Vick, Washington Post, 12/22/07).

According to the Times, in 2008 the "focus may shift to the presidential campaign, where the leading candidates for the Democratic nomination have each proposed major overhauls." Larry Levitt, a vice president of the Kaiser Family Foundation, said, "It's significant that what they've been talking about in California is similar to what many of the leading Democratic presidential candidates are talking about as well," adding, "There seems to be some convergence at least on the part of those supporting universal health care on how to get there." The result of the overlap, however, is that some state leaders "may be tempted to wait out the year to gauge whether the next president will push for a national health plan that might subsume state efforts," the Times reports (New York Times, 12/25/07).

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