News CoverageLA Daily News
HMOs eye universal care
Blue Cross, Kaiser propose statewide plan
by Evan Pondel
Apr 25, 2003
Thursday, April 24, 2003 - A proposal that insures the 6.6 million Californians who lack medical coverage would increase the cost of health care by $7.8 billion for businesses, individuals and the state, according to a study commissioned by Blue Shield of California.
The "universal coverage, universal responsibility" plan would require individuals who are not employed to pay for health insurance. Those with incomes at or below poverty level would have their premiums completely subsidized, according to the not-for-profit insurer.
Assemblywoman Rebecca Cohn, D-Campbell, has already introduced a bill under the proposal. Sponsored by the California Healthcare Association, Kaiser Permanente and Blue Shield, the legislation will be considered by the Assembly Health Committee early next week.
"We needed to do something about a system that's hemorrhaging," said Cohn, who is a physical therapist. "Everyone needs to be covered in order to have an effective health care system."
To create such a plan, the state government would pay $4.5 billion, while approximately $3.83 billion would come from businesses and individuals. If the bill passes, the state could also receive $2.3 billion in federal matching funds for Medi-Cal and Healthy Families -- money that would be lost to California without full state funding of the programs initiated by this proposal, Blue Shield said.
Among other factors, the proposal requires employers to provide health insurance for their employees or pay an equivalent amount to a fund that would provide even more health care options.
Though the proposal would cause the public and private sector to incur more costs, some companies would actually pay less because they are already paying insurance rates that cover the uninsured, Blue Shield said. Tom Epstein, a spokesman for the insurer, said if everyone was required to have health insurance it would ultimately help control rising premiums.
But critics of the proposal say mandatory health insurance coverage shouldn't be implemented until the state begins regulating rate increases. "This bill is merely the case of health insurers supporting a tax increase to pay them to cover the uninsured," said Jerry Flanagan with The Foundation For Taxpayer and Consumer Rights in San Francisco. "This is very disingenuous of Blue Shield."
Instead, the health care advocate believes there will be no solution to what ails the health care system until a piece of legislation deals with the public's main concern, affordability.
To do that, the foundation is sponsoring legislation that would require health insurers to gain state approval before raising premiums. The initiative parallels current standards set for the home and auto insurance industry, which require state regulators to sign off on all rate changes.
State Sens. Liz Figueroa, D-Fremont, John Burton, D-San Francisco, and state Assemblyman John Laird, D-Santa Cruz, introduced the new bill last week in Sacramento.
While Blue Shield is against rate regulation, Russell Korobkin, a law professor at UCLA, said the insurer's attempt to create a mandatory health insurance system could be a positive.
"I generally tend to favor the idea," he said.
That's because the current system has to compensate for those who are uninsured. For example, premiums have become a function of paying for those who end up in a hospital without insurance.
Korobkin said if healthy people were forced to buy insurance, it would help pay for the uninsured who are currently sitting in emergency rooms.
And while Blue Shield's proposal would require the state government, businesses and individuals to pay for insurance, Korobkin sa the reduction of premiums.