BILL ANALYSIS                                                                                                                                                                                                    




                   Senate Appropriations Committee Fiscal Summary
                           Senator Christine Kehoe, Chair

                                           810 (Leno)
          
          Hearing Date:  5/4/2009         Amended: 4/23/2009
          Consultant: Katie Johnson       Policy Vote: Health 7-4
          _________________________________________________________________ 
          ____
          BILL SUMMARY:  SB 810 would establish the California Healthcare  
          System (CHS), an entity that would provide affordable and  
          comprehensive health care coverage for all Californians.
          _________________________________________________________________ 
          ____
                            Fiscal Impact (in thousands)

           Major Provisions         2009-10      2010-11       2011-12     Fund
                                                                  
          CHS Implementation                Major implementation costs in  
          the billions  General
                                   at least $200 billion annually ongoing
          _________________________________________________________________ 
          ____

          STAFF COMMENTS: This bill meets the criteria for referral to the  
          Suspense File.

          This bill would establish the CHS, which would be administered  
          by the California Healthcare Agency under the control of a  
          Healthcare Commissioner appointed by the Governor and confirmed  
          by the Senate. The CHS would provide specified health care  
          benefits for which all Californians would be eligible. The CHS  
          would, on a single-payer basis, negotiate for or set fees for  
          health care services and would pay claims for those services.  
          This bill would require the commissioner to seek all necessary  
          federal waivers, exemptions, agreements, and legislation to  
          implement the CHS. This bill would prohibit the sale of any  
          private health care service plan or health insurance policy in  
          the state. This bill would provide that a resident with an  
          income at or below 200% of the Federal Poverty Level (FPL) would  
          be eligible for benefits like those provided by California's  
          existing Medi-Cal program. This bill would create various  
          offices and boards to aid in the administration of the CHS.

          This bill would specify that only the provisions relating to the  
          Premium Commission would become operative on January 1, 2010,  










          and that the remaining provisions would become operative on the  
          date that the Secretary of California Health and Human Services  
          states that sufficient funding exists to implement the CHS. This  
          bill would require that the CHS become fully operative 2 years  
          from that date.

          This bill is nearly identical to SB 840 (Kuehl), which the  
          Governor vetoed in 2008 saying, "According to the Legislative  
          Analyst's Office, the bill is estimated to cost $210 billion in  
          its first full year of implementation and cause annual  
          shortfalls of $42 billion. To place this in proper  
          perspective-our state budget deficit this year started at $24.3  
          billion." Since this bill is nearly identical to SB 840, and as  
          such, would have a similar fiscal impact on the state, it does  
          not address the veto message.

          This bill is also similar to SB 921 (Kuehl, 2004), a bill that  
          would have implemented a single-payer health care system. SB 921  
          was held in the Assembly Health Committee.
          Page 2
          SB 810 (Leno)

          In response to SB 921 in 2005 and to SB 840 in 2008, the Lewin  
          Group and the Legislative Analyst's Office (LAO), respectively,  
          analyzed the concept of a single-payer government health care  
          entity with respect to California.

          The LAO report analyzed SB 840 and its funding mechanism SB 1014  
          (Kuehl, 2008), which would have imposed a combined 12 percent  
          tax on employers and employees for the purposes of providing a  
          funding source for SB 840, as a comprehensive "single-payer  
          proposal" and assumed an implementation date of January 1, 2011.  
          The analysis predicted a net shortfall of $42 billion in the FY  
          2011-2012, the first full year of implementation, and $46  
          billion in 2015-2016, due to a faster rate of growth for health  
          benefits costs relative to SB 1014 revenues. The LAO estimated  
          that it would take a tax of 16 percent to mitigate the predicted  
          shortfall in revenues. The LAO estimated annual costs of $210  
          billion in the first year of implementation, which would grow  
          over subsequent years to $250 billion in 2015-2016. The LAO  
          assumes that the state would realize savings due to reduced  
          physician and hospital administration costs and that the system  
          would be able to operate at relatively low administration costs.  
          The analysis also assumes that federal, state, retired state  
          employee health contributions and local government contributions  
          would shift to the single-payer system.











          The Lewin Group's analysis of SB 921 estimated costs would be  
          $167 billion in 2006 and would increase to $280 billion in 2015.  
          The group assumed similar revenues to those later proposed in SB  
          1014 in 2007. It is important to note that the Lewin Group based  
          its estimates on 2004 cost data and that health care costs have  
          increased faster than anticipated.

          Unlike previous bills, there is no funding source identified for  
          the implementation of this bill. Thus, there would be  
          considerable General Fund pressure in the hundreds of billions  
          of dollars. Also, were there a funding mechanism, the pressure  
          on the General Fund would continue to exist, although to a  
          lesser extent, because the General Fund would be responsible for  
          providing supplemental moneys in the event of a shortfall.

          It is likely that the costs associated with the implementation  
          of this bill would result in costs similar to those projected in  
          both the LAO and Lewin Group analyses. However, the LAO and  
          Lewin Group analyses do not take into consideration several  
          effects of the transition between California's current health  
          care system and a single-payer system. For example, there would  
          likely be significant up-front implementation costs, labor  
          market disruptions, as well as reduced tax revenue from  
          insurance companies. It is also possible that the provisions in  
          this bill would make the state ineligible for federal Medicaid  
          and Children's Health Insurance Program (CHIP) federal matching  
          funds if the Centers for Medicare and Medicaid (CMS) do not  
          approve waivers of federal Medicaid law. Medi-Cal, California's  
          Medicaid program, and the Healthy Families Program, California's  
          CHIP, receive federal funds which match state General Funds to  
          provide health care benefits to low-income individuals.