State Can Take Action on Health

Most Americans with health insurance get it through their employers, so it stands to reason that our now-prosperous economy would result in more people having decent health insurance. But the opposite appears to be happening. A Census Bureau survey finds that the percentage of uninsured Americans has jumped to 16.4%, the highest rate in a decade.

The situation is likely to worsen with expected increases of 5% to 25% next year in managed care premiums. These predictions have generated some modest, low-cost proposals in Congress worth considering.

Congressional Republicans suggest allowing small and medium-sized businesses to band together to buy health insurance through trade associations and professional organizations. Most adults who lack health insurance work for firms with 50 or fewer employees; about 40% of such firms offer no health insurance.

The Clinton administration has another timely idea: allow people aged 55 to 64 who’ve lost their jobs to buy into Medicare. The government would contribute part of the cost, much as companies do for employee health care. The administration also wants to set some money aside to enable disabled people who take a job--and their dependents--to retain Medicare and Medicaid benefits. Now, fewer than 1% of the 8 million working-age disabled people who receive Social Security and related benefits return to work, even though nearly two-thirds say they would if they wouldn’t lose their health benefits.

Unfortunately, consensus for these moderate steps is unlikely because the Republican leadership is insisting that any health care reforms be tied to a radical idea: divorcing health coverage from employment and subsidizing workers so they can buy private insurance directly and individually. The government essentially would give individuals tax credits for buying basic health coverage--credits it now gives to business.

In practice, health care analysts say, it would result in astronomical rates for individuals who are less healthy, exacerbating the current crisis. It would also free employers of responsibility for seeing that employees have health coverage.

The good news is that California can do a lot on its own while Congress bickers. Gov.-elect Gray Davis could sign two bills by state Sen. Herschel Rosenthal (D-Los Angeles) that Gov. Pete Wilson vetoed earlier this year. The first would allow Californians between 55 and 59 to retain a link to their group-sponsored health insurance if they lost their jobs, while the second would expand California’s successful “small business” health insurance reforms to “mid-size” firms with between 51 and 100 employees.

The uninsured in California are not slackers; at least 85% come from working families. When they lack health insurance, all taxpayers lose out. The uninsured often end up in an emergency room or urgent care clinic where their health care costs are ultimately borne by those who have insurance and pay for it. Insuring more people helps bring individual premium costs down; government should prod employers toward that goal.