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Insurance Expansion Won't Die, Vow Calif. Governor, Advocates

Mental health advocates insist that any future statewide push to expand insurance and health care access in California will focus on maintaining the state's insurance parity requirements.

The California dream of comprehensive health insurance died after state senators roundly rejected a $15 billion plan backed by Gov. Arnold Schwarzenegger (R). But mental health advocates nevertheless remain committed to keeping alive the goals of the failed proposal.

The governor and Democratic leaders in the state Assembly backed the bill (ABX1 1), which would have directed large employers to fund insurance for those unable to afford it. The measure aimed to alleviate health care disparities in the most populous state and the one that also has the largest number of uninsured residents—6.5 million people.

However, the health care proposal came as the state faced a $14.5 billion budget deficit. A critical state Senate committee voted against the measure in January—it was defeated by a vote of 7-1—claiming it was too costly.

Schwarzenegger and proponents of increased access to health care and insurance remain committed to some type of health insurance expansion.

Randall Hagar, government affairs director of the California Psychiatric Association (CPA), said psychiatrists in the state plan to push for another effort to expand health care access.

"There is some energy, and a lot of us in the health care advocacy community and patient groups are worried that this will now derail [the expansion effort], and so everybody is talking about continuing to push the process," he told Psychiatric News.

A new push for expanded health care access will have to await the selection of new leaders in the California legislature after voters rejected a ballot proposition in early February to alter term limits for California politicians. Keeping the status quo will result in the retirement of many legislative leaders at the end of the current session. The change in leadership, when it comes, may help allay concerns among Senate critics of the insurance measure who complained that they were not consulted before the governor and Assembly leaders agreed to a plan and sent it to voters for approval of funding.

"So some of those relationship issues also have to be worked out before people [in state government] can start negotiating again," Hagar said.

CPA's priority in any new health care expansion measure is to ensure that the needs of residents with mental illness are "fully addressed," including the provision of insurance coverage at full parity with that provided for other medical disorders and coverage of all disorders in DSM-IV, including substance use disorders, Hagar said.

The defeated measure limited parity coverage to the state's existing parity law, which the CPA considers the minimum coverage it will accept in any future effort.

Sen. Darrell Steinberg (D) is slated to become the new Senate president pro tem after the current legislative session ends. Steinberg was described by the CPA as a "mental health champion" who has long supported mental health measures and children's health issues. Steinberg opposed the Schwarzenegger plan but supports another effort—as yet unspecified—to improve health care access.

Information on ABX1 1 is posted at <www.assembly.ca.gov/acs/acsframeset2text.htm>.

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