California Prepares for Clinton's Health-Care Reform

HEALTH officials across California are expecting an era of dramatic changes in the state's health-care system under sweeping reforms outlined before Congress Sept. 22 by President Clinton.

Among the chances contemplated by state leaders is the creation of a new state health-care agency, the establishment of regional health alliances, and the revamping of the state's Medi-Cal program, the state's insurance program for the poor.

Though Mr. Clinton himself is expected to outline the framework that will regulate how coverage is purchased, how much it will cost, and what benefits are offered, officials here expect that several key details will be left to the states.

To deal with such contingencies, state legislators recently formed a conference committee of Democrats and Republicans that will begin hearings in October to draft needed legislation. One of the primary tasks will be to create a new entity to consolidate services now handled by several different agencies.

``We want to be one of the first states in the nation to submit a qualified plan to Washington so we can be one of the first states to get dollars from Washington,'' says Assemblyman Burt Margolin (D) of Los Angeles, co-chairman of the new committee. ``Given our budget crisis, we can't afford to be a late-qualifying state.''

State Sen. Art Torres (D) of Los Angeles, another co-chairman, says it is unlikely that California will be ready to implement a new system by the White House's target date of 1995.

But he advocates immediate statewide debate ``so we can let Clinton know what California can live with.''

One large task to be tackled is how to define and operate health alliances envisioned under the Clinton plan. The alliances are to negotiate health coverage for nearly every employer with fewer than 5,000 employees. Some advocate having a single statewide alliance as a more efficient body with more bargaining clout. Others say they feel that the state should be divided into six or 10 parts, each having its own alliance.

Other questions: Will alliances be government agencies, for-profit firms, or non-profit companies? Who will serve on the alliances' boards, and will they be elected?

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