California is on the verge of voting to approve a plan that would provide healthcare to nearly all of its citizens.

After more than a year of negotiations with Republican Gov. Arnold Schwarzenegger, the Democrat-controlled Assembly is scheduled to vote today on a compromise bill that lays out the structure of health care reform in the state. 

Schwarzenegger, House Speaker Fabian Núñez and Senate President pro Tem Don Perata reached an agreement Friday on the $14 billion to $18 billion plan that the California House and Senate are expected to approve with a simple majority vote before the Governor signs it.

The leaders, however, have agreed to ask California’s voters in November to approve a referendum that would require employers to spend between 1 percent and 6.5 percent of their payroll on health care, put a levy of at least $1.50 a pack on cigarettes, and assess a 4 percent fee on hospital revenues, which the California Hospital Association has agreed to, provided the money goes back towards patient care. 

If voters approve the funding mechanism, the state’s universal health coverage plan will have a self-contained revenue stream, free from the state budgeting woes that often plague California.  The plan would take effect in January. 

"Our health care reform plan will bring billions of dollars of badly needed money to our healthcare system and ensure that future governors will not have to make the decisions we are being forced to make today," Schwarzenegger said Friday during a press conference.

Nunez said the plan ensures that every Californian has access to affordable health care.  “Even people who have health insurance will benefit immensely because their premiums will not continue to escalate the way they have been over the past six years,” he said.

Last year, Massachusetts legislators were the first to approve and implement universal health coverage for its residents. But state legislators, hospitals and ARM professionals nationwide are closely watching the outcome of California’s reform efforts. Experts say universal healthcare in California would likely speed efforts by other states, and possibly the country, to require all Americans to have coverage.

Indeed, as outlined, California’s plan would change the way healthcare is packaged, mainly because it bars insurers from denying coverage to people because of existing medical ailments. It also requires insurance companies to reinvest 85 cents of every dollar collected from health care premiums back into patient care.

The Los Angeles Times reported Saturday that many insurers, including Kaiser Permanente and Blue Shield of California, have supported the approach for months. But the state’s largest insurer, Blue Cross of California, is preparing to fight the ballot measure, the newspaper said.


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