Assembly and Senate Health Care Bills Explained

Assembly Speaker Fabian Núñez’s Proposal (AB 8) – Prior to Merge with Perata’s SB 48
Speaker Núñez’s proposal will cover an estimated 3.4 million (or two thirds of Californians uninsured at a given point in time).  This plan would require most businesses to provide health care for workers or pay 7.5 percent of payroll into a state insurance fund to help pay for coverage for those employees who are not offered a plan through their employer.  The Nunez plan was recently passed by the state Assembly and is now before the Senate. 

Senate President Pro Tem Don Perata’s Proposal (SB 48) – Prior to Merge with Núñez’s AB 8
Senator Don Perata’s health reform proposal aimed to significantly expand affordable coverage for Californians. The proposal would have imposed a mandate that all working Californians in families earning above 400% FPL maintain health coverage (envisions maximum premium contribution would be 5% of income). The proposal would have established a "pay or play" system for employers of all sizes; employees whose firms opt to pay into a new trust fund would receive coverage through the newly created Connector. The proposal also would have expanded eligibility for public health insurance programs for children and parents. In addition, the proposal would have been financed through employer fees and through new federal matching dollars associated with public program expansion, and included specific elements to help control health care costs.

Senator Sheila Kuehl’s Proposal (SB 840)
This bill would have created a so-called “single-payer” system to cover all Californians. Senator Sheila Kuehl’s health reform proposal aimed to provide affordable health coverage for all Californians by creating a new single-payer system. This new government-administered system would have replaced private health insurers and would provide a uniform, comprehensive set of benefits for all. A new California Health Insurance System Commissioner would negotiate and set rates for health care services, prescription drugs, and medical supplies.  Companion legislation, SB 1014, would finance the proposal via new payroll taxes (anticipated at three to four percent for individuals and eight percent for employers), an additional income tax on those earning more than $200,000, and anticipated administrative and other savings. The proposal included specific elements to help control health care costs. 

Republican Proposal (SB 246)
Republican Senator George Runner's health reform proposal (SB 236) proposed to expand access to affordable care and coverage by providing incentives for hospitals and private industry to create more clinics, giving employers incentives to offer Health Savings Accounts, and allowing the same tax treatment for the self-employed who purchase health coverage as for large employers. The bill also sought to increase competition among health plans by allowing great flexibility in small group premiums and relaxing health plan regulatory requirements. The bill would offer health care providers a tax credit for costs of caring for the uninsured.  The proposal would be financed by redirecting existing safety net and other funding for clinic and coverage expansion.

The Núñez and Perata bills were merged and passed as AB 8 by both the Assembly and the Senate and sent to the Governor for his approval, which he vetoed on October 12, 2007.

Senator Kuehl’s “single-payer” bill, and the Republicans’ proposal both “died” when the normal session of the Assembly ended in September.  However, these bills could be refiled and proposed for consideration during the Special Session Governor Schwarzenegger is due to call this coming November.