THE TREATMENT OCTOBER 1, 2009
When California's effort at health reform fell apart two years ago, Jordan Rau saw it first-hand, as a correspondent for the Los Angeles Times. Now Rau is in Washington, following the reform debate for Kaiser Health News. And the plot line is starting to seem awfully familiar:
In 2007, California Gov. Arnold Schwarzenegger proposed covering the state’s 6.5 million uninsured residents through a plan similar to the one Massachusetts had deployed the previous year. The California program would have required all citizens to obtain insurance, with the state subsidizing part of the premiums for lower earners. Under Schwarzenegger’s $12-billion plan, insurers would have been compelled to accept all applicants regardless of their health status.
California’s political climate seemed conducive to change. Voters had just returned Schwarzenegger to office after he refashioned himself as a “post-partisan” politician. The Democratic leaders of the California Legislature, who controlled both chambers as they do in Congress, pledged to work with the Republican governor. Public opinion polling showed early support, and most of the health care industry didn’t oppose the proposal.
Yet, in January 2008, after a year of setbacks, Schwarzenegger’s plan was killed by a state Senate committee. While Obama’s prospects remain stronger than Schwarzenegger’s ever were, the president’s effort is hitting blockages reminiscent of the California experience.
Rau goes on to list the parallels, all of which are real. Progressives should take note. The California example is a reminder of just how difficult an enterprise health reform is--and how fragile the coalitions behind it can be.
That said, there are also some key differences between the two situations. By far the most important is the fact that the same party controls the executive and the legislature. The political fate of Sacramento Democrats was not intertwined with Schwarzenegger's, at least not in the sense that the fate of Washington Democrats is intertwined with President Obama's. That alone could be a decisive factor.