Capitol Alert

The latest on California politics and government

March 24, 2014
Big California ballot battle looms over malpractice limit


Consumer Watchdog submitted more than 800,000 signatures Monday for a ballot measure that would modify the state's $250,000 cap on pain and suffering injuries in medical malpractice cases, touching off what promises to be a fierce battle with medical providers and their insurers.

The cap (known as MICRA) was signed by Gov. Jerry Brown in 1975, during the first year of his first governorship, and has been the subject of political maneuvering ever since between the medical industry and Consumer Attorneys of California, whose members file and pursue personal injury cases.

Most recently, with signatures being collected for the measure, Senate President Pro Tem Darrell Steinberg has been trying to work out a legislative compromise on the long-burning issue, but that effort apparently failed. And once the 830,000 signatures were submitted, the measure, if qualified, could not be removed from the November ballot.

"My suggested compromise was to raise the MICRA cap on damages due to medical malpractice from $250,000 to $500,000," Steinberg said in a statement. "A cap of $500,000 is far below the rate of inflation since MICRA became law 39 years ago. That number is a reasonable compromise that fairly compensates injured patients without significant increases in medical costs.

"If one side says no, it's a terrible missed opportunity. An initiative battle is costly and uncertain, and will damage the reputation of two fine professions. This issue cries out for a legislative solution, and what I'm offering is a conservative increase that's fair to injured patients as well as the medical and legal communities."

Consumer Watchdog, a Southern California organization that has long been allied with the trial lawyers, submitted the petitions in Los Angeles and staged a news conference at which families of malpractice victims decried the limit. One was Robert Pack, a Bay Area businessman whose two children were run over and killed by a driver who had been overprescribed with drugs by doctors.

Pack, who is the out-front spokesman for the measure, said not only should the cap be lifted as a deterrent to malpractice but the proposal's other provisions, requiring drug testing of doctors and compelling them to check a registry of drug addicts to curb over-prescription of drugs, are needed to stop what was called a "patient safety crisis."

The medical and insurance industries have been gearing up to oppose the Consumer Watchdog-Pack measure and say they are ready to spend more than $30 million on a campaign against it. They contend that the cap has held down malpractice insurance rates, which also hold down medical costs, and that the drug-testing provisions of the measure are unneeded and mask a measure that would put more money in the pockets of lawyers.

Update: Amended at 11:50 to include Steinberg statement.

PHOTO: A West Sacramento billboard highlights the looming ballot fight to overturn the state law capping pain-and-suffering damages in medical negligence cases. Photo courtesy of Consumer Watchdog.

March 5, 2014
Ted Gaines sues California insurance exchange over nixed plans


State Sen. Ted Gaines has filed a lawsuit against the state health insurance exchange, claiming agency officials exceeded their power when they instructed participating health insurance companies to terminate existing policies for hundreds of thousands of Californians.

Covered California later declined a presidential offer letting insurance companies extend the canceled policies to roughly 1 million Californians.

The lawsuit, filed in Los Angeles County Superior Court, seeks to prevent the exchange from requiring cancellation of policies that do not comply with the provisions of the federal law. That, presumably, would allow insurance companies to continue offering the plan.

"A lot of people have policies that have not changed, and they've had them in place for decades, and now they are out," said Gaines, R-Rocklin, a candidate for state insurance commissioner. "They were forced out of the plan into something that was more expensive and in many cases with higher deductibles. There are some real abuses."

Gaines' lawsuit also alleges the exchange is wasting taxpayer dollars on public relations.

Anne Gonzales, a spokeswoman for the exchange, declined to address Gaines' claims.

"Covered California hasn't received service in this matter," she said. "When it does, our legal team will review the complaint."

The exchange last fall refused to give insurance companies more time to end individual policies that don't conform to the federal heath care overhaul. The cancellations applied to individual plans purchased after passage of the health law.

The decision came shortly after President Barack Obama in November allowed states to extend millions of canceled insurance policies for one year amid uproar over his statements that customers who like their plans could keep them.

Among the most vocal critics of the exchange at the time was state Insurance Commissioner Dave Jones, a Democrat. Jones also used the threat of legal and other action to persuade two insurance industry giants to delay terminating scores of plans across the state.

Still, Gaines, the president of Gaines Insurance in Roseville, argues Jones did not do enough to prevent the plans from being canceled.

His lawsuit also requests an order from the court to halt exchange spending on things like infomercials and public relations. Specifically, it identifies as unrelated to the exchange's mission allocating $1.3 million for a six-hour infomercial featuring health and fitness guru Richard Simmons, more than $10 million on a contract with the public relations firm Weber Shandwick and "untold funds" on a contract with Ogilvy Public Relations.

PHOTO: Senator Ted Gaines, R-Rocklin, during session in the Senate chambers in Sacramento on March 11, 2013. The Sacramento Bee/Hector Amezcua.

January 14, 2014
State keeps Wednesday, but insurers pushing payment deadlines


Beset by processing delays and customer confusion, two providers offering health coverage through California's new insurance exchange have pushed back their premium payment deadlines.

On Tuesday, a spokesman for Anthem Blue Cross of California said the company was pushing back its payment deadline to Jan. 31. Meanwhile, Kaiser Permanente set its new payment due date for Jan. 22.

Covered California had already extended its payment deadline for people with coverage beginning Jan. 1. The exchange's deadline is Wednesday, a change from the earlier deadline of Jan. 6.

A Covered California spokesman said the exchange's deadline would remain Wednesday.

"It's a deadline that was agreed unanimously to by the 11 health providers," spokesman Roy Kennedy said.

People who signed up for health coverage through the exchange have been complaining about long delays in receiving invoices needed to pay their first monthly premium. Others who made their payments are awaiting confirmation. Officials at Covered California and several insurance companies have acknowledged the raft of delays, including exceedingly long wait times for telephone customer service questions.

"We have extended the payment deadline for Jan. 1 coverage to Jan. 22 for those affected by processing delays, to allow all of our members time to receive and pay their invoices," Kaiser spokesman Chris Stenrud said.

"We have also started an outbound call campaign to reach members proactively to help them make payments on-line or by phone, and to know how to get needed care."

Stenrud noted that the "overwhelming majority" of those who enrolled in coverage that began this year have already received their invoices and paid for their coverage.

PHOTO: Enrollment operators take phone calls during the launch of Covered California in Rancho Cordova on Tuesday, Oct. 1, 2013. The Sacramento Bee/ Randall Benton

October 1, 2013
On launch day, Covered California website stalls


Technical issues have hobbled the launch of California's online health insurance portal, created as part of the federal health care overhaul.

While a dispute over the new law sent the federal government careening into a shutdown, states have stuck to an Oct. 1 open enrollment date for the new health insurance exchanges that constitute one of the law's central features. California marked the occasion with fanfare, holding official events around the state.

But a Tuesday morning visit to the online marketplace where consumers can shop for insurance plans and compare price and benefits, suggested that the roll out has slowed.

A click on the "start here" button leads to a page that takes several minutes to load. When the page does load, its formatting appears to be faulty, and clicking through to the next step brings additional delays. When The Bee called the customer support line, a recording advised that the wait for service would be longer than 30 minutes.

A non-scientific search of the hashtag "#CoveredCA" on Twitter revealed users encountering similar problems, with a steady stream of messages testifying to long lags.

"We're thinking there may be some individual browser problems but obviously the high traffic can slow it down," said Anne Gonzales, a spokeswoman for Covered California, pointing to a "very high volume" of people logging on. "We're making fixes as we go along, so it should be better later in the day, but it's up and running."

PHOTO: Executive Director of Covered California Peter V. Lee speaks to members of the press during the launch of Covered California in Rancho Cordova on Tuesday, October 1, 2013. The Sacramento Bee/Randall Benton.

August 30, 2013
California has nation's 10th highest medically uninsured rate

healthcare.jpgWith the new federal medical insurance program on the verge of implementation, California has the largest number of medically uninsured residents of any state, but its percentage of uninsured is only 10th highest, according to a new Census Bureau report.

Just over 20 percent of Californians under the age of 65 were uninsured in 2011, the last year for which data are available. Texas had the highest rate, more than 25 percent, while Massachusetts had the lowest, less than 5 percent.

The report covers counties as well as states and reveals that in California, wealthy Marin County has the lowest rate of uninsured at 12 percent -- about the same as Iowa's rate, the nation's eighth lowest.

California has more than six million residents without medical insurance and is among the states that have most vigorously embraced the Affordable Care Act. It is implementing the optional extension of Medicaid (Medi-Cal in California) to more low-income residents and has set up an exchange, Covered California, to facilitate acquisition of insurance by individuals and employers. State officials believe that the state's medically insured total will be reduced at least by half with those steps.

PHOTO: Nurse Practitioner David Weller, left examines patient Jose Andino at The Effort medical clinic in North Highlands on Friday, July 13, 2012. The Sacramento Bee/Randall Benton

May 31, 2013
California consumer-advocacy group's executive steps down

130530-doug-heller-4-2012-courtesy-heller.JPGNonprofit advocacy group Consumer Watchdog issued an email this afternoon announcing that its executive director is leaving, effective immediately.

Doug Heller is stepping down after 16 years with the Santa Monica-based organization best known for its battles with the insurance industry. As Consumer Watchdog's executive director, Heller was the oft-quoted face of the group for the last nine years.

In a telephone interview after the announcement, Heller said that he had discussed his departure with the organization's board some months ago. Despite the suddenness of today's news, he said, "there's zero acrimony" prompting his exit.

Heller intends to continue consumer-issues consulting work. Carmen Balber, Consumer Watchdog's Washington, D.C., director is the organization's new executive director.

PHOTO CREDIT: Doug Heller. Courtesy of Doug Heller / Sacramento Bee file, 2012

May 23, 2013
California health exchange reveals premium costs

surgery.JPGCalifornians received the bottom line Thursday on which insurance firms will sell policies on the state's new health-care exchange this fall and how much those premiums will cost.

The announcement by Covered California, the marketplace for such policies, brings into sharper focus the impact of the nation's health-care overhaul on families and their pocketbooks.

Thirteen health plans were picked to sell plans, with none of the state's 19 designated regions having fewer than three plans to serve consumers, Covered California announced.

Anthem Blue Cross, Blue Shield of California, Health Net and Kaiser Permanente were among the firms chosen. Their tentative selection is subject to rate review by state regulators.

California's 19 geographic regions will average five health plans from which to choose. Even in most rural areas, consumers will have two or three options - though in a small number of counties only one plan will be available, officials said.

April 30, 2013
California insurers, Commissioner Jones headed for showdown

RP_INSURANCE_AUTO_BODY_BUFF.JPGCalifornia Insurance Commissioner Dave Jones and the state's insurance companies are headed for a legal showdown over whether his power to regulate premiums includes a responsibility to provide insurers with a fair profit.

A suit filed against Jones by Mercury General Corp., one of the state's most aggressive issuers of auto and other personal insurance, is the latest skirmish in the 25-year-long legal and political maneuvering over the impact of Proposition 103, the 1988 ballot measure giving the insurance commissioner more rate-setting authority and making it an elective position.

On Tuesday, five national and state insurance trade organizations asked permission to intervene in the Sacramento Superior Court case, saying its outcome could affect the premiums paid by millions of Californians.


Capitol Alert Staff

Amy Chance Amy Chance is political editor for The Sacramento Bee. Twitter: @Amy_Chance

Dan Smith Dan Smith is Capitol bureau chief for The Sacramento Bee. Twitter: @DanielSnowSmith

Jim Miller Jim Miller covers California policy and politics and edits Capitol Alert. Twitter: @jimmiller2

David Siders David Siders covers the Brown administration. Twitter: @davidsiders

Christopher Cadelago Christopher Cadelago covers California politics and health care. Twitter: @ccadelago

Laurel Rosenhall Laurel Rosenhall covers the Legislature, the lobbying community and higher education. Twitter: @LaurelRosenhall

Jeremy White Jeremy B. White covers the Legislature. Twitter: @capitolalert

Koseff Alexei Koseff edits Capitol Alert's mobile Insider Edition. Twitter: @akoseff

Dan Walters Dan Walters is a columnist for The Sacramento Bee. Twitter: @WaltersBee

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