The current debate in the California legislature over health care access and health care reform is of great interest to California's injured workers. Many of those injured workers end up losing their group health benefits and cannot get health insurance.

In recent posts we looked at some of the Schwarzenegger proposals. But there are other proposals being floated. Here is a link to an article about Senator Don Perata's plan:
http://www.insidebayarea.com/oaklandtri ... ci_5074498

Senator Perata is raising money which can be spent on promoting his plan. Check out this link:
http://www.capitolweekly.net/news/artic ... le_id=1230

For a whimsical but accurate comparison of the legislative Republicans' position on health care reform with the Schwarzenegger, Nunez, Perata and Kuehl plans; check out this article by Steve Wiegand:
http://www.sacbee.com/111/v-print/story/109570.html

Schwarzenegger has been accused by business interests of "jumping the shark" on health care reform. See The Wall Street Journal piece:
http://opinionjournal.com/diary/?id=110009557

Republican legislators, led by Assembly Republican leader Mike Villines, appear hostile to the various health care reform proposals. See the following:
http://www.sacbee.com/111/v-print/story/111180.html

But as the San Jose Mercury notes, many high tech leaders are supportive of health care reform that might broaden coverage and help control costs:
http://www.mercurynews.com/mld/mercuryn ... 524204.htm

Meanwhile, George Bush, looking for an upbeat issue to divert attention from his Iraq fiasco, proposes tax breaks to help low-income people buy health insurance. See the New York Times description:
http://www.nytimes.com/2007/01/21/washi ... ref=slogin

Stay tuned. Workerscompzone will cover it.

Julius Young
www.boxerlaw.com

This year's debate in the California legislature over health care access is important to California injured workers. Most injured workers lose their coverage if they don't return to work after an injury.

Over the last several decades, some large employers have either reduced health care coverage or refused to offer it at all. Wal-Mart has been the "poster boy" for big employers that offered little or no coverage. The result? Since these workers are not paid a salary that will support them buying coverage on their own (even if it were available), the burden has been shifted. Shifted where? To taxpayers. To states and the Federal government under the Medicaid program. And to counties and the various entities that operate local hospitals.

Many non-union employers do not provide health care coverage. As part of health care reform, some states are experimenting with laws to require employers to carry coverage. This is what Maryland did, requiring employers with 10,000 or more employees in the state to pay 8% of their payrolls for health insurance or pay into a state-mandated fund for that purpose. Wal-Mart challenged the law.

In a recent decision, the Fourth Circuit of the United States Court of Appeals (one step below the U.S. Supreme Court) ruled that Maryland's law violated a federal law known as ERISA, which generally governs health and disability plans on a national basis.

You can read a more detailed account from the New York Times by clicking here:
http://www.nytimes.com/2007/01/18/busin ... nted=print

The Clinton administration failed to achieve health care reform and the Bush administration has not tried. So states are beginning to experiment with plans to achieve wider coverage. For a good analysis, look at Bill Ainsworth's piece in the San Diego paper:
http://www.signonsandiego.com/uniontrib ... ealth.html

If states cannot require large employers to carry coverage on their employees, the trend towards offering no coverage may accelerate. Perhaps there will eventually be health care reform by the U.S. Congress, but that is probably at least a few years down the road. Meanwhile, California's legislature begins its debate on the Schwarzenegger, Nunez, Perata and Kuehl health care reform proposals.

This is a debate worth watching closely.

Julius Young
www.boxerlaw.com

The term of California Workers' Compensation Appeals Board commissioner Merle Rabine is ending. Earlier this week, I attended a goodbye event honoring Rabine. Held at the San Francisco building which houses the California Supreme Court, the event was pretty much a who's who of California workers' compensation law.

Present were heavy hitters from various groups, including the applicant attorneys (representing injured workers), the defense attorneys, the staff of the Department of Industrial Relations, the workers' compensation judges, the remaining WCAB commissioners, and other figures in the comp industry.

Rabine was appointed to a six-year term in 2000 by then-Governor Gray Davis. Rabine served as chairperson of the WCAB until Gov. Schwarzenegger appointed current chairperson Joseph Miller as the chairperson. Rabine's term was marked by the most significant changes in the system since the 1913 passing of the Boynton Act, which set up much of the system. Separate reforms passed in 2003 and 2004 have been the subject of a huge volume of litigation. Many issues from the 2003 and 2004 reforms addressed by the WCAB during Rabine's term are now headed for the California Courts of Appeal and, in at least one case, the California Supreme Court.

In the eyes of many system observers, Rabine's term was something of a surprise. As a former President of the California Applicants' Attorneys Association and as a partner and protege of legendary Santa Ana applicant attorney Eugene Leviton, many expected Rabine to be reflexively "applicant oriented". During his tenure, there were grumblings from a number of his former colleagues that his decisions did not sufficiently "carry the torch" for injured workers and that decisions on his watch were not especially well crafted. There was never any doubt about Rabine's competence, integrity or work ethic.

Frankly, it is probably too soon to assess Rabine's term on the WCAB. Legal historians may be able to better assess his term some years from now, depending on the outcome of many of the appellate cases under consideration.

In a short speech at his goodbye event, Rabine noted that he felt that one of his major accomplishments was the revision of the WCAB's Rules of Practice and Procedure.

Governor Schwarzenegger now has a chance to further shape the system by filling Rabine's slot with a new six-year appointee. WCAB commissioners do not necessarily always come from a workers' comp legal background . It is not clear how long it will take Schwarzenegger to settle on a new nomination. But any nominee will be subject to legislative confirmation, so the appointment could become wrapped up in Sacramento politics. Stay tuned.

Julius Young
www.boxerlaw.com

In my January 13 post, I summarized the key elements of Schwarzenegger's proposal to extend health coverage to all Californians. Key interest groups in California -- doctors, hospitals, large employers, counties, unions, drug companies, among others -- will be doing heavy lobbying to influence the outcome of this year's health care debate.
Since many injured workers either don't have group health insurance to begin with, or lose their coverage if they are off work for an extended time due to injury, reform of California's health care system is critical to unions and injured workers. As State Senator Sheila Kuehl (Chair of the California State Senate Health committee) noted recently:
"Plenty of money is being spent on health care-one out of every six dollars
spent in America, it's just not enough to cover everyone. And, while spending generally has risen by 7.5%, insurance premiums have gone up by double-digits every year for the last five. Wages have increased only 1.7%. Costs are getting shifted to patients and physicians are not getting reimbursed for their work."

Kuehl has her own health care reform bill in the hopper, SB 840. SB 840 would set up a state insurance trust fund, collecting premiums paid by employers and individuals alike. It is a version of a "single-payer" system pushed by many reform advocates. A "single-payer" system would greatly reduce health care administration and bureaucracy costs.

State Senate leader Don Perata has his own plan, Senate Bill 48. Assembly Speaker Fabian Nunez also has his own plan, AB 13, which would cover employees through a purchasing pool funded by fees on employers who do not offer health coverage.

Thus, we have at least four major proposals: one by Gov. Schwarzenegger, and the others, by power players Kuehl, Perata and Nunez. It will be interesting to see what emerges.

For a more detailed description of how some of these proposals would work, see
Senator Kuehl's article in the California Progressive Report:

http://www.californiaprogressreport.com ... re_in.html

To follow the details of the health care debate this year, you may want to bookmark the site of Health Access California, a consumer advocacy coalition working for affordable health care for all Californians:

http://www.health-access.org/

Julius Young
www.boxerlaw.com

Well, it's a beautiful Saturday... picking up the paper, I see that California has slipped from 6th to 8th in the world economy. .. the Siskiyou salamander won in court... and tortilla prices are up in Mexico City.... A poll just out from the well-respected San Jose State Survey shows the Governor basking in a 63% approval rating, including 61% of Bay Area voters and 53% of Democrats, as well as a majority of blacks and Hispanics. Good news for the Schwarzenegger folks, indeed. But it's time for Workerscompzone to comment on Governor Schwarzenegger's new health care proposal.

Sacramento has been abuzz the last few weeks with talk about the health care reform debate. A recent Field Poll showed that over 75% of California voters favor reforming the current health care system. I'll be dealing with this repeatedly as the legislative session moves along, since it is an issue that is in many ways intertwined with workers' comp and the California economy. You can check the "related link" section just below this blog entry to see some of the more interesting articles that have appeared in the press about the plan. In future posts, I will be exploring some of the interesting interplay issues between health care reform and workers' comp. But first, lets get a grip on what the proposals are.

In case you missed it, what are the essentials of Schwarzenegger's health care proposals? Note that these are ONLY proposals now. As summarized in the San Francisco Chronicle, the key elements are as follows:
-a pilot plan would be set up to try "24 hour care" coordinating workers' comp and group health care coverage (CALPERS employees would be in the pilot plan)
-employers with 10 or more employees that do not provide medical coverage would be required to pay a 4% payroll tax that would be pooled into a state fund to purchase coverage
-everyone would have to have insurance through an employer or purchase it individually. Minimum benefits would be a plan with a cap of $10,000 out-of-pocket expenses per family and a $5,000 deductible
-over a million low-income persons would get payment assistance to help them get coverage
-the state would provide health insurance to all children (including illegal immigrants) who are living below 300% of the federal poverty level ($60k for a family of 4)
-Medi-Cal would be expanded to cover about 630,000 indigent adults not now eligible for benefits
-Medi-Cal rates would be increased to pay doctors and hospitals more, but doctors and hospitals would be charged a 2% and 4% tax (or is it a fee?) respectively
-insurers would no longer be allowed to deny coverage to individuals based on their medical history
-insurers would have to spend 85% of their revenue on services

The headlines in reaction to the proposal have been interesting. Dan Walters of the Sacramento Bee: "Bold health plan faces rough road"; also see Walters' piece http://www.sacbee.com/111/v-print/story/106704.html; Peter Nicholas of the LA Times:
"When are 'fees' not new taxes?"; Harrison Sheppard of the LA Daily News: "Ready to
rumble in the capital." Also, see Steve Wiegand's piece: http://www.sacbee.com/111/v-print/story/107259.html
Stay tuned. In future posts, I will be exploring health care reform and workers' comp.

Julius Young
www.boxerlaw.com