California canvas: California Association of Health Plans' Chris Ohman sees shared responsibility as critical to state's future

When you're the most populous state in the union, any extraordinary policies you sketch out could likely become a national catalyst for change. California has begun working on its state initiative for comprehensive healthcare reform, not simply for lack of a national proposal, but also because the health of its 36.1 million residents is at stake.

In his State of the State Address in January, Gov. Schwarzenegger proposed a radical plan to mandate health coverage and reform California's healthcare system to one that covers everyone and relies on a variety of funding streams and reallocations. Currently, between 6 million and 7 million California residents are uninsured; nearly one in three have family incomes of $50,000 or more. Those who do have insurance tend to be in HMOs, and a surprising amount are enrolled in individual plans not associated with an employer.

According to Ohman, the governor's plan for universal coverage does not put health plans out of business or force a single-payer system, and for the 40 plans that comprise CAHP, that's good news. So far, healthcare reorganization proposals coming from various governors' offices nationwide have included health plans as part of the solution.

Certainly the driving force behind states' aggressive reorganization attempts is the need to better manage healthcare costs and to have the wiggle room to serve residents' needs for the long-term. It seems the time is right for states to expand public programs and get all the stakeholders involved in the big picture.

Schwarzenegger's Plan

Under California's introduced proposal:

Critics say the governor ruffled some feathers among small- and medium-sized business, but polls indicate that as many as 80% of Californians support the shared-responsibility approach.