Health Care & Prescription Drugs In the News

For months, a health care overhaul seemed so within reach. Then came Tuesday's Senate vote in Massachusetts, and suddenly the hopeful mood that once buoyed health care advocates from coast to coast turned into a vast sinkhole of disappointment.

Anthony Wright, executive director of Health Access California, couldn't bear the news as election returns from Massachusetts added up to a resounding victory for Republican Scott Brown and a clear defeat for Democrats and health care advocates.

"Haven't watched any cable news tonight. Given my mood, no good can come from it," Wright tweeted Tuesday night.

On the morning after, overhaul advocates in California expressed disappointment that Democrats had lost their filibuster-proof majority in the Senate, portending increasing difficulty to pass sweeping health care legislation.

While efforts on the national level are far from dead, one question seemed clear: What now?

"We've been talking things through, trying to figure out what this all means, and working out strategy," said Michael Russo, the health care advocate at the left-leaning California Public Interest Research Group.

Russo and other consumer advocates on Wednesday took stock of the new environment in which supporters of a health care overhaul must tread. "There's no doubt that we're not as cheery as we were," Russo said. "It seemed like such a clear path to getting a health care reform bill enacted just a few days ago. … Certainly, now it seems harder to get there."

Democrats on Capitol Hill tried not to look back Wednesday, as the road that could have led to a health care bill took an unexpected twist.

In November, House Democrats narrowly won passage of sweeping measures to overhaul the country's health care system. The Senate approved its own package the day before Christmas.

Following the Massachusetts vote, the White House signaled that it would seek to take a more deliberate approach to winning passage of a health care bill. Democratic leaders were said to be considering scaling back the legislation to salvage what they could. The long-held ambition of near-universal health insurance coverage, in a country with 46 million uninsured, could be jettisoned from the legislation – a clear victim of the new political realities.

President Barack Obama urged lawmakers to scale back legislation to "those elements of the package that people agree on."

Some key tenets could survive the purge, including subsidies to help low-income people pay for health insurance and guaranteed coverage for those with pre-existing health problems.

If Congress failed to pass a health care bill, "it would be very disappointing because we have come a very long way," said state Sen. Mark Leno, D-San Francisco, a member of the Senate Health Committee. "Should it not succeed, it does indeed give greater importance to leadership coming from state legislatures," he said.

Leno has authored the latest iteration of a state single-payer health care bill – which twice before won passage only to be vetoed both times. The Senate Appropriations Committee is to consider the legislation today.

Other members of the Legislature say California has a role to play, even if Congress does act.

"I do think there will be a federal health care bill," said Assemblyman Dave Jones, D-Sacramento, who chairs his chamber's Health Committee. "But I've always thought California should still have the flexibility to improve upon it."

Just a few years ago, the state seemed poised to act on its own, with Gov. Arnold Schwarzenegger on the brink of winning support for universal health care in California.

In the end, he could not bridge the differences between some liberals and factions in his own Republican party.

In the absence of comprehensive change, California has taken a piece-by-piece approach. Last year, the governor signed legislation banning gender discrimination in health insurance coverage, outlawing the practice by insurance companies of charging different premiums for men and women.

Consumer advocates have been unable to secure many items on their wish lists, such as guaranteed health insurance coverage regardless of pre-existing conditions, a protection included in federal legislation now steeped in uncertainty in Congress.

The same challenges that vexed health care advocates in California have intensified on the federal level, particularly in light of Tuesday's vote.

"I think the need and urgency for health care reform is the same today as it was the day before. It's the same this year as it was last year. It didn't change because of a special election in Massachusetts," said Wright, of Health Access California.

"It happened in a state where health reform is needed least, because they've already adopted many of the elements of health care reform," he said of the Massachusetts vote. "Sure, there's a lot of symbolism" in Tuesday's election results, he said. "But there's an underlying math that health care advocates still have 59 votes in the Senate."