EDITORIAL: While Trump tweets, Newsom leads on health care

Contra Costa Times (Walnut Creek, CA)

Jan. 23--While President Trump and congressional Republicans roll back national progress toward universal health care, Gov. Gavin Newsom proposes changes to improve health outcomes, reduce the number of uninsured Californians and lower prescription drug prices.

Newsom's strategy puts him on a path to fulfill his campaign promises for universal health care and lower drug costs in California.

The new governor's penchant for bold statements prompted concern that he would propose a single-payer system that 1) still doesn't have a credible financial plan and 2) would be impossible to implement as long as Trump is president and Republicans control the U.S. Senate.

Newsom instead called for reinstatement of the individual mandate in California, requiring those who are uninsured purchase health care insurance or face a fine. The mandate was a cornerstone of President Obama's health care reforms, but Trump and congressional Republicans eliminated it -- a move that will raise insurance prices and leave more Americans uninsured.

Reinstating the individual mandate in California would raise $700 million-$900 million, which would pay for the governor's $250 million proposal to expand Medi-Cal eligibility to young adults ages 19-26 living in the country illegally.

Reinstating the individual mandate encourages those who would go without insurance to enroll and have access to routine, preventive appointments that sharply reduce the threat of costly, chronic disease.

The cost of treating the uninsured is too often passed on to those who carry insurance. By covering those currently uninsured, the individual mandate adds healthy enrollees into the insurance pools, lowering premiums for other participants by an estimated 10 percent.

Republicans, including Trump, rail against providing health care insurance for those who are here illegally. But federal law requires that they be treated when they arrive at emergency room hospitals in need of care. That's a far more costly way to deliver health care.

It should be a conservative value to treat everyone in California in the most cost-effective manner possible. Offering health insurance to those who are here illegally provides them with the basic care they need to keep them out of hospital ERs.

Newsom's plan to restore the individual mandate and expand access for the undocumented raises political challenges, but it should find favor in the Democratic-controlled Legislature.

The governor's proposal to lower prescription drug costs poses a more difficult issue.

It's a simple matter for the governor to sign an executive order calling on California to create a unified purchasing system allowing the state to negotiate prescription drug prices in bulk. But each of the state agencies have their own separate needs. The prison system is different from CalPERS, which is different from Medi-Cal, which, by the way, buys drugs for 13 million people through managed care plans that each do their own negotiations.

Getting all of the state agencies to agree on what drugs to negotiate at what price may prove as challenging as herding cats. But it's worth a try. Prescription drug costs have doubled since 2000, and even a small reduction in prescription drug expenditures would save Californians billions.

Rising health care costs are threatening California businesses' ability to compete with their global competitors. The president and Congress show no indication of addressing the issue. Newsom's plan won't solve the problem, but it's a solid step toward lowering costs, improving health outcomes and moving the state closer to universal coverage.

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