The California Health Insurance Reliability Act is based on a model released in January 2005 by the Lewin Group, an independent health care analysis firm. It would provide all state residents with full coverage of medical, dental, vision, and hospitalization services, and pharmaceutical benefits, through a statewide, single payer system.
The Lewin Group study was commissioned by California Health and Human Services, in accordance with a bill passed by the state legislature in 1999 that required a study of universal health coverage options. Nine proposals were studied- three single payer models and six proposals that increase coverage through public program expansions, employer incentives, or combination approaches.
The study was presented at the state capitol in 2002. John Shiels of the Lewin Group concluded the presentation by saying, “One of the major claims of the single payer advocates for a long time has been that we could cover more people, for more services, for less money. Our study is showing that, for these very carefully designed plans, that’s true. To the best of our ability to estimate it, that’s true.”
The first bill based on the study, the Health Care for All Californians Act, was passed by the California Assembly Health Committee in 2004. It was based on recommendations from the public, health care stakeholders, and features of the three single payer models evaluated in the study. It was then put on hold, pending an additional Lewin Group study commissioned to evaluate financing alternatives.
The California Health Insurance Reliability Act (SB 840) was introduced in February 2005 and passed the legislature in 2006. The bill was vetoed by the Governor on September 22, 2006.
Accordingto the summary, the bill would establish the California Health Insurance System to be administered by the newly created California Health Insurance Agency under the control of a Health Insurance Commissioner appointed by the Governor and subject to confirmation by the Senate. The bill would make all California residents eligible for specified health care benefits under the California Health Insurance System, which would, on a single-payer basis, negotiate for or set fees for health care services provided through the system and pay claims for those services. The bill would require the commissioner to seek all necessary waivers, exemptions, agreements, or legislation to allow various existing federal, state, and local health care payments to be paid to the California Health Insurance System, which would then assume responsibility for all benefits and services previously paid for with those funds.
More information:
- The full text of the bill (SB 840) is available from the California Legislature
- Lewin Group report on the economic impact of SB 840 (formerly SB 921) (PDF)
- A Background of SB 840, from Health Care for All- California
- Health Care for All California
- American Health Care Reform is tracking the progress of the California Health Insurance Reliability Act during the 2005 legislative session. It also has information on single payer initiatives throughout the U.S.
- Physicians for a National Health Program