California Embraces New Health Care Law

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House Republicans plan to vote next week to repeal the new federal health law, but most representatives from California are unlikely to be joining them.

California has blazed many trails — from wheat-grass shots to personal computing. But with the health overhaul, it's shaping up less as a trailblazer and more as a renegade. Its congressional delegation and new crop of state leaders, including new California insurance chief Dave Jones, are not only embracing the law — they are championing it.

"As to my first priority — the implementation of health care reform — I believe it is important to move forward here in California even if a new Republican majority in the House of Representatives wants to turn the clock back and deny Americans health reform," Jones said.

To wit: Jones' first act was signing an emergency order expanding his powers to enforce the federal law. He says the move was necessary should the Republican majority in Washington, D.C., handcuff federal enforcement through budget cuts. And like a good old barn-raising, the California insurance exchange — a centerpiece of the plan — is rising out of the earth practically overnight, with help from both parties.

Earlier this week, outgoing Republican Gov. Arnold Schwarzenegger made two appointments to the board that will oversee the exchange: his chief of staff, Democrat Susan Kennedy, and former Secretary of Health and Human Services Kim Belshe, a Republican.

Belshe noted that California wasn't starting from scratch with implementation. She led Schwarzenegger's effort to remake the state's insurance market in 2007, an overhaul similar to what is now federal law. The proposal failed, but Belshe said it created momentum.

"California's guiding motto for health reform implementation has been '2014 is tomorrow,' " she said. "And it's true that many federal reforms aren't slated to take effect until 2014, but the magnitude and the import of the state responsibilities require action now."

Not everyone is waving their pompoms, however.

The state's chamber of commerce and other business groups oppose the federal health law, which they say is too costly for employers.

Still, strong support for the health law isn't surprising, said Democratic political consultant Chris Lehane. California Democrats have a big lead in voter registration, in part because of a loyal — and growing — Latino population.

"Part of it is the demographics," he said. "Part of it is just the culture that exists out in California — people are forward-looking; they embrace change."

California's enthusiasm is buoyed, no doubt, by the fact that the state won't pay for the expanded coverage out of its own depleted vault -– at least not right away. And it has much to gain. The state has legions of uninsured residents — many working low-paying, service-sector and agricultural jobs. Some 3.4 million people are projected to gain coverage by the middle of the decade.

"There is a huge benefit for folks in California from this legislation," said Robert Restuccia, the head of Community Catalyst, a Boston-based consumer advocacy group that supports the federal law. "You have an insurance market that really discriminates against anyone who is sick. You have one of the highest number of uninsured. You have a delivery system that is underfinanced."

Elsewhere in the nation, the federal health plan isn't giving state leaders the warm-and-fuzzies: Oklahoma's new Republican insurance chief is part of a lawsuit challenging the law's constitutionality. At least 20 states have joined legal efforts to scuttle the health care law. In Alaska, Republican Gov. Sean Parnell has given federal planning grants the cold shoulder.



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