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Schwarzenegger's healthcare reform legacy

October 1, 2010 |  3:41 pm

Gov. Arnold Schwarzenegger, health, healthcare reform, insurance exchangesThe GOP's surge across the country has put Obamacare in jeopardy, but California's lame-duck Republican governor has nevertheless signed a series of bills that implement key pieces of the federal healthcare reform law. And in so doing, he put California at least part of the way down the path toward comprehensive reform, regardless of what happens to Obamacare.

It's not exactly the healthcare reform legacy Gov. Arnorld Schwarzenegger envisioned; he tried in vain to push a bill through the Legislature in 2008 that would have used mandates on individuals and employers, subsidies and tax credits to bring coverage to an estimated 87% of uninsured children and legal residents  in California. But given how much the federal Patient Protection and Affordable Care Act has in common with Schwarzenegger's initiative, the bills he signed amount to a reasonable consolation prize.

Most notably, Schwarzenegger signed two bills (AB 1602 and SB 900) that make California the first state to create an independent insurance exchange for individuals and small businesses to shop for coverage. Insurers and the California Chamber of Commerce mounted an 11th-hour blitz against the measures, alarmed by language that would let the operators of the exchange exclude insurers that didn't offer enough value to consumers. But Schwarzenegger's aides had helped craft the bills, and they supported the idea of enabling the exchange to negotiate better terms for consumers. The exchange won't be the only outlet for individual and small-group policies, but it will be the only place where working-class Californians can obtain policies subsidized by federal taxpayers. 

Schwarzenegger also signed a bill (AB 2244)  by Rep. Mike Feuer (D-Los Angeles) that enacts into state law the new federal ban on denying individual policies to children with preexisting conditions. That ban has led several major insurers, including Anthem Blue Cross in California, to stop offering new kids-only policies.  Feuer's bill is a worthy response to that problem, offering insurers both carrots and sticks  to keep them from abandoning the market.

Other bills receiving Schwarzenegger's blessing include AB 2345  by Rep. Hector De La Torre (D-South Gate), which requires insurers to cover certain types of preventative care without requiring co-payments; AB 2470  by De La Torre, which bars insurers from canceling policies retroactively except in cases of fraud; SB 1163  by Sen. Mark Leno (D-San Francisco), which requires independent actuaries to review health insurers' proposed rate increases; SB 1088  by Sen. Curren Price (D-Los Angeles), which allows young adults to remain on their parents' insurance policies until age 26; and a pair of measures -- SB 227  by Sen. Elaine Alquist (D-Santa Clara) and AB 1887  by Rep. Mike Villines (R-Clovis), which expand the state's insurance pool for "high risk" individuals unable to obtain coverage because of preexisting conditions.

The governor vetoed healthcare bills too, including AB 1825  by De La Torre, which would have required individual policies to include maternity coverage, and SB 220 by Sen. Leland Yee (D-San Francisco), which would have mandated coverage for certain tobacco-cessation programs and medications. But on the most important elements of reform, Schwarzenegger showed again that he's closer in spirit to Mitt Romney  (circa 2006) than Meg Whitman ( circa 2010).

Credit: Irfan Khan / Los Angeles Times

-- Jon Healey

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