BILL ANALYSIS                                                                                                                                                                                                    



                                                                       


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                                 IN CONFERENCE


          Bill No:  SB 2
          Author:   Burton (D) and Speier (D)
          Amended:  6/23/03
          Vote:     21

           
           SENATE INSURANCE COMMITTEE  :  6-3, 4/30/03
          AYES:  Speier, Escutia, Figueroa, Perata, Scott, Soto
          NOES:  Johnson, Morrow, Oller

           SENATE HEALTH & HUMAN SERV. COMMITTEE  :  9-3, 5/7/03
          AYES:  Ortiz, Alarcon, Chesbro, Figueroa, Florez, Kuehl,  
            Romero, Vasconcellos, Vincent
          NOES:  Aanestad, Ashburn, Battin
          ABSENT/NO VOTE RECORDED:  Escutia

           SENATE APPROPRIATIONS COMMITTEE  :  8-5, 5/29/03
          AYES:  Alpert, Bowen, Burton, Escutia, Karnette, Machado,  
            Murray, Speier
          NOES:  Battin, Aanestad, Ashburn, Johnson, Poochigian

           SENATE FLOOR  :  25-14, 6/4/03
          AYES:  Alarcon, Alpert, Bowen, Burton, Cedillo, Chesbro,  
            Ducheny, Dunn, Escutia, Figueroa, Florez, Karnette,  
            Kuehl, Machado, Murray, Ortiz, Perata, Romero, Scott,  
            Sher, Soto, Speier, Torlakson, Vasconcellos, Vincent
          NOES:  Aanestad, Ackerman, Ashburn, Battin, Brulte, Denham,  
            Hollingsworth, Knight, Margett, McClintock, McPherson,  
            Morrow, Oller, Poochigian
          ABSENT/NO VOTE RECORDED:  Johnson

           ASSEMBLY FLOOR  :  45-30, 7/7/03 - See last page for vote


                                                           CONTINUED





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                                                                Page  
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           SUBJECT  :    Health care coverage

           SOURCE  :     California Labor Federation, AFL-CIO


           DIGEST  :    This bill enacts the Health Insurance Act of  
          2003 to ensure all working Californians and their families  
          are provided health care coverage.  (NOTE:  The bill makes  
          only findings and declarations and is to be enacted as a  
          vehicle for the same subject matter.) 

           Assembly Amendment  makes a technical change in order to  
          have the Senate non-concur and send this bill to Conference  
          Committee.

           ANALYSIS  :    Existing law provides for the creation of  
          various programs to provide health care coverage (coverage)  
          to persons who have limited incomes and meet various  
          eligibility requirements.  These programs include the  
          Healthy Families Program (HFP) administered by the Managed  
          Risk Medical Insurance Board (MRMIB), and the Medi-Cal  
          program administered by the State Department of Health  
          Services.  It also provides for the regulation of plans by  
          the State Department of Managed Health Care and health  
          insurers by the State Department of Insurance. 

          This bill enacts the Health Insurance Act of 2003 and makes  
          the following findings and recommendations:
           
           1. Working Californians and their families should have  
             health insurance coverage.

          2. Most working Californians obtain their health insurance  
             coverage through their employment.

          3. In 2001, more than 6,000,000 Californians lacked health  
             insurance coverage at some time and 3,600,000  
             Californians had no health insurance coverage at any  
             time.

          4. More than 80 percent of Californians without health  
             insurance coverage are working people or their families.  
              Most of these working Californians without health  
             insurance coverage work for employers who do not offer  







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             health benefits.

          5. People who are covered by health insurance have better  
             health outcomes than those who lack coverage.  Persons  
             without health insurance are more likely to be in poor  
             health, more likely to have missed needed medications  
             and treatment, and more likely to have chronic  
             conditions that are not properly managed.

          6. Employers who do not provide health benefits to their  
             workers have an unfair competitive advantage over those  
             employers who provide health benefits.  Employers who  
             provide health benefits often pay directly for the  
             failure of other employers to provide health benefits by  
             providing health benefits to spouses and other  
             dependents who should be covered by the spouse's or  
             dependent's employer.  Employers who provide health  
             benefits also pay directly when a previously uninsured  
             person becomes an employee and the accumulated health  
             costs due to lack of insurance burden the employer  
             providing health benefits.

          7. Health benefit costs in California generally are lower  
             than costs in other states but employers generally are  
             less likely to offer coverage.

          8. Controlling health care costs can be more readily  
             achieved if all working people and their families have  
             health benefits so that cost shifting is minimized.

          9. It is the intent of the Legislature to assure that  
             working Californians and their families have health  
             benefits and that their employers shall either provide  
             those benefits or pay a user fee to the State of  
             California so that the state may serve as a purchasing  
             agent to pool those fees to purchase coverage that would  
             otherwise have been purchased directly by employers.

          10.While covering all working people and their families  
             will substantially reduce the number of Californians  
             without health insurance, several million Californians  
             will still lack health coverage.

          11.It is therefore not the intent of the Legislature to  







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             reduce or eliminate funding for safety net programs that  
             provide access to care for those who remain uninsured.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  No    
          Local:  No

           SUPPORT  :   (Verified  7/8/03)

          California Labor Federation, AFL-CIO (source)
          Alliance of Catholic Health Care
          Amalgamated Transit Union Locals 1555 and 1574
          American Association of Retired Persons, California
          American College of Cardiologists (California Chapter)
          American College of Emergency Physicians (California  
            Chapter)
          American Federation of Government Employees Local 1881
          American Federation of State, County, and Municipal  
            Employees, plus Locals 1555, 1574, 1902
          American Nurses Association of California
          Art Directors Guild
          Asian Pacific American Legal Center of Southern California
          Association of Flight Attendants Local 11
          Bakery Wagon Drivers Local #484
          Being Alive Los Angeles
          Brewery Soda and Mineral Water Bottlers of California Local  
            896
          Building and Construction Trades Council of San Mateo  
            County
          Building Material, Construction, Industrial, Profession and  
            Technical Teamster Union Local #36
          Butchers' Union Local 120
          California Association of Public Hospitals & Health Systems
          California Commission on Aging
          California Commission of the Status of Women
          California Conference Board of the Amalgamated Transit  
            Union
          California Conference of Machinists
          California Faculty Association
          California Federation of Teachers
          California Independent Public Employees Legislative Council
          State Insurance Commissioner John Garamendi
          California Medical Association
          California National Organization for Women
          California Optometric Association







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          California Organization of Police and Sheriffs
          California Physical Therapists Association
          California Professional Firefighters
          California School Employees Association
          California State Employees Association
          California Teachers Association
          California Women's Law Center
          Central Labor Council of Alameda County
          Central Labor Council of Contra Costa County
          City and County of San Francisco
          Coalition for Humane Immigrant Rights of L.A.
          Commission on the Status of Women
          Communications Workers of America Locals 9000, 9414, 9415,  
          9423, 9503 Congress of California Seniors
          Consumer Federation of California
          Consumers Union
          East Bay Automotive Machinists Lodge 1546
          Electric Workers Local 595
          E-Loan
          Engineers and Scientists of California, Local 20
          Faculty Association of California Community Colleges, Inc.
          General Teamsters Local 386
          General Teamsters, Warehousemen, Cannery Workers & Helpers  
            Union #94
          General Truck Drivers, Chauffeurs and Helpers Union Local  
            692
          Glaziers, Architectural Metal & Glass Workers #718
          Greenlining
          Harman International
          Health Access California
          Hotel Employees & Restaurant Employees International Union  
            and Local 49 
          International Association of Bridge, Structural, Ornamental  
            and Reinforcing Iron Workers Union Locals 155 and 377
          International Association of Machinists and Aerospace  
            Workers Local 1528
          International Brotherhood  of Electrical Workers Local  
            Union 11, 18, 100, 302, 551, 569, 1245 
          International Federation of Professional & Technical  
            Engineers Local 21
          ITUP
          JERICHO
          Joint Council of Interns and Residents
          Korean Resource Center







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          Latino Issues Forum
          League of Women Voters of California
          League of Women Voters of Whittier and Sonoma County
          Lieutenant Governor Cruz Bustamante
          Los Angeles County Board of Supervisors
          Machinists Automotive Trades District Lodge #190 of  
            Northern California
          Marine Firemen's Union
          Mental Health Association in California
          Mexican American Legal Defense & Educational Fund
          National Association of Broadcast Employees and Technicians
          National Association of Letter Carriers Branch 183
          Northern California District Council - International  
            Longshore and Warehouse Union
          National Immigration Law Center
          Office & Professional Employees International Union Local  
            #3
          Older Women's  League of California
          Painters & Allied Trades District Council 36
          Peninsula Automotive Machinists Union Local 1414
          Planned Parenthood Affiliates of California
          Planned Parenthood Golden Gate
          Plumbers, Steamfitters & Refrigeration Fitters Local Union  
            #467
          Professional and Technical Engineers, Local 21
          San Diego-Imperial Counties Labor Council
          San Francisco Labor Council
          San Mateo Building & Construction Trades Council
          Service Employees International Union Locals 104, 2028,  
            3998
          Sheet Metal Workers' International Association
          Southern California Typographical and Mailer Union Local  
            14904
          State Building and Construction Trades Council
          Teamsters Locals 350, 601, 517
          Teamsters Joint Council 7 and 42
          Union of American Physicians & Dentists
          United Farm Workers of America
          United Food & Commercial Workers Region 8 States Council  
            plus Locals 373, 839, 870, 1179
          United Food & Commercial Workers Retiree's Club Locals  
            373R, 532
          United Nurses Associations of California/ Union of Health  
            Care Professionals







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          United Steelworkers of America
          United Teachers of LA
          Utility Workers Union of America Local 246
          West Hollywood Democratic Club
          Work and Family Coalition of Alameda County

           Support, if amended  :

          California Association of Health Underwriters
          California Association on Physicians Groups

           OPPOSITION  :    (Verified  7/8/03)

          Alhambra Chamber of Commerce
          American Electronics Association
          Blue Cross of California
          California Assisted Living Association
          California Bean Shippers Association
          California Business Properties Association
          California Business Roundtable
          California Chamber of Commerce
          California Farm Bureau
          California Federation of Republican Women
          California Grain and Feed Association
          California Manufacturers and Technology Association
          California Small Business Association
          California State Floral Association
          California Warehouse Association
          California Women for Agriculture
          Coalition of California Insurance Professionals
          Life Priority Network
          Metal Finishing Association of Southern California
          Mueller Homes, Inc.
          National Association of Insurance and Financial Advisors,  
          California
          National Federation of Independent Business
          Newport Beach Chamber of Commerce
          Novy, Linda (Gardeners' Guild)
          Orange County Business Council
          Pacific Egg and Poultry Association
          Paper, Pulp and Film Converters
          Redondo Beach Chamber of Commerce
          West Orange County Legislative Committee
          Western Growers Association







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          Women Insurance Agents' Association
          Women Volunteering in Politics

           ARGUMENTS IN SUPPORT  :    According to information provided  
          by the authors' office:

          Working Californians and their families should have health  
          insurance coverage and that most working Californians  
          obtain their coverage through their employment.  In 2001,  
          more than six million Californians lacked coverage at some  
          time, 3.6 million had no coverage at any time, more than 80  
          percent of these were working people or their families, and  
          most of these working Californians without coverage work  
          for employers who do not offer health benefits.  People who  
          have coverage have better health outcomes than those who  
          lack coverage, are more likely to be in poor health, more  
          likely to have missed needed medications and treatment, and  
          more likely to have chronic conditions that are not  
          properly managed. 

          Employers who do not provide coverage to their workers have  
          an unfair competitive advantage over those employers who  
          provide coverage, and that employers who provide coverage  
          to dependents often pay directly for the failure of other  
          employers to provide coverage for those dependents.   
          Employers who provide coverage also pay directly when a  
          previously uninsured person becomes an employee and the  
          accumulated health costs due to lack of insurance burden  
          the employer providing coverage.

          Controlling health care costs can be more readily achieved  
          if all working people and their families have coverage so  
          that cost shifting is minimized. 

           ARGUMENTS IN OPPOSITION  :    Blue Cross believes this bill  
          cannot achieve its aims due to Employee Retirement Income  
          Security Act (ERISA)  preemption problems that may result  
          in higher rates.  Under the federal ERISA preemption act,  
          state law cannot dictate what benefits an employer provides  
          if the employer is self-insured.  Blue Cross states many  
          larger employers are self-insured, which means the mandates  
          for coverage and benefits do not affect them, and that the  
          extremely rich mandates in this bill will force even more  
          employers into self-insurance to avoid its mandate.  As the  







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          healthier employer groups with fewer claims increasingly  
          self-insure, the remaining employers will have higher rates  
          since the pool would be sicker.

           ASSEMBLY FLOOR  : 
          AYES:  Berg, Bermudez, Calderon, Canciamilla, Chan, Chavez,  
            Chu, Cohn, Corbett, Correa, Diaz, Dutra, Dymally,  
            Frommer, Goldberg, Hancock, Jerome Horton, Jackson,  
            Kehoe, Koretz, Laird, Leno, Levine, Lieber, Longville,  
            Lowenthal, Matthews, Montanez, Mullin, Nakano, Nation,  
            Negrete McLeod, Nunez, Oropeza, Parra, Pavley,  
            Ridley-Thomas, Salinas, Simitian, Steinberg, Vargas,  
            Wiggins, Wolk, Yee, Wesson
          NOES:  Aghazarian, Bates, Benoit, Bogh, Campbell, Cogdill,  
            Cox, Dutton, Garcia, Harman, Haynes, Shirley Horton,  
            Houston, Keene, La Malfa, La Suer, Leslie, Maldonado,  
            Maze, McCarthy, Mountjoy, Nakanishi, Pacheco, Plescia,  
            Richman, Runner, Samuelian, Spitzer, Strickland, Wyland


          DLW:mel  7/15/03   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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