A new report finds that San Francisco State Senator Leland Lee received the most money of any senator from health insurers and HMO’s during the last two campaign cycles, outpacing even Republicans. The study by MAPLight.org found Yee receiving $79,991.72 during the 2006 and 2008 campaign cycles, over $5000 more than the nearest Democrat and over $10,000 more than the closest Republican. Much has been written about Congressional “Blue Dog” Democrats who take health insurer money and become opponents of reform, and a similar pattern can be found with Senator Yee. While Yee backed a single payer measure that the Governor announced in advance that he would veto, he opposed or abstained from a huge number of health reform bills, including those signed by Schwarzenegger. He even opposed on the Senate floor a bill that would have created a statewide public insurer, rejecting the state version of the “public option” progressives have promoted nationally.

State Senator Leland Yee, rumored to be mounting a San Francisco mayoral run in 2011, has taken more health insurance and HMO money than any California state senator over the last two campaign cycles. Yee took in nearly twice as much money as Republican Caucus Chair George Runner, and over $23,000 more than Lou Correa, often viewed as the most conservative Democratic Senator.

After inspecting Yee’s health care voting record, it is easy to understand why health insurers and HMO’s dispense largesse to the San Francisco Bay Area Democrat.

Yee Opposed Public Option

Progressives have mobilized nationally to create a “public option” that enables a government entity to compete with private insurers. The only Democrats in Congress who opposed this provision were the “Blue Dogs,” and the only non-Republican Senators clearly opposing a public option were Joe Lieberman, Ben Nelson, Mary Landrieu, and Blanche Lincoln.

Yet Leland Yee also opposed a public option when it first came to a full California State Senate vote in June 2007.

State Senator Joe Simitian’s SB 973 created a statewide public insurer, and would have connected existing regional, county-based health care plans to compete with private health care plans and provide consumers more affordable coverage choices.

Yee was one of four Democrats (joining Correa) who voted against Simitian’s bill when it first passed the Senate. After an amended version passed the State Assembly with unanimous Democratic support, Yee then joined all other Senate Democrats in supporting it.

Yee’s flip-flop is all too typical of his health care record.

By voting against the public option when it first reached the Senate, he helped the health insurance industry by ensuring that the bill would be weakened to get the unanimous Democratic support that was needed to reduce chances of a veto. By then casting a later vote in favor of the public option, his official record stands as “yes” and few constituents will know about the earlier “no.”

It’s no different from Joe Lieberman or Ben Nelson, neither of whom have any recorded votes against a public option, or even against health care reform. In fact, the official record says both voted for reform, just as it says that Leland Yee backed California’s public option.

Yee cast his vote against a public option after the city he represents enacted a “Healthy San Francisco” program. Public option proponents have touted San Francisco’s plan as a real-world model of success.

Yee Opposed Health Insurer Administrative Caps

Recall the effort that Democrats made nationally to require health insurers to spend at least 85% of premiums on patient care? Howard Dean and others saw this provision as critical to stop billions of dollars in premiums from being diverted from the providing of health care to administrative costs and huge insurer profits.

State Senator Sheila Kuehl sponsored SB 1440 in the 2008 session to impose this 85% cap.

There were two Senate Committee votes -- Leland Yee was the only Democrat to vote "no" in the first Committee, and then voted "yes" to send it to the Senate floor when it was a party-line vote. The bill then went to the floor, where he was the only Senate Democrat to vote "no." It then passed the State Assembly, where Fresno Democrat Nicole Parra also voted "no" - which means it was not a party-line vote, so he could afford to still be against it. It then went back to the Senate, where he again was the only Democrat to vote "no."

Governor Schwarzenegger ultimately joined Yee’s opposition, vetoing this critical effort to improve health care.

Yee Abstained on “Never Events”

Is it fair for health providers to bill patients or insurers when they have operated on the wrong person, prescribed the wrong drugs, or left a foreign object inside a surgery patient? Or how about getting a bill when they amputated your wrong leg?

Like most of us, Assemblymember Mike Feuer was outraged by such practices. During the 2008 session he introduced AB 2146, a common sense measure to ban insurer billing for avoidable mistakes.

In Committee, State Senator Leland Yee abstained on AB 2146, with all other Democrats voting yes.

Schwarzenegger Supports Rescission Reform, Yee Abstains

Among the public’s biggest complaints about the current health care system is the lack of process that often accompanies insurers rescinding existing insurance coverage. Assemblymember Kevin De León’s AB 2569 addressed this by prohibiting health plans and insurers from revoking an entire family’s coverage based on misinformation from a single family member, and requiring the health plan or insurer to issue a new plan contract or policy to the family members covered prior to the rescission. This bill also placed a duty on insurance agents and brokers to assist the applicant in answering health questions, and to explain to applicants the potential consequences of not providing accurate information.

“Entire families should not be held hostage when someone faces rescission of their health insurance coverage,” stated Veronica Montoya, Policy Director for Latino Coalition for a Healthy California. “AB 2569 is critical in ensuring that families have the option of keeping their health care coverage.”

Yee thought otherwise. After the State Assembly passed the bill with unanimous Democratic support, Yee abstained in committee from supporting De Leon’s bill to protect family members from losing health care. He then switched his vote to yes in a later committee meeting, and on the floor.

Yee Protects Hospitals over Patients

A perfect example of Yee’s modus operandi of casting both yes and no votes on the same measure is shown on State Senator Ellen Corbett’s SB 1300. This bill prohibited confidentiality clauses in contracts between providers and insurers that keep secret from consumers’ information on pricing and health care quality.

Yee voted "yes" in Committee -- on a party-line vote. On the first Senate floor vote, he voted "yes" -- when a few conservative Democrats abstained (and Correa voted "no.") It then went to the State Assembly, where it passed -- but a few conservative Democrats abstained or voted "no." It then went back to the Senate floor -- where he was one of six Democrats to vote "no" (Correa, Calderon, Florez, Padilla & Negrete McLeod.)

Because of Yee and these other Democrats, the bill failed 18-21 on the Senate floor.

Yee also abstained from supporting San Francisco Assemblymember Fiona Ma’s 2942, a common-sense measure that would impose standards on non-profit hospitals that must provide “community benefits” to retain their non-profit status (Sutter Health, whose proposed mammoth development at the site of the Cathedral Hill Hotel on Van Ness is likely to seek approval under San Francisco’s next mayor, is among the non-profits Ma’s bill would have covered).

Yee was the only Senate Democrat to abstain in Committee, where Ma’s bill passed on a party-line vote.

Yee was also the only Democrat to abstain in Committee on Assemblymember Jared Huffman’s AB 2697. This bill would have required “boutique” hospitals to annually assess their impacts on a community’s health system. This has become a big issue in recent years, as many health experts argue that these upscale facilities are siphoning off doctors from caring for less affluent patients.

Yee backed AB 2697 on the Senate floor, fitting a familiar pattern of withholding support, or outright opposing health reform bills, until the time comes for the last publicly recorded vote.

Yee’s Blue Dog Agenda for Health Care

Health insurers and HMO’s appreciate the value of having Bay Area Democrat Leland Yee on their side, as he plays a valuable role in blocking or weakening reforms at the committee level. The health industry recognizes that Yess is often required by the political realities of his district to vote “yes” once a bill reaches the Senate floor, and has not held these votes against him in disbursing campaign funds.

Over the past several months, we have seen how votes in House and Senate committees help advance or limit federal health care reform measures. The health insurance industry heavily funded “Blue Dog” Democrats to become obstacles to real reform, knowing full well that many may ultimately have to serve their districts by casting votes in favor of the final bill.

Due to the publicity, everyone knows that Joe Lieberman and Ben Nelson did everything in their power to kill real reform, despite public voting records that show a “yes” vote. But Sacramento politics gets far less scrutiny, which is why State Senator Leland Yee’s full record of non-support for Democratic health reform measures is hard to uncover. The the public record of final votes can be deceptive but, as we show above, the full story can be found if one looks hard enough.

Based on his actions, it’s no surprise to that those profiting from the current health care system have lavished Yee with campaign donations.

But Yee has received little public progressive criticism for his health care obstructionism, and even SEIU, a staunch advocate of the type of real reforms Yee has opposed, has become his cheerleader. Oddly, SEIU backs Yee while strongly opposing San Francisco Mayor Gavin Newsom, who signed Healthy San Francisco into law, and would likely have strongly supported all of the Democrat-sponsored bills discussed above.

Perhaps Yee’s support for a single-payer measure with no chance of enactment gives him a pass on the many other Democratic and progressive-backed health reform bills. Or maybe his full record---the one that shows more than the final vote--- is not well known.

But health insurers and HMO’s do not hand out contributions lightly. It speaks volumes that the vast majority of Senate Democrats received less than a third of the dollars given to Leland Yee, and that no Republican received within $10,000 of Yee’s total.

Randy Shaw is Editor of Beyond Chron and author of Beyond the Fields: Cesar Chavez, the UFW and the Struggle for Justice in the 21st Century.