graphic - health care for all california

California Universal Health Insurance Coverage Study (CUHICS)

In August 1998, John Burton, President Pro Tempore of the California State Senate, called for a study that would examine how California could provide universal high quality, cost effective health care. Senator Burton was joined in his call for the study by Senator Hilda Solis, Senator Martha Escutia, Chair of the Senate Health Committee, Assemblymember Antonio Villaraigosa, Speaker of the State Assembly, and by Assemblymember Martin Gallegos, Chair of the Assembly Health Committee.

Three forces came together to prompt this legislative interest in a study of
universal health care:

1. seven million uninsured Californians
2. mounting complaints from insured Californians about the quality of care, and
3. pressure from a strong consumer movement for universal health care.

The consumer movement was lead by Health Care For All-California, which was the principal sponsor of the legislation, S.B. 2123, that lead to this study. Senate Concurrent Resolution 100 (SCR 100) specifies the intent of the Legislature in calling for the CUHICS study.

The study is unique in several ways.

  • First, it recognizes that the quality of care is as important as the cost of care and calls for any potential universal health care system to demonstrate how it will meet a set of quality criteria laid down in the SCR 100. These quality criteria were drafted by consumer advocates from around the state.
  • Secondly, the study is to be conducted jointly by academic experts, consumer, legislative and health industry advisors with technical support from the Senate Office of Research. Rarely do consumers have a strong voice in such studies. In this case an advisory board of experienced consumer advocates is in place and actively participating.
  • Thirdly, it calls for public involvement in the process. Educational forums and focus groups about universal health care will be held around the state during and after the study.
  • Finally, the study is supported by a second piece of legislation, which calls for the Department of Health and Human Services to investigate means of achieving universal health care and directs the Department to utilize the results of Senator Burton's study.

At least three options for achieving universal health care will be studied, using a combination of computer-simulated models and a series of adjunct "white papers" developed with the assistance of advisory committee members. The types of financing to be studied are:

1. an integrated package of incremental reforms based on the current multipayer system
2. a voucher / tax subsidy system, and
3. a single payer system.

Each of the above financing options will be crafted to the specific needs of California and each will be measured against the quality criteria of SCR 100. The study will be funded by private California foundations. The academic team overseeing the modeling will be headed by researchers from several University of California campuses.
It is anticipated that the study will be completed by December, 2000.

Update

In 1999, the Legislature passed SB 480, which brought the governor and Department of Health and Human Services into the process of investigating options for financing universal health coverage which the legislature initiated. In mid-march gubernatorial aides began a dialogue with key health system stakeholders that will hopefully get an SB 480 task force off the ground. This task force will carry out the mandate of the bill.
It is anticipated that the results of the Health Care study will be used in the discussion of options which would be available, and would aid the participants in the SB 480 process in determining what proposals might be made to the legislature and to the public.

In February, 2000, the Senate Office of Research (SOR) assembled a group of nationally recognized technical experts in the field of health care analysis and computer modeling to guide the study toward resolution of problems it has encountered. The SOR panel of technical experts will make recommendations about how the study might best proceed. Their report is expected by the end of March, 2000.

SB 480 requires that the Secretary of the California Health and Human Services Agency investigate options for financing universal health coverage and report them to the Legislature by December 1, 2001. Our goal is that the universal health coverage options recommended by the study and the SB 480 process will become universal health reform legislation in the January 2002 legislative session.