The Assembly’s partisan passage of a health care plan has been described in historic terms.
But things are not necessarily what they seem.
In reality, with all of the bill’s financing and, indeed, the bill’s very implementation, contingent upon passage of an
initiative in November, the real-world impact of this week’s vote is minimal. In fact, the passage of the bill
may have as much to do with term limits as it does
with health care.
The vote — with every Republican in opposition — simply had the force of a parliamentary white paper,
a nonbinding reflection of where Assembly Democrats
and the Republican governor are on health care reform.
The Assembly’s move prompted many, most notably Senate leader Don
Perata, to ask, “What’s the rush?” The speaker’s office claims there is a set of fast-approaching deadlines, and that quick passage is necessary
to get the health care financing initiative on the
November ballot. The speaker’s term limits initiative is on the February ballot.
In order to get the health care financing on the November
ballot, an initiative would need a title and summary
from the attorney general’s office by Feb. 14. In order to get the measure on the ballot, proponents
would need to gather 1.2 million signatures, to be submitted to county election
offices no later than April 21.
It is that tight window that is motivating the speaker,
says spokesman Steve Maviglio.
“Every day, thousands of more Californians lose their
health care coverage. The longer we wait, the worse
the problem gets,” Maviglio said.
But in the meta-language of California politics, the vote was a loud
affirmation of just who’s in charge of the Assembly, and hinted strongly to
others that the governor and the speaker may forge
a political alliance that could lead to the continuation
of Núñez’s speakership for six more years. It also is a sign
of the tensions between Núñez and his Senate counterpart, and the coming weeks
promise to be used in part to pressure the Senate to
act quickly.
The speaker was able to coax his caucus to vote for
a bill that few of them had read. And though the state’s largest labor organization had expressed reservations
about the bill, urging Núñez and caucus members to delay the vote, there was
not a single dissenting Democratic vote Monday.
Núñez’s show of strength comes less than a week after he
made an animated speech to his caucus, pushing for
health care reform, urging more money for the Yes on
93 Committee, and insisting to his caucus that no matter
what happens in February, he intends to be speaker
well into 2008.
But there is another theory: That the timing of the health care plan’s passage was meant to increase momentum for Proposition
93, the initiative on the February ballot that would
allow Núñez and Perata to remain in power.
Skeptics of that theory note that the bill’s chief obstacle is now Perata — one of the people who stands to gain the most by Proposition
93’s passage. If a quick health care deal is really the
ticket to Proposition 93’s passage, why then is Perata slowing down the Núñez health care juggernaut?
The Núñez bill is scheduled for its first Senate hearing in
a Jan. 16 meeting of the Senate Health Committee.
But there is evidence for those who want to make the
health care–term limits connection. Some of the health care proposal’s strongest supporters, namely the Service Employees
International Union and the American Federation of
State, County and Municipal Employees, are also among
the top donors to Proposition 93, a point not lost on No on 93 spokesman Kevin Spillane.
“Obviously, huge sums of money have been pouring in
from these unions in recent days,” he says. “The link seems pretty clear. It’s basically pay-for-play politics with proposition 93. Health care legislation has become a fund-raising vehicle for Fabian Núñez to cling to power.”
SEIU unions have contributed $1.1 million to the Yes on 93 effort. AFSCME unions have given another $610,000. (Not all donors to Proposition 93 are supporters of the speaker. The chief opponent
of the health care pan, Blue Cross, has given the Yes
on 93 campaign $50,000.)
Any policy linkage between the two has been denied
not only by Núñez’s office, but also by the Schwarzenegger administration.
“They’re two separate issues,” says Schwarzenegger spokesman Aaron McLear. “He hasn’t taken a position on Proposition 93, and his position has nothing to do with health care.”
McLear noted the governor has said that he would not
support a change in term limits without a change in
the way the state draws legislative districts. But
it was still unclear what the governor’s ultimate stand on Prop. 93 would be.
What is clear is there is plenty for the service unions
and county employees to like in Núñez’s proposal. In amendments introduced just hours before
the vote, home care workers, many of whom are represented
by SEIU, would receive more state money for health
care coverage. The bill sets out an additional 50 cents per hour from the state to help pay for health
coverage for home care workers.
“We represent low-wage workers. We have an interest in doing something
for them,” said SEIU spokeswoman Jeanine Meyer Rodriguez. “This provision is consistent with the larger goals
of the bill — to provide health care coverage to people who don’t have it.”
Rodriguez also said there was no link between her union’s support for health care and Proposition 93.
“Health care is complex enough. There are enough issues
here to work through. Whatever speculation people want
to make, they can make. We’ve demonstrated we’re focused on getting health care right.”
There is also something for county workers in the bill.
In the amendments adopted Monday, there is a new provision
for a $25 million “Workforce Development Program Fund” to be “used exclusively for retraining county hospital and
clinic systems’ health care workers.”
Jerry Flanagan of the Foundation for Taxpayer and Consumer
Rights called the $25 million “slush-fund money to do the work the union should be doing
themselves.”
Flanagan said these amendments were “stuck in at the last moment and hidden in the fine
print of the bill.”
And the new state coverage for low-income adults drives people to public hospitals — hospitals that have union representation. Section
72 of the new bill states, “each enrollee shall be assigned a medical home at a
public provider affiliated with a public hospital or
at a community clinic. … All covered services shall be provided by designated
public hospitals, their affiliated public providers,
and community clinics, except with respect to those
medically necessary services that are not available
or accessible through these providers.”
