The Universal Health Coverage Study: Background, Overview and Update

During the 1998 legislative session, state senators Diane Watson (D-L.A.) then Chair of Senate Health and Human Services, and now U.S. Congresswoman Barbara Lee (D-Oakland) introduced SB 2123, a single payer universal health coverage program. This bill was written by consumer and health professional advocates. The principal sponsoring organization was Health Care for All-California. The bill did not pass out of committee, but in the course of the hearings there was broad support for a study to investigate options for financing universal health coverage. Senator Diane Watson introduced Senate Concurrent Resolution 100 (SCR 100) which calls for an evaluation and comparison of alternative strategies for achieving universal coverage and lists criteria to be met by all reform options. They include cost controls, comprehensive benefits, patient satisfaction and outcomes and various measurements of the quality of care.

Senator John Burton, joined by Senators Hilda Solis, Martha Escutia and Assembly Members Antonio Villaraigosa and Martin Gallegos called on the Senate Office of Research to work with the University of California and stakeholder constituencies to carry out the study.

In early 1999 a planning grant for the study was received from the California Health Care Foundation. Teams of consumer advocates, legislative, academic and industry members were formed. The effort was to be cooperative and broadly representative of the interests of key health system stakeholders. Work began in March 1999.

In the summer of 1999 important differences of opinion on technical and political issues arose among advisory team members. The advisory teams were unable to resolve the differences. In December 1999, the Senate Health Committee and the Senate Office of Research intervened and recommended that a group of independent technical advisors be formed to review methodology and modeling assumptions and to recommend a future course for this important project.

The Universal Health Care Technical Advisory Committee (UHTAC), the SOR/ Senate Health appointed expert panel, began work in January 2000. Their members were Larry Levitt (Kaiser Family Foundation), Judith Feder (Georgetown), Jose Escarce (Rand), Linda Bilheirmer (Robert Woods Johnson), Laurence Baker (Stanford) and Paul Gertler (UC-Berkeley). In February they met with members of the study advisory boards and interested members of the public to discuss health system modeling that responds to SCR 100.

In April 2000, UHTAC issued its report. In response to and guided by the UHTAC recommendations, funding for the SCR 100 study of universal health finance options will be introduced for the 2000 Legislative budget. Hopefully, the Governor will sign this budget augmentation.