Broader Medical Insurance Sought

Assembly Speaker Willie Brown, hoping for a dramatic reduction in the number of Californians without medical insurance, introduced legislation Wednesday that would require employers with five or more employees to provide basic health-care coverage.

Brown, a San Francisco Democrat who has been seeking to blunt criticism that he is more interested in politics than in policy, predicted that his proposal would provide health-care coverage for about 2.5 million workers and half a million dependents.

Brown said California, with 5 million uninsured, ranks among the states with the highest percentages of residents without health coverage. He said his plan would move it to the ranks of those with the lowest percentages.

At the same time, he said it would help provide financial relief to the state’s beleaguered hospitals, which have absorbed much of the cost of providing care to those without insurance.

The coverage would include physician care and acute hospital inpatient and outpatient care.

Brown estimated that the cost of coverage would be roughly $85 monthly per employee.

Several health professionals disputed that figure. “It seems impossibly low,” one said privately.

The $85 figure does not include the cost of providing coverage for dependents, which could either be provided at the employee’s expense or by the company as an additional negotiated benefit.

“The working poor are virtually without any coverage at all currently, and that’s exactly what this is designed to address,” Brown said.

The proposal drew an unenthusiastic response from public-interest advocates, who said they see it as failing to fully address the state’s health-care crisis. Business representatives also said they feared it would encourage more small-business failures.

“It places a further burden on employers without reining in (health-care) costs. The Speaker’s bill doesn’t move toward cost containment. It sort of sidesteps that very thorny issue,” said Maryann O’Sullivan, executive director of Health Access, a statewide coalition of consumer interest, religious, labor and senior citizen organizations.

Martyn Hopper, state director of the National Federation of Independent Business, said: “Those who don’t provide health insurance don’t do so because they literally cannot afford it. What is the effect of this on these marginal small businesses? I shudder to think.”

Hopper, whose organization’s 50,000 members average eight employees, said Brown’s proposal would require a particularly expensive basic coverage plan with few deductibles. “We all recognize there is the societal problem of the uninsured in California, but the question is: On whose back is it to be solved?”

Brown, acknowledging that his bill would primarily affect small businesses because most large enterprises already provide health-care insurance, argued that it would help stabilize the business economy by providing an incentive for workers to stay in their jobs.

He said businesses that provide insurance would get tax benefits to help offset the cost. He also said his legislation would provide for pooling coverage, which would make lower rates available to employers.

Although his plan is modeled after a similar program in Hawaii that applies to businesses with one or more employees, Brown said he chose initially to require that insurance be provided by businesses with five or more full-time employees.

“What’s magic about five?” he asked. “Just a pure, unadulterated practical number.”