Commentary: Implementing health-care plan sets California on 'collision course'

If, as several experts anticipate, the Supreme Court strikes down some or all of the Patient Protection and Affordable Care Act (PPACA), California will find itself in the untenable position of having promised services it cannot possibly provide without federal funding.

California policymakers, in a rush to lead the nation in implementation of the federal law, have given little attention as to how California will address issues like funding should the PPACA fail to pass the Constitutional sniff test.

The California Health Benefit Exchange is a case in point. Created in 2010, the Exchange will operate under the assumption that massive federal subsidies will be available to accommodate the needs of low- and middle-income earners needing assistance to afford the health coverage offered through the Exchange.

Based on their public comments, it is my belief the Democratic leadership has every intention of fully implementing any legislation concerning the PPACA, regardless of the U.S. Supreme Court's decision.

As vice chairman of the Senate Health Committee, I have heard hours of testimony on legislation seeking to implement some facet of the PPACA. These measures are irresponsibly moved forward, often in the absence of definitive federal guidance, and without any plan to unwind the implementation that has taken place thus far, should the court reject the PPACA.

For example, we recently heard a bill dealing with Medi-Cal eligibility for former foster youth. The measure was amended to include language stating that it "is the intent of the Legislature to ensure full implementation of the Affordable Care Act so that millions of uninsured Californians can receive health insurance coverage and those that have already obtained coverage under its provisions can keep that coverage.

"It is further the intent of the Legislature to enact into state law any provision of the Affordable Care Act that may be struck down by the United States Supreme Court and that is necessary to ensure all Californians receive the full promise of the act."