State lawmakers are engaged in special sessions to discuss water and health issues. Here’s a primer on the health care debate, the Sacramento Bee reports.
Q: Why is the Legislature holding a special session on health care issues?
A: Gov. Arnold Schwarzenegger called the special session after he was unable to reach agreement with legislative leaders on a plan to reduce the number of Californians without health insurance, now estimated at 6.7 million. The Republican governor and Democratic lawmakers blamed the 52-day state budget impasse for their failure to reach a compromise during the regular session. But serious differences remain about how to pay for health care expansion. Republican lawmakers oppose any fee increases and are calling for an incremental approach rather than the sweeping changes proposed by the governor and the Democrats.
Q: How does the special session work?
A: The special session will work much like state budget negotiations. The governor has been meeting privately with the two Democratic leaders — Assembly Speaker Fabian N & #250; & #324;ez and Senate President Pro Tem Don Perata — and Assembly Republican leader Mike Villines and Senate Republican leader Dick Ackerman. The chairmen of the Assembly and Senate health committees and administration health care officials and staff members in the Legislature are also lending their input.
Even without the support of any Republican lawmakers, the Democratic-dominated Legislature could pass a health care bill on a simple-majority vote. But without a two-thirds vote in the Legislature, voters would have to approve tax or fee increases to fund any proposal. Schwarzenegger and Democrats say voters will ultimately make the decision. Signatures would have to be collected to qualify a ballot initiative, with the November 2008 general election the likely target.
The special session designation allows the suspension of some legislative rules and allows measures approved with a majority vote to take effect 90 days after the session closes.
Q: What are Republicans proposing?
A: Republican lawmakers say the state should encourage market-based solutions instead of dramatically expanding the role of government in health care. Among their proposals is creating state health savings accounts, which the federal government has done. Republicans also want to encourage expansion of neighborhood clinics, which provide lower-cost care than hospitals and doctors. They also want to expand the state program of guaranteeing coverage for people with pre-existing medical conditions.
Q: What is the Democratic proposal?
A: Democrats would require employers to spend 7.5 percent of their payroll on health care and insurers to cover people with pre-existing conditions. Insurers would also be required to spend at least 85 percent of premiums on medical care. Their proposal would cover two-thirds of the people in the state without insurance, including all 800,000 children. The cost of employee contributions to insurance premiums would be capped at 5 percent of income.
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