| I thought this was the key moment in the Appropriations Committee debate over ABx1 1, which passed the Assembly yesterday.
Republican Assemblywoman Mimi Walters asked Nunez and the Department of Finance whether they were certain financial projections would come through. AB x1 1 relies on $4.5 billion in federal dollars in addition to other revenue sources. Department of Finance staffer Tom Sheehy said one provision in ABx1 1 would not be implemented unless the Director of Finance declared that money to pay for the program was in hand and in state coffers.
Assemblyman Mark Leno, Democrat chairman of the Appropriations committee, followed up with questions about whether the program could be turned off if money did not come in as expected. Nunez' staff responded that ballot initiative would contain provisions to assure that insufficient funds would trigger a series of events to pull back the program, including the individual mandate and the market reforms. It would first allow the governor and legislature to fix any fiscal imbalances. If lawmakers and the governor did not act, then the pieces of the legislation would be repealed, including the public program expansions and tax credits, returning the state to the status quo.
This is the key because this is what has happened to every single state that has tried to implement anything approaching universal health care. They pass the bills with a lot of fanfare but are either unable to control costs or keep up with population or their numbers on revenue fall short (nobody EXPECTED the $14 billion dollar budget deficit this year, to use a parallel example), and the program has to be scaled back and eventually scrapped. And there's no massive celebration or gathering on that day, where everyone gets in a room and congratulates each other. But that's what's happened very single time.
The bill has some advances on the health reform front, and is not an ignoble effort. But nobody seems to want to deal with these historical facts. "This is better than nothing" doesn't mean anything when 5-7 years down the road, you're ACTUALLY left with nothing. And I think walling off the funding and claiming that it's revenue neutral makes it more likely that road will be travelled again. The state budget should reflect priorities. We all want every Californian to have access to health care. Paying for it with part gimmick taxes, part wishes and hopes of federal support, et cetera, shows that you really don't value it all that much. And admitting that the program will fall apart unless people continue smoking a lot of cigarettes... well, you see where I'm headed.
UPDATE: Ezra Klein, the sharpest commentator on health care in the progressive blogosphere, on the plan:
It is, in short, a pretty good plan -- better, in certain ways, than those offered by the national Democrats -- and it's got the support of folks ranging from the Democratic legislature to Arnold Schwarzenegger to Andy Stern. I'm not super confident in its long-term prospects, as various groups are going to spend hundreds of millions to defeat the ballot initiative containing its financing package, and even if the plan survives that, I still don't believe states have the fiscal strength to sustain universal health care in times of recession. But I'd like to see it pass, if only for the momentum it would give the national conversation over health reform.
Klein doesn't get back to his native California much, so I can forgive him for later plaudits in the post about Schwarzenegger. But I definitely associate with the remarks I've bolded.
UPDATE II: Shorter Sen. Perata: Fuhgettaboutit.
"I think it's DOA. I haven't found anybody yet that I have talked to that can make any sense out of it. It sounds ridiculous to say that we're going to have health care for everybody in four years, but in the meantime most people won't have health care because we have to cut the budget," Perata told KPIX.
On Monday, the Senate leader sent a letter to the nonpartisan legislative analyst asking what the fiscal impact of the health plan would be on California's budget deficit.
"You couldn't balance your home checkbook that way, much less run the fifth or sixth largest economy in the world," Perata continued in the interview.
Then he ended with this: "He simply does not understand the way in which this works," though it's not clear from the clip who the Oakland Democrat is referring to.