SHEEP'S CLOTHING:

Mandatory Health Insurance Is Urged: Requiring all in the state to carry coverage would address healthcare crisis, backers argue. Critics say subsidies for the poor would be needed. (Jordan Rau, December 15, 2004, LA Times)

The concept of requiring all Californians to carry their own health insurance is gaining momentum in the Capitol, as some lawmakers and healthcare advocates see it as a politically viable way to deal with the state's 5.3 million uninsured.

With the November defeat of Proposition 72 halting efforts to require employers to provide healthcare coverage, the concept looks likely to be part of next year's legislative debate. But it faces huge hurdles over how to make it financially feasible for the poor and enforce it.

Gov. Arnold Schwarzenegger has spoken supportively of the notion in recent months, and that has spurred the California Medical Assn., as well as some lawmakers, to draft their own plans.

"We have too many people that are uninsured in this state," Schwarzenegger said in October at the Panetta Institute in Monterey. "We have to really address this once and for all, and figure out a way of how we do it, like with car insurance, where we make it law that people carry insurance and that they are really insured, because it's unfair to so many people when you have people using the hospitals for emergency, and then creating a huge cost."

But healthcare experts say enacting what they call an "individual mandate" would be challenging. Requiring all Californians to carry their own insurance would have to involve some sort of subsidies for those too poor to pay the premiums — a difficult task for a state deep in debt.

The key, for Republicans, is to combine mandatory coverage with Health Savings Accounts, so that the poor build savings and become owners rather than just dependents of government.

Posted by Orrin Judd at December 15, 2004 9:47 AM