Alright Arnold, let's rock. Sorry I couldn't get to this in more detail yesterday, but I was busy fighting lions with my bare hands. Nevertheless, as you've likely heard, Arnold Schwarzenegger has returned from some point in the distant future to save Alright Arnold, let's rock. Sorry I couldn't get to this in more detail yesterday, but I was busy fighting lions with my bare hands. Nevertheless, as you've likely heard, Arnold Schwarzenegger has returned from some point in the distant future to save John Connor, now an uninsured Californian at a low wage service job who's going to need some critical diagnostic tests but currently lacks health coverage. So Schwarzenegger, in what's really an unexpected plot twist for the Republican governor, has proposed a comprehensive reform package for California.
If you remember my posts on Wyden's health reform bill, you're basically up to speed. Arnold's strategy is an individual mandate to guarantee universality, subsidies up to 250 percent to ensure affordability, and community rating (meaning insurers can't price discriminate based on health history or preexisting conditions) to keep the costs of the general pool affordable. All kids are covered -- including the children of illegal immigrants, which has the right in a predictable tizzy, but gives me far greater respect for Arnold. The bill diverges from Wyden's plan in that Arnold's offering what's called a Pay-or-Play scheme: Where Wyden dynamited the employer-based system, Arnold is using them for funding. Under his bill, businesses with 10+ employees can either offer their own health care or pay a tax (I'm sorry: "fee") equal to 4% of payroll. Doctors and hospitals would have to pay 2 and 4% of their revenue respectively into a fund for the uninsured. This too is called a "fee," a way for Arnold to keep saying he won't raise taxes -- a dodge I'm perfectly happy to watch him make.
Arnold's plan, which actually has a hope of passage, is more ambitious than anything a Democrat has been able to seriously propose in over a decade. This, again, shifts the conversation left, and it's unimaginably heartening to see a major Republican propose community rating. Nothing in health policy today is more important than instituting community rating. That said, it's got some problems: The subsidies are too stingy, and the minimum required coverage -- a very high deductible plan -- isn't nearly coverage enough. The Wyden plan, by contrast, subsidized up to 400% of the poverty line and demanded benefits equal to a Blue Cross standard plan -- a barebones but still protective insurance package. The worry here is that insurers will compete by offering the least coverage for the cheapest price, and Arnold's plan doesn't do enough to stop that.
