Enabling regional based models for expanded coverage: SB 1622

In the wake of Schwarzenegger's 2007 proposal for universal health insurance, the California Legislature is considering legislation (SB 973 as of July 28, 2008) to establish what the Governor once called a “backdoor single-payer”, i.e., a public health insurance alternative to private insurance.

Most California counties already have public health insurance alternatives that have been successfully competing with private insurers for a decade. They cover mostly Medicaid and SCHIP beneficiaries, but also provide employment-based coverage. The county plans have tried to develop multi-county plans in the past, but needed technical assistance and legal support that was not available to them.

The proposed state program, the California Health Benefits Service Program would provide technical assistance to combine county public health insurance plans and could help form a state-wide public insurance network. In addition to providing technical assistance, the legislation would address the legal problems in county health plans forming combinations.

The 111th Congress may address the issue of universal health insurance and one of the major issues it would face is how to establish a public insurer to compete with the private insurers. So, the California legislation could have implications for national policy.

This presentation will outline how the issue of a public insurer is being addressed in California and the implications of this legislation for action the 111th Congress.