Republican Assemblyman Brian Nestande of Palm Desert opposes the federal health care overhaul. Hes uneasy about its potential adverse effects on small businesses. He worries that it will drive up health care costs.
But hes teaming up with officials from the states new health insurance marketplace Oct. 17 to host an informational town hall to help constituents navigate the new system.
I think there are large concerns on the economy, said Nestande, who is challenging freshman Democratic Rep. Raul Ruiz in the Inland Empire. At the federal level, its a big issue and its a partisan issue.
But our argument is really with the federal policy, not necessarily with the states role.
As congressional Republicans stand resolute against the 3-year-old heath care reform amid a government shutdown, California Republican legislators even those who oppose the law are marking its launch by setting aside politics at a series of meetings designed to dispel constituent confusion. The events differ dramatically from the raucous town hall meetings hosted by members of Congress during debate over the Affordable Care Act.
Assemblyman Don Wagner, R-Irvine, said plainly he believes customers will experience increased costs under the law. Demographics are such that if many young people dont seek coverage through the exchange, it runs the risk of becoming economically unsustainable, Wagner said.
That said, its the law of the land. The opportunity to get rid of it passed with the election in November, so were stuck with trying to make it work as best as we possibly can, said Wagner, who earlier this year co-hosted a town-hall event on the Affordable Care Act with Assemblywoman Diane Harkey, R-Dana Point.
Wagner said he is responsible for ensuring that his constituents understand their options in order to make a decision that is right for their families.
My job as a state representative is not to try to thwart the federal law and throw monkey wrenches into it, he said. My job, given the unfortunate federal circumstance, is to make it as good as humanly possible for my constituents. So thats what we are trying to do.
A positive response
In deep-blue California, polls have shown no drop in voter support for the law. For lawmakers, the town halls also provide a forum, however brief, to embrace the nuances of policy over partisanship and distance themselves from the national GOP brand, which is receiving more blame for the shutdown than the Democratic Party.
Republican legislators have a long list of complaints about the insurance marketplace called Covered California, which expects to enroll 487,000 to 696,000 people who are eligible for subsidies by April 1. They say it will increase operating costs and discourage growth for large businesses by imposing penalties on those that dont provide coverage.
The individual mandate, at one time a Republican counter to a single-payer system preferred by many Democrats, has been mostly rejected by a flourishing libertarian, anti-government strain of conservatism. They believe the individual mandate is unconstitutional because it requires nearly everyone to obtain health insurance or pay a penalty for noncompliance.
Supporters of the law argue that the employer mandate has already been delayed and that, once it takes effect, the number of businesses that would pay a penalty is relatively small, since many already provide employee health care. They maintain that discussion over the individual mandate is moot because it was upheld by the U.S. Supreme Court.
Bill Carrick, a veteran Democratic strategist, said he suspected Republican lawmakers were receiving questions about the law and that town-hall forums were a convenient outlet from which to provide answers. About half the public and two-thirds of the uninsured believe they dont have enough information about the law to know how it will affect their family, according to the latest Kaiser Health tracking poll released in late September.
Forgetting all the political shenanigans, sometimes its better to just say you are having a seminar and you should come, Carrick said. This gives them a positive response and a positive way of dealing with all of the questions.
For California legislative Republicans, he said, theres little danger of a backlash from the right at election time.
The risk is that the hard-core people and tea party right consider this appeasement, Carrick said. I dont think its much because the truth is most of these tea party people, their activism doesnt appear to go beyond primal scream level.
As governor, Republican Arnold Schwarzenegger signed several of the early health bills to implement key pieces of the federal law. Since then, Republican lawmakers have sometimes joined with Democrats to support health measures. At the same time, Assembly Republicans recently launched a website that takes a skeptical view of the law.
Most congressional Republicans held out hopes of defunding the health law because thats what their constituents were urging of them, GOP consultant Wayne Johnson said. State legislators have no influence over Washington.
When something is the law, you are not going to be an obstructionist in such a way that it harms your constituents, Johnson said. If thats the law that everybody has to live under, you are going to hold the information hearings like you do on Medicare or Social Security or anything.
Johnson said its too early to tell how the health law will play out politically in California. If people are using the law as code for their distaste for President Barack Obama, he said, the notion is unlikely to recede by next spring. If they begin to associate it with personal hardships such as increasing costs or unavailable doctors and hospitals, it could have more sway come campaign season, he said.
Thats when were going to find out whether this is a potentially potent political issue going into the elections, Johnson said.
Its pretty scary
The depth of Republican opposition to the health care changes varies from district to district.
Assemblyman Dan Logue, R-Marysville, among the acts biggest critics, said he began his session earlier this year in Yuba City by announcing the meeting was not the place to say whether its good or bad, but to basically explain what the steps are.
Joined by representatives from the state exchange, small business community and medical field, Logue said later the reaction from attendees was absolute terror.
Were looking to get government in the middle of our personal health care, and its life and death. Its pretty scary, he said.
Logue said he has fielded calls from constituents telling him that their hours were being cut back and their health care benefits slashed. Other concerns include possible rationing of care once customers begin receiving benefits on Jan. 1.
As he mounts his own campaign for Congress, Logue said the health law remains the No. 1 concern for voters.
People are really terrified that now this government that cant afford to balance the budget wants to basically balance out their life when it comes to health care, he said. Its not about Republicans or Democrats. Its about whether anyone trusts government any more.
At his town-hall meeting this week, state Sen. Anthony Cannella, R-Ceres, hosted a panel of experts that worked to distill the complicated law. The senator recorded the meeting and plans to post online the video, audio and even the slides used by each of the panelists because I think its a wealth of information for anyone thats interested in signing up, he said.
Cannella, whose district has a high rate of uninsured residents, said he does not have a position on the federal law. But he emphasized several positive elements, including the facts that children can stay on their parents plans until age 26 and customers cant be denied for pre-existing health conditions. The senator said he knows families who have filed for bankruptcy because of out-of-control medical expenses.
If you can make insurance affordable for people that are struggling, its our responsibility as elected officials and representatives to get that information out there, Cannella said, referring to the law as groundbreaking and the meeting as very rewarding.
We should be having these town halls everywhere, he added. I just cant imagine the stress a family must have to be uninsured and then have someone get sick. Now, there is something they can do about that. I think thats exciting.
Call Christopher Cadelago, Bee Capitol Bureau, (916) 326-5538. Follow him on Twitter @ccadelago