California mandate would offer health coverage to 1.3 million

The state's solution is viewed by some as a promising attempt to deal with the growing problem of the uninsured.

By Joel B. Finkelstein, AMNews staff. Oct. 6, 2003.

Washington -- All eyes are turned to California, and not just because of the gubernatorial recall election. The state has adopted legislation that some say is the first step toward universal health coverage.

The "pay-or-play" measure would require companies with 50 or more employees to pay into a state-run program that would offer health benefits to workers in the state. If companies offered health benefits to their employees, they would get credit for it and avoid paying the fee.

The bill also contains a similar mandate for companies with 20 to 49 employees that would be rolled out in 2006 if the state can find the money to subsidize 20% of their premiums.

As it stands now, the measure is expected to expand employer-based coverage to about 1.3 million of the nearly 7 million working uninsured individuals in California. Another 300,000 would be covered if the program was expanded to the smaller companies.

As of press time, the legislation was on Gov. Gray Davis' desk, with no word as to whether he would sign it.

The California Medical Assn. supports the bill.

"Physicians will certainly be more viable if they can get compensated fairly for taking care of [currently] uninsured people," said Jack Lewin, MD, CMA executive vice president. "We do it; it's our duty. But increasingly we see physician practices in jeopardy."

Coverage also means that patients can get access to the laboratory tests and prescription drugs they need and that children with complaints that aren't urgent, such as ear infections, don't have to go to the emergency department, he said.