Among the more significant bills on Gov. Arnold Schwarzenegger's desk are two that would create a health insurance exchange to implement federal health care reform in California in 2014. The exchange will function as a marketplace for small businesses and low- and middle-income Californians who qualify for subsidized health insurance and tax credits.

Opponents of health reform are mounting a last-ditch effort to dissuade the governor from signing the bills. A recent column in The Bee by Dan Walters draws heavily from a memo by a paid consultant to the California Chamber of Commerce, which opposes the bills. Regrettably, the column and the memo make several misinformed claims, including that the legislation would:

• "Shift control of the largest single element of the California economy - health care - to a five-member board." The exchange board serves as a portal for low-income Californians and small businesses to obtain federally subsidized coverage if they want it. The exchange board will affect few people with health coverage today unless they qualify for subsidies. It won't control anyone's health care.


• "Assume management of the state's current multibillion-dollar health program for the poor, Medi-Cal." Under the two bills, Medi-Cal is run by the same state department as it is today. The role of the exchange is to screen and enroll applicants that aren't eligible for the exchange in other programs.


• "Expand coverage way beyond the federal government's minimum requirements." The legislation says the board must "determine when an enrollee's coverage commences, and the extent and scope of coverage." This means that the board will determine if applicants are eligible for state programs based on eligibility rules, and if they are eligible for the "catastrophic coverage" option, available to those under 30. Both of these responsibilities are required under the new federal law. The exchange cannot "unilaterally expand" benefits, or rack up billions in state costs.

As the nonpartisan Legislative Analyst's Office concluded, "The Legislature would retain full authority to set eligibility and benefit levels for state programs as well as benefit requirements of plans." This conclusion makes sense, because the legislation explicitly prohibits the board from imposing new state costs without the governor's and Legislature's approval.

Three years ago, the governor and then-Assembly Speaker Fabian Núñez helped jump-start the national dialogue over health care reform. It is fitting that the governor can sign these measures now. Despite 11th-hour claims to the contrary, these bills do only what their proponents say they will do: implement health care reform in California.

By David Lansky and Scott Hauge
Special to The Bee
Published: Sunday, Sep. 26, 2010 - 12:00 am | Page 3E

Read more: http://www.sacbee.com/2010/09/26/3055077/health-care-exchange-wont-usurp.html#ixzz11ddtW28l