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Insurance News Today - January 13, 2007

A proposal announced on Monday by California Gov. Arnold Schwarzenegger (R) that would require all state residents to obtain health insurance "is promising and ambitious but faces a long, hard fight before enactment," the New York Times reports (McKinley, New York Times).

Under the proposal, California employers with 10 or more employees would have to offer health insurance for workers or pay a fee of 4% of payroll to a state pool that would help workers purchase coverage, with the amount that they pay based on income. Employees could pay for health insurance with pretax income.

Arnolds idea would require health insurers to sell policies to all state residents, regardless of whether they have medical conditions. State residents who refuse to obtain health insurance could face reductions in their state income tax refunds or have their wages garnished.

This proposal also would extend coverage under Medi-Cal, the state Medicaid program, to all adults with annual incomes of as much as 100% of the federal poverty level and to children -- regardless of their immigration status -- in households with annual incomes of as much as 300% of the federal poverty level.

This new plan would provide additional subsidies to help state residents with annual incomes of as much as 250% of the federal poverty level purchase health insurance. In addition, the proposal would increase by $4 billion reimbursements to health care providers under Medi-Cal.

Under the proposal, physicians would have to pay 2% and hospitals would have to pay 4% of their revenue to help cover the cost. According to Schwarzenegger aides, the governor would finance the proposal in part with about $5 billion in federal matching funds that the state will receive as a result of restructured health care programs and with state funds currently used to finance charity care