California health reform debate enters new phase after veto

The governor and Democratic lawmakers agree on some broad principles, but major sticking points remain.

By Doug Trapp, AMNews staff. Nov. 5, 2007.

Washington -- California Gov. Arnold Schwarzenegger moved the state's health system reform debate into a new, possibly lengthy phase, in October when he vetoed the Democrats' bill and offered a legislative proposal of his own.

The governor, a Republican, and leading Democrats have been working on competing health care measures for months and still could reach an agreement this year. But observers said it's possible that the governor's 200-page bill could require months' more work through the formal legislative process. An informational hearing on his proposal was scheduled for Oct. 31.

Carla Kakutani, MD, president of the California Academy of Family Physicians, said the organization has not endorsed Schwarzenegger's bill but that it supports the governor's goal of universal care.

"It's been a little disappointing in the sense of how slow things are going and how [the process tends] to get very bogged down in the politics," Dr. Kakutani said.

The California Medical Assn. likewise hasn't taken a position on the governor's measure but supports the reform effort, according to CMA spokeswoman Karen Nikos.

Schwarzenegger and the leading Democratic negotiator -- Assembly Speaker Fabian Núñez -- share many of the same goals. Both would expand the state's Medicaid program, cover at least a majority of the state's 4.9 million uninsured and offer more affordable health insurance through a state-organized purchasing pool. Although Schwarzenegger included a 2% tax on physician revenues in his initial 10-page reform outline proposed in January, he dropped the provision from his Health Care Security and Cost Reduction Act.