Gov. Arnold Schwarzenegger pledged California's full support Thursday for national healthcare reform, throwing the weight of one of the nation's most prominent Republicans behind an overhaul that has caused a deep political divide and prompted at least 18 states to file legal challenges.
Schwarzenegger said he has long supported the concept of universal health coverage, and in 2007 proposed a $14.7 billion overhaul of the healthcare market in California.
That effort failed in part because of concerns over cost, but the governor credits the effort with helping lay the groundwork for the federal bill signed this year.
Schwarzenegger said it's time to set politics aside and start implementing the new law, even as many cash-strapped states worry the costs of the overhaul will widen their budget shortfalls.
"The plan is not without flaws," Schwarzenegger said in remarks prepared for a speech he will give later in the day that were obtained in advance by The Associated Press. "But it is the law. And it is time for California to move ahead with it. Thoughtfully. And responsibly."
The Republican Governors Association said it believed Schwarzenegger was the first GOP governor to come out strongly in favor of the healthcare reform law.
Schwarzenegger's comments marked a change in tone from earlier this year. After the U.S. Senate had passed its own version of the healthcare bill, which has since been revised, Schwarzenegger was among many critics who lambasted a provision that gave Nebraska additional Medicaid money.
The move was widely seen as a way to secure the vote of Nebraska Sen. Ben Nelson. At the time, Schwarzenegger called the bill "a rip-off."
Schwarzenegger spokesman Aaron McLear said the governor still has concerns about the potential costs to California of implementing the plan and how the state will administer it. California already faces a $20 billion deficit over the next 14 months.
Schwarzenegger, however, feels those concerns can be worked out, McLear said.
"The bottom line is this: If national healthcare reform is going to succeed, it is up to the states to make it happen," Schwarzenegger said in his remarks.
U.S. Secretary of Health and Human Services Kathleen Sebelius said she welcomed Schwarzenegger's support and his "dedication to strengthening the healthcare system."
She said the Obama administration has made progress in protecting consumers and lowering costs since the president signed the bill.
"This is a very state-friendly law and our administration has worked closely with governors to both pass and begin implementation of it," Sebelius said in a statement.
Schwarzenegger's move could have broad consequences for the state and for the success of the national reform effort. The nation's most populous state also has the highest number of uninsured residents in the country, roughly 8.2 million, a number that has swelled by 1.8 million during the past two years because so many Californians have lost employer-based health insurance during the recession.
Schwarzenegger said that reality is placing an enormous strain on uninsured families and on the state economy. Deep state budget cuts in recent years also have left tens of thousands of poor, vulnerable residents with severely reduced coverage.
Schwarzenegger said California would take several immediate steps to begin implementing the federal plan, including the formation of a healthcare reform task force.
The steps also include contracting with the federal government to operate a new high-risk pool for people who have been refused coverage, and developing a purchasing pool so small businesses and individuals can shop for health insurance at competitive rates.
In addition, state agencies will begin enforcing some of the cornerstones of the federal law, such as removing lifetime dollar limits on health insurance payouts, allowing children to stay on their parents' policies until age 26, preventing insurance companies from denying coverage to children and banning retroactive policy cancellations.
Schwarzenegger said the initial steps will be fully funded by the federal government. He intends to convene a special session of the Legislature if legislative action is necessary.
The governor alluded to the political divisions that arose during the national healthcare debate and caused some attorneys general across the country — most of them Republicans — to challenge the federal overhaul in court. Most of the legal arguments involve whether the government can require people to buy insurance or pay a penalty.
Schwarzenegger said the government does have such a right because society already is paying a high price for the uninsured. Those who don't have health insurance, he said, in effect force others to pay for their medical care when they are injured or become ill.
"Now, many people have asked, 'How can you be a Republican governor but in support of healthcare reform?'" Schwarzenegger said. "The answer is that this is not a partisan issue. It doesn't matter whether you are Republican or Democrat. Rich or poor. Young or old. We all need quality healthcare."
The two Republicans contending for the right to succeed Schwarzenegger after he is termed out of office next year have a different view of the federal law.
Former eBay chief executive Meg Whitman and state Insurance Commissioner Steve Poizner agree with national Republicans' "repeal and replace" approach and say they will work to overturn the law if elected.
Whitman would encourage the California attorney general to join the lawsuit filed by other states, saying the overhaul could cost California $3 billion and devastate small businesses, said her campaign spokeswoman, Sarah Pompei.
Poizner's campaign spokesman, Jarrod Agen, said the insurance commissioner believes the overhaul will be a financial burden on California while doing nothing to address rising healthcare costs.
During a news conference in Sacramento Thursday morning, Schwarzenegger dismissed the differences, saying he can only worry about his own time in office.
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