Rough seas ahead for healthcare hybrid plan
Gov. Arnold Schwarzenegger and Democratic legislators are navigating in uncharted waters -- brackish waters -- on a strange voyage searching for elusive healthcare reform.
They’re headed on a route never traveled before, at least that I’m aware of.
The plan is to first pass a bill. Nothing unusual there. That’s what legislators do. This bill would contain the basic framework of dramatic healthcare expansion in California, extending medical coverage to most of the 4.9 million people currently uninsured.
Then the twist: A separate ballot initiative would contain the tax increases needed to finance the healthcare plan. Voters would decide whether to enact Sacramento’s ambitious program.
This hybrid combo -- a bill and an initiative -- is highly unusual, if not unprecedented. Citizens sponsor initiatives -- write the proposals and collect enough signatures to qualify them for the ballot. Well, that’s admittedly Pollyannaish. High-rolling special interests mostly sponsor them.
But legislators don’t, at least not as part of a bill package. California’s Progressive reformers created the initiative system a century ago as a citizens’ check on the political power structure, not as another lawmaking tool of the Capitol elite.
Legislatures and governors do place measures on ballots -- bonds, constitutional amendments -- but those aren’t initiatives.
Individual legislators, on rare occasions, have sponsored their own initiatives without pairing them with bills. Assembly Speaker Fabian Nuñez (D-Los Angeles) currently is backing an initiative on the Feb. 5 ballot to provide term limit flexibility.
Nuñez is going the initiative route on term limits for two reasons: He misguidedly thinks the proposal will be more acceptable to voters if it seems to originate from citizens, not legislators. Also, pushing the measure through the Legislature could be difficult, since it would require a two-thirds majority vote. Many Republicans are skittish about term limits. With an initiative, legislators can avoid having to vote against the popular system.
That’s similar to why Nuñez and Schwarzenegger cooked up the idea of a tax initiative to finance healthcare expansion. This generation of Republicans will never put up the votes necessary to attain a two-thirds majority for passage of any tax hike, no matter the cause. Sales taxes, hospital taxes, employer fees -- all likely to be part of any initiative -- are off-limits for GOP lawmakers.
Like brackish waters -- part salt, part fresh -- the Schwarzenegger-Democrat solution is a fragile mix, a concoction of bill and initiative. It’s designed to circumvent the legislative process on taxes. Some well-heeled interests -- it’s not clear which -- would bankroll the initiative’s signature collecting and big bucks campaign.
So what’s the problem with this, even if it hasn’t been tried before?
For starters, it would confirm many people’s view that the Legislature is indecisive and irrelevant. It can’t even pass a healthcare financing bill and is asking voters for a lifeline. Never mind that it’s because California clings to a rare two-thirds vote requirement for legislative passage of a budget or tax hike.
But beyond that, Schwarzenegger would further alienate Republican legislators. He would be shunting them aside again, signaling that they’re not needed. They are needed, however, in this respect: Any new program as complex and costly as healthcare expansion is likely to require bipartisan support to win public acceptance.
Schwarzenegger, you’ll recall, tried bypassing the Legislature and taking his “reform” measures directly to the people without bipartisan support two years ago. And he piled up on the rocks.
This time, he’d have Democrats onboard. That would be a help. And he’d need it.
There would be troublesome problems of timing.
Early this fall, the Democratic-dominated Legislature would pass a healthcare bill on a majority vote. It would be too late to place a tax initiative on the Feb. 5 presidential primary ballot. It also probably would be too late for the June state primary; signatures would have to be collected by Christmas. So the initiative probably couldn’t get on a ballot until the November 2008 general election.
Schwarzenegger would be signing the bill with trumpets blaring. But everyone would have to wait for more than a year to find out whether the healthcare expansion was real -- whether voters were willing to pay for it. Meanwhile, the opposition drumbeat would grow louder.
Moreover, next year’s state budget brawl is expected to make this summer’s look like a pillow fight. The deficit is projected at roughly $5 billion. Schwarzenegger this year whacked a program for the homeless mentally ill, froze benefits for the aged, blind and disabled and pilfered $1.3 billion from transit. Next year’s cuts could be more Draconian.
Then the voters would be asked to dig deeper for a pricey new state program when Sacramento already wasn’t living within its means. That would be like a family planning to build a fancy new addition on a house that’s crumbling from wood rot.
Schwarzenegger and Democratic leaders dismiss the thought of considering smaller, incremental healthcare steps. Republicans have some worthy ideas: Encourage expansion of neighborhood clinics. Expand the state program of guaranteeing coverage for the uninsurable with preconditions. Create state health savings accounts, as the federal government has.
“The governor’s position has been to welcome everybody’s ideas, but basically embrace nobody’s idea but his own,” complains Republican Sen. George Runner of Lancaster.
Schwarzenegger doesn’t like to take small steps. He’s a political Evel Knievel.
The governor and the Democrats feel they have no other choice than to chug through these brackish waters, challenging the rocky shoals. Republicans are blocking the regular route.
Success is possible. But Schwarzenegger will need to exhibit more skilled seamanship than he has on past ventures.