PD Editorial: State can’t afford to go its own way on health care

The nonpartisan Congressional Budget Office’s assessment of the latest Obamacare replacement bill is sobering: 14 million people would lose their health insurance in the first year, with the number ballooning to 23 million within a decade.

As for people with pre-existing conditions who couldn’t get coverage before the Affordable Care Act, the CBO said many of them wouldn’t be able to get comprehensive health insurance at a comparable price - “if they could purchase it at all.”

The market for individual insurance policies would be destabilized, the CBO said, and the high-risk pools that are supposed to provide a safety net for people who cannot otherwise obtain insurance would be too underfunded to help.

Is it any wonder that GOP leaders jammed this bill through the House before the analysis was completed?

Unfortunately, there’s little reason to believe the CBO’s brutal assessment will prompt Senate Republicans to rethink the haste with which they’re trying to pass their own bill.

As campaign promises to improve the Affordable Care Act give way to a stubborn determination to kill Obamacare at any cost, California elected officials should be looking for ways to ensure that their constituents don’t lose their health insurance.

But the single-payer health plan now pending in Sacramento isn’t the correct response.

The appeal of state Sen. Ricardo Lara’s proposal is obvious: universal coverage with little, if any, out-of-pocket expense for consumers. But the price tag would be staggering.

A legislative committee report - released this week in advance of key votes on Lara’s Senate Bill 568 - pegged the cost of a state-run single-payer system at $400 billion a year. To put that figure in perspective, the state’s budget is about $185 billion a year.

The report said existing revenue streams such as Medicare and Medi-Cal would cover about half the costs. But that assumes funding for those programs isn’t cut by Congress. And even then it would leave California on the hook for $200 billion, which would require a substantial tax increase in a state that already has high taxes.

No one should be surprised. Vermont set out to implement a state-level single-payer health system six years ago and abandoned the program because it was going to cost too much.

It’s too much for any state, at least at this time. Lara, a candidate for insurance commissioner, and his allies, most notably the California Nurses Association, should acknowledge the political realities and turn to a more pressing battle.

California, which created its own health insurance exchange and adopted the optional Medicaid expansion, has the most to lose if the Affordable Care Act is undermined. The uninsured rate in the state has fallen to a record low 7.1 percent since the law took effect, according to the latest figures from the Centers for Disease Control and Prevention.

Preserving those gains should be the state’s top priority.

The way to do that is to stay focused on protecting and improving the Affordable Care Act, not looking elsewhere while a health insurance system relied upon by millions of Americans is dismantled.