Hopes for comprehensive healthcare reform in California in the near term crashed and burned in late 2007. Even a special legislative session failed to produce a comprehensive healthcare package.

But-to its credit-the legislature hasn't given up. Recognizing that millions of Californians have no healthcare coverage (including many disabled workers who are no longer covered by group medical), Democrats in the legislature have sponsored a number of bills to ease access to coverage and prevent abuses by health insurers.

Injured workers have a dog in this hunt.

AB 1945 (DeLaTorre) would prevent insurers from retroactively canceling coverage unless they could show that intentional misrepresentations were made in the application for coverage. Over the past few years there have been occasional horrendous stories of insurers yanking coverage from seriously ill folks. This bill would force insurers to face a high standard of proof before rescinding coverage.

SB 1440 (Kuehl) would require health insurers to spend 85% of premium dollar collected on patient care. That's a fine concept, and one the governor has supported as part of his 2007 healthcare proposal.

Other provisions would expand the list of required items to be covered.
AB 1877 (Beall) would require coverage for diagnosable mental illness.
AB 1962 (DeLaTorre) would require maternity care be covered. AB 1198
(Kuehl) would require durable medical equipment (wheelchairs, etc) be covered.

AB 2 (Dymally) would reform the high risk insurance pool, attempting to make insurance more available for high risk individuals.

You can read about these and other healthcare bills in an excellent article on the California Progress Report by Hanh Kim Quach of Healthcare Access California:
http://www.californiaprogressreport.com ... al_25.html

It's not clear what Governor Schwarzenegger will do with these bills.
Schwarzenegger's governorship will be in its sunset phase before we know it, and with that goes his chance of leaving a legacy. Piecemeal reform was clearly not his first choice, but it may be his only option.
If he fails to sign these bills, he may find that he will achieve absolutely nothing in healthcare reform during his tenure.

Given the state's budgetary distress, it's hard to envision comprehensive healthcare being enacted in next year's 2009 legislative session. One hopes the Goverrnor will think twice before rejecting these "piecemeal reforms".

Stay tuned.

Julius Young
www.boxerlaw.com
(you can subscribe to the blog by clicking on the RSS reader button on the right lower column under "Most recent entries")

It was an interesting weekend. Those of us who hadn't previously followed Alaska politics were introduced to Sarah Palin, who has registered the name "Rouge Cou" (translated as "redneck") for a marketing venture.

Rust belt hockey moms, NASCAR dads and Catholic women may be deciding whose fairy tale comes true.

Turns out Palin is the part owner of an Anchorage car wash. Here in California the car wash industry has been the poster-boy for labor law violations. It'll be interesting to see whether that's the case in Alaska or whether Palin ran a "clean" car wash.

But while you were barbecuein' and the media was reeling at the Palin pick, the California legislature was wrappin'.

We may not have a state budget yet. But we have comp legislation on its way to the Governor's desk.

The bill in increase benefits to permanently disabled workers over a 3 year period-SB 1717- passed its last Assembly hurdle. The vote on August 29 was 46-31, with 3 absent or abstaining. The California Senate voted in favor 23-14 back on May 17. To see how the Assembly voted, click here:
http://www.leginfo.ca.gov/pub/07-08/bil ... floor.html

To see the official analysis of SB 1717, click here:
http://www.leginfo.ca.gov/pub/07-08/bil ... floor.html

SB 1717 is now on its way to the Governor, where it faces almost certain veto. Similar bills were rejected in 2006 and 2007. The third time is not likely to be the charm.

Also on its way to the governor is the Migden bill on apportionment discrimination, SB 1115. Here is the official analysis of SB 1115:
http://www.leginfo.ca.gov/pub/07-08/bil ... floor.html

SB 1115 passed out of the Assembly on 8/19, on a 46-31 vote, with 3 absent or abstaining. Here is the Assembly tally:
http://www.leginfo.ca.gov/pub/07-08/bil ... floor.html
And here is the Senate tally:
http://www.leginfo.ca.gov/pub/07-08/bil ... floor.html

I'll be covering any developments as these bills head toward Schwarzenegger's desk.

Stay tuned.

Julius Young
www.boxerlaw.com
(you can subscribe to the blog by clicking on the RSS reader button on the lower right column under "Most recent entries")

J.P. Morgan. Savior of Bear Stearns. Now coming to workers' comp.

Huh?

There's a reason why the folks on Wall Street are on Wall Street. They understand how to gin up new financial opportunities.

Credit debit swaps and slice n' dice mortgage pools. Been there. Done that.

Where's there a huge pool of cash ready for the tapping?

Workers' comp. That's where.

What if we could get the float on some of worker indemnity payments? We'll handle the funds-cash deposited by the insurer up front-and invest those monies, all the while making the funds available to the disabled worker.

Voila! Workers' comp debit cards. The worker can use them like cash to pay for a wide range of items or withdraw cash like an ATM. A toll free number would allow workers to check balances. Workers without bank accounts would not be forced into expensive check cashing services.

Advantages? Problems with account holds and missing or late checks would be reduced if not eliminated. Transaction costs for employers and carriers might be lowered.

But like all plastic, there are problems. ATM-like access to cash might facilitate irresponsible financial planning by impulsive injured workers.
And how to pay landlords and utilities? Many of these workers are not folks who do electronic banking.

And with the entire banking system under cloudy skies, involving large banks in new financial products may be a bit much for many to stomach.

I've yet to hear discussion of workers' comp debit cards in California.
I'll leave it to wiser oracles to analyze whether comp debit cards would be permitted under current statutes or whether there would need to be enabling legislation.

But stay tuned.

Julius Young
www.boxerlaw.com
(you can subscribe to the blog by clicking on the RSS reader button on the right lower column under "Most Recent Entries")

Californians like to think of themselves as the ultimate trendsetters. From beach volleyball and skateboards to iPods and iPhones, it tends to happen here first.

But consider Alabama. There's a cutting edge place for you. Hey, it's not Santa Cruz, Venice Beach or Cupertino, but even Tuscaloosa can generate a trend now and then.

The State of Alabama plans to start surcharging obese state workers for part of their healthcare coverage. State workers who aren't fat will continue to get coverage for free. Those who don't meet the weight goal
(a body mass index of under 35 or lack of progress thereto) will be paying $25 per month.

Smokers are already surcharged in Alabama.

Other states have been experimenting with various financial incentives to promote wellness and reward healthy behavior.

It's doubtful that we'll see these kinds of penalties in
California workers' comp. As a statutory scheme, using a stick rather than a carrot will probably never fly politically.

But it would be interesting if an insurer offered incentive programs to disabled workers to help keep them in shape. In an era of rising medical costs, might it be cost effective for an insurer to actually give small financial incentives (slightly higher indemnity payments?)
to workers who met certain performance incentives? Incentives to workers who demonstrated motivation in their treatment regimen or progress dealing with associated problems such as obesity?

Granted, the current prevalence of utilization review and ACOEM guidelines seems to discourage such an approach.
Try being a lawyer fighting for a gym membership or a structured weight loss program for a worker who wants to keep in shape. Sometimes you can win these fights, but it's a battle.

But-thinking outside the box-wouldn't it be cost effective for a large insurer like SCIF to provide some gym or pool facilities or gym discounts where workers could keep in shape under proper supervision?

Silicon Valley companies have long recognized the advantages in this type of approach. In the comp arena it won't be effective for everyone. But getting the worker active is the whole concept behind functional restoration.

The problem is that most injured workers have no workout equipment and no concept of how to get started. Keeping motivated is hard and the risk of reinjury is higher without training. And many workers are afraid to be too active lest they be accused of comp fraud.

This is one concept that Arnold would understand.

Stay tuned.

Julius Young
www.boxerlaw.com (you can subscribe to the blog by clicking on the RSS reader button on the lower right column under "most recent entries")

The public's attention is not exactly on workers' comp as the summer winds down. The Olympics, the impending vice-presidential picks and McCain's apparent pull ahead, the financial teeter-totter of Fannie Mae and Freddie Mac, the spectre of a restless Russia... is it John Edward's baby? .There's a lot on the public mind.

You, dear reader, perhaps live in a quiet corner of the state with gated communities and manicured lawns. But here in Oakland the public's mind is on a spate of brazen restaurant robberies. Young hooded thugs in baggy pants barging into restaurants-even in upscale, trendy areas-and holding up diners and staff at gunpoint (there's a comp case for ya!)

Restaurants installing countersecurity measures. Some owners locking doors and considering doing racial profiling before inviting customers into the premises. A lethargic mayor who blames thuggery on lack of hope for young men without economic opportunities.

Sometimes its not hard to image society devolving into shocking lawlessness.

Workers' comp is a backwater.

Last week's announcement that the WCIRB may recommend as much as a 20% increase in comp premiums received some press coverage. But the story dropped out of sight quickly, causing few ripples.

At the WCAB district offices today, a collective sigh of relief. The Governor's plan to reduce state employees to minimum wage pay has been put off til a September hearing. Board employees I've talked to this summer have been dispirited.....concerned over the pay issue and
unenthused over what they've seen of EAMS so far.

Meanwhile, the California legislature grinds towards the finish of this term. Carole Migden's anti-discrimination in apportionment bill cleared its last legislative hurdle yesterday and heads to the Governor.

Here's a link to the roll call vote tally in the California Assembly:
http://info.sen.ca.gov/pub/07-08/bill/s ... floor.html

You'll notice the vote is along party lines. The California Republican party is reliably in the service of California business interests.

Never mind that Migden's bill, SB 1115 codifies basic tenets of fairness that are a consensus in our society. Discrimination is not in vogue.

In coming posts I'll be looking at SB 1115 in more depth.

Stay tuned.

Julius Young
www.boxerlaw.com