California Eyes Health Insurance for All Gov. Arnold Schwarzenegger unveils plans to require all Californians to have health insurance and to extend coverage to more than 6 million state residents who have no insurance.
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California Eyes Health Insurance for All

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California Eyes Health Insurance for All

California Eyes Health Insurance for All

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RENEE MONTAGNE, host:

Here in California there are far more uninsured Americans than in any other state. One fifth of the state's population doesn't have health insurance, but that could change soon. Republican Governor Arnold Schwarzenegger has announced a dramatic and detailed healthcare plan which could appeal to both Republicans and Democrats.

NPR's Patty Neighmond reports.

PATTY NEIGHMOND: It's a big plan with big goals, bringing the state's six and a half million uninsured citizens into the healthcare system. Governor Arnold Schwarzenegger.

Governor ARNOLD SCHWARZENEGGER (Republican, California): There's a lot of people on the table, a lot of stakeholders in everyone. Some people would not be pleased to tell us these things; other people would be very pleased with other things. But it's perfectly OK because there is not package that is perfect.

NEIGHMOND: The plan would cost billions but Governor Schwarzenegger says it can be done, everyone will benefit. State Health and Human Services Secretary Kim Belshe.

Ms. KIM BELSHE (Secretary, California Health and Human Services): We mean individuals, employers, government, health plans and health professionals. All have a responsibility to be a part of the solution. If California's going to fix its broken healthcare system, it's going to require changes from all of us.

NEIGHMOND: Under the plan, businesses with ten or more employees would be required by law to provide health benefits. Those with less than ten employees would be exempt. But all state citizens would be required to have insurance, sort of like auto insurance, so those without it would have to buy it. They'd get a tax break, and if they're low income but not low enough to qualify for Medi-Cal, California's version of Medicaid, there would be subsidies.

Ms. BELSHE: A family, for example, of four making $20,000 a year would have to contribute about $800 over the course of the year for their health coverage.

NEIGHMOND: A significant discount considering that today's average family of four policy runs about $10,000. Overall, Schwarzenegger's plan would cost about $12 billion. State officials say that cost would be covered by the new contributions from employers, individuals and a tax on doctors and hospitals.

The debate has already begun, starting practically the minute the plan was unveiled to members of the press and a variety of special interests, including Joel Fox with the Small Business Action Committee. Fox says he's concerned about the proposal's unintended consequences.

Mr. JOEL FOX (President, Small Business Action Committee): For instance, will some businesses opt out of covering their employees and go into the pool, thus overwhelming the pool? Will they cherry-pick the employees to find employees who are more easily covered by insurance rather than old guys like me who are starting to fall apart?

NEIGHMOND: But Belshe says there would be new rules preventing insurers from refusing to sell coverage to anyone or dumping coverage and driving prices up when people get sick. Len Nichols is an economist with the New America Foundation, which has worked with the governor over the past year or so to help craft the plan. He says it's a well thought out plan with bipartisan appeal. For Democrats, it's universal coverage. For Republicans, it's Schwarzenegger's record.

Mr. LEN NICHOLS (Economist, New America Foundation): He has a credibility to speak from the right about the nature of the situation on the ground in California, the nature of the healthcare crisis they face, and the reluctance that he has always shown to spend new money.

NEIGHMOND: But in the case of health reform, Nichols says, the governor determined that the cost was worth it. As a result, Schwarzenegger's locking arms, says Nichols, not only with Republicans but with Democratic centrists and even liberals.

Patty Neighmond, NPR News.

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