It’s stunts like this that drive Consumer Watchdog’s efforts to beat back the insurance lobby and regulate untenable health insurance premiums.

When I first noticed the ad below while hunting for cookie recipes, I was surprised to see a health insurance company buying a full page in the first pages of a cooking magazine. But reading it was another surprise. The headline touts “Free Annual Checkups,” and the text of the Anthem Blue Cross ad takes credit for this brand-new benefit: “100% coverage for checkups, flu shots and other preventive services.”

Anthem, however, had nothing to do with the prevention benefit. It’s a requirement of the federal health reforms passed last year. Blue Cross, along with every other major health insurer, fought to eliminate such mandatory benefits and later falsely blamed the law for outrageous, unjustified double-digit premium increases. (The prevention benefit is just one of the things that will disappear if the courts or Congress succeed in voiding the health reform law.)

Anthem must figure a deceptive claim of “free” care will make us feel better about insurance payments bigger than our mortgage.

It’s stunts like this that drive Consumer Watchdog’s efforts to beat back the insurance lobby and regulate untenable health insurance premiums.

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Posted by Judy Dugan, research director for Consumer Watchdog, a nonpartisan, nonprofit organization dedicated to providing an effective voice for taxpayers and consumers in an era when special interests dominate public discourse, government and politics. Visit us on Facebook and Twitter.

The San Francisco Chronicle reported this morning on the front page about the landmark insurance reform we expect to be spending the next fifteen months working for. Insurance companies, the legislature and recent court rulings have all turned against consumers, much like they had in 1988, when California voters struck back with the toughest insurance reform in America: Proposition 103.

The San Francisco Chronicle reported this morning on the front page about the landmark insurance reform we expect to be spending the next fifteen months working for.

Insurance companies, the legislature and recent court rulings have all turned against consumers, much like they had in 1988, when California voters struck back with the toughest insurance reform in America: Proposition 103.

By 2014, all of us will be required to buy health insurance or face tax penalties. The problem is that health insurance companies can charge whatever they like and raise premiums at will in California. This is the same scenario that drivers faced in 1988 when mandatory auto insurance laws forced drivers to pay for policies many couldn’t afford. Voters then required auto insurers to pay drivers a 20% refund and to get permission before they ever raised rates again.

Just like in 1988, insurance stalwarts in the statehouse are now holding insurance premium regulation hostage. The companies have given the politicians millions so they can make billions overcharging you. And, as in 1988, the California Supreme Court has issued several rulings taking away the right of policyholders to hold insurance companies accountable.

If we go to the ballot with a 1988-style 20% rollback in health insurance premiums, will you be with us?

Our “Proposition 103 Part Two” ballot measure will have to be filed by November 2011 in order to begin signature collection so it gets on the ballot for November 2012.  

The main provisions of the ballot measure are as follows:

1- A 20% rate rollback in health insurance rates to reverse five years of unwarranted double-digit price gouging;

2- Require health insurance companies to seek permission from the elected insurance commissioner before raising rates, as auto insurance companies must, and application of other Prop 103 protections to health insurance companies;

3- Prohibit all insurance companies from raising your rates or refusing to renew you because of your credit score, claims or insurance history;

4- Allow consumers to join a non-profit public health plan administered by CALPERS instead of having to buy insurance from private insurance companies;  

5- Correct court rulings that have misinterpreted the law to benefit the insurance industry;

6- Create a “three strikes and you’re out of California” law for insurance companies that repeatedly violate the state’s consumer protection laws

7- Prohibit health insurance companies from forcing you to sign arbitration agreements as a condition of enrollment.  

We want to go to the ballot in November 2012. Will you be with us? Click here to sign up!

Together we can move health care reform forward in California and America.

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Jamie Court is president of Consumer Watchdog and author of The Progressive’s Guide To Raising Hell.

by Wendy Lazarus

In the year since President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law on March 23, 2010, a sea of ink and digital bits have been spilled on every possible angle of commentary and advocacy about the law.  But a year later, one simple conclusion deserves its share of sunshine:  Health Reform is good for America’s 74 million children.

The Good News:

Insurance companies are no longer able to deny any child health coverage for chronic conditions.  Common conditions such as asthma or diabetes were previously excuses for refusing coverage, even though these are the conditions that most often require health care for children.  These diagnoses are grim enough to receive anyway. You can imagine the relief, now, for families who no longer have to fear whether they can get basic health insurance for their child.  In California, alone, 1.1 million children and youth under age 25 have pre-existing conditions that previously would have resulted in health coverage denials.

Take, for example, this story from Celina, a MomsRising member from California. Her story demonstrates why moving forward with health care reform is critical for ensuring all kids have the chance to grow up healthy:

Another relief to many families is that young adults can stay on their parent’s insurance through the age of 26. With a struggling economy, this option can be essential for young adults who are just getting started, and especially for those for whom a gap in health coverage would be life-threatening. Here’s an example from our colleagues at Young Invincibles: Sara, a 22-year-old with Type I Diabetes.  After she began working a part-time job, she no longer qualified for Medicaid, and, without insurance, she would have to pay over $850 a month to control her condition.  Her options are woefully limited without health reform.

And it’s not just these individual stories that show how the law is making a difference.  After the first year, the impact of the expanded coverage can be seen in a rise in enrollment.  In California alone, Health Access estimates the number of newly eligible enrollees to be 200,000. And the California Public Employee Retirement System (CalPERS) reports to have enrolled 28,000 new older children.

For children and young people, especially, the focus needs to be on wellness and prevention-and it is under the Affordable Care Act.  The good news is that families cannot be required to pay co-payments for preventive screenings, a provision that will protect nearly 6 million children under age 19 in California alone.  By ensuring that children receive the right vaccinations and diagnoses, more expensive health care costs down the road can be avoided.  More good news: insurance companies can’t just drop children when they are sick or limit the lifetime value of coverage.

And, families will finally have more control over their own lives. Without being restricted to employer-based coverage, if a child has a condition that would have been previously denied, a parent can make employment decisions that are in the best interest of their family, without risking their child’s coverage.

The Challenge Ahead:

If we are to reach our goal of making sure all of America’s 74 million children are insured by 2014, we cannot sit back now and jeopardize these tremendous gains. We must encourage political leaders to ensure that federal funding and guidance are available for full and effective implementation of ACA.  

Making health reform work for families depends on states taking thoughtful and swift action, too. At this time when states across the country are struggling with serious budget deficits, we urge elected officials along with employers and philanthropic leaders to support states as they leverage the available federal funding for implementation as soon as possible.

As debate about the law continues in Congress and in the courts, we must remind ourselves that quality healthcare is good for our kids-and every child should have the opportunity to grow up healthy.

Wendy Lazarus is the Founder and Co-President of The Children’s Partnership, which advocates for improvements in child health care. Ms. Lazarus has been involved in advocacy for health coverage for all children for more than 35 years.

At the National Governors Association, President Obama just threw his weight behind a bi-partisan effort in the US Senate to allow states to innovate with health reform, including adopting a public insurance system or single payer health care system by 2013 instead of 2017.

At the National Governors Association, President Obama just threw his weight behind a bi-partisan effort in the US Senate to allow states to innovate with health reform, including adopting a public insurance system or single payer health care system by 2013 instead of 2017.

The governors embraced the state innovations waiver proposal, since conservative states want to weed back the federal health reform and states like California might like to push ahead with public insurance options or single payer health care systems.

The idea is to let states meet federal targets anyway they want to, rather than how the federal government prescribes, by 2013 rather than the current 2017 deadline.

This is one of Obama’s only moves left, and a smart one. It gives progressive reformers in California and elsewhere the ability to move forward on ambitious reform plans that can pass at the ballot box in 24 states but would never get the time of day in Washington.

Facing strong legal challenges to the individual mandate, Obama did the right thing by offering flexibility to states to meet targets for access and benefits in the Affordable Care Act.  He took a page from longtime labor leader Joe Hill: “Don’t Mourn, Organize.” He’s giving those of us who favor a public insurance option to the private insurance market an opportunity to move our states forward. We better take Joe Hill’s advice too and start organizing.

In my book The Progressive’s Guide To Raising Hell, I point out how the initiative process in 24 states and the District of Columbia are the best hope to get the type of health insurance reform that Obama promised in 2008.  Today’s announcement, if Republicans in Congress bite, lets us act on ambitious reform via ballot measure before 2014, the date mandatory insurance is set to take effect.  Game on.

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Posted by Jamie Court, author of The Progressive’s Guide to Raising Hell and President of Consumer Watchdog, a nonpartisan, nonprofit organization dedicated to providing an effective voice for taxpayers and consumers in an era when special interests dominate public discourse, government and politics. Visit us on Facebook and Twitter.

The largely peaceful revolution in Cairo and Americans’ celebration of it raises the question:

What would it take to mount a peaceful revolution in America against the Wall Street and corporate powerhouses that have turned the government against the best interests of our people?”

The largely peaceful revolution in Cairo and Americans’ celebration of it raises the question:

What would it take to mount a peaceful revolution in America against the Wall Street and corporate powerhouses that have turned the government against the best interests of our people?”

In America, the corporation is king and the abuses of corporate power are the subject of our people’s greatest grievances.

The 2008 election was supposed to settle the score with Wall Street and the corporate elite that have ransomed, ransacked and run over the average American. The change never came, and it’s even less likely in 2012.

At Consumer Watchdog we build populist revolutions one spark at a time where the public has spoken but the rich and powerful won’t listen. While our work cannot compare to the heroism of the Egyptian people, we are inspired by their example.

The revolution in Cairo showed the power of online platforms like Twitter and Facebook to authentically air outrage and connect change makers. In Washington, DC, Consumer Watchdog is fighting to protect individuals’ freedom online, which is being threatened in the name of greater profit, by some of the very corporate innovators that created these platforms.

On Friday, the “Do Not Track Me Online” revolution began with the introduction of legislation by Congressional Rep. Jackie Speier (HR 654) to force corporations to respect our right to keep personal information and online habits private. You can weigh in with your Congressional Representative to pass the legislation here.

Our freedom to be revolutionaries in America depends on how well we can maintain the online commons as free, open, and in the service of the individual, and our privacy needs, rather than the corporation and its commercial needs.  This is an American battlefield that begins with online privacy, the right not to tracked online, extends to net neutrality and evolves to the greater notion that online technology should be in the service of individuals not corporate robots (in spirit of the teaching of Jaron Lanier’s You Are Not A Gadget.

If there is a nonpartisan street revolt brewing in America today it is against the staggering health insurance premium increases that insurance companies are foisting on Americans.  I was in the streets against Blue Shield’s 59% rate hike two weeks ago with angry patients and the California Nurses Association. Blue Shield actually agreed to delay the hike when we showed up.

Consistent premium hikes and the pending mandatory health insurance law to take effect in 2014 are bound to continue a growing rebellion.

Health insurance companies like Blue Shield and Anthem Blue Cross thumb their noses at our democracy daily.  They hijacked health reform to give themselves a guaranteed market, even as they fight daily to erode the consumer protections in the new federal law. Consumer Watchdog is working with regulators to force the health insurance companies to live by the new rules and with California legislators for “Do Not Gouge Me” legislation — giving government the right to stop unnecessary premium hikes. (You can weigh in for AB 52, if you have not already, here. )

Ultimately, the 24 states with ballot initiative processes will be a vehicle to get the people what Congress will not deliver – a public insurance alternative to the private market. Consumer Watchdog is already drafting such a ballot measure for California.

What happens after a revolt is as important as the uprising itself. Insurance companies like Mercury Insurance, Allstate and Farmers have been fighting for two decades against the ballot box revolution of insurance reform Proposition 103. Consumer Watchdog’s lawyers fight back daily to protect and further that voter revolt, which has saved motorists $62 billion on their auto insurance, and to show that even the biggest and most powerful companies have to respect the people’s will.

Revolutions in America today take place in the corporate suites, not the streets.  CEOs are generally the ones deposed, not presidents, which is the first clue to who really holds the power in our nation… But if a governmental revolution were to come, how would it unfold?

Bob Herbert in his New York Times column Saturday artfully makes the case  of the price we have paid for the sins of Wall Street and self-serving interest of those at the very top of the economy.  America will never be the same, nor will our schools, parks, colleges, social programs and deficit, without a major re-rewrite of how our government works to divorce it from the state of corporate capture that is its numbing existence.

Elections are not tools of revolutions in America anymore. What will it take to get Americans in the streets?  

Higher prices for everything coming with growing inflation, higher unemployment,  no jobs for our youth, the closing down of public services and public assistance?

The powerful in America have too much to lose and usually buckle when they smell the whiff of a revolution. That’s why it’s worth putting that smell in the air and in the streets again when the moment calls for it.

Dramatic changes in ideas and practices are the results of long, hard marches toward freedom and accountability. We need to start marching together in America again.

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Posted by Jamie Court, author of The Progressive’s Guide to Raising Hell and President of Consumer Watchdog, a nonpartisan, nonprofit organization dedicated to providing an effective voice for taxpayers and consumers in an era when special interests dominate public discourse, government and politics. Visit us on Facebook and Twitter.

House HELP Passes Amendment to Allow State Single-Payer Experimentation

America’s registered nurses and other guaranteed healthcare activists are hailing the vote last night by House Education and Labor Committee to amend the national healthcare reform bill and give individual states the freedom to adopt single-payer, Medicare-for-All style reforms.

This bi-partisan vote affirms the best of American democracy.  The exemptions would life federal mandates on healthcare money and free states to act as the laboratories of democracy they are supposed to.  The vote is also an encouragement to progressives who are looking for paths to improve the parameters of the healthcare debate.

Here is Sen. Sanders discussing the Senate version of the amendment, which was recently voted down in the Senate Finance Committee.  And here Rep. Kucinich reports on the vote call.

In addition, nurses and healthcare activists cheer the vote because it gives hope for the kind of genuine healthcare reform that is not based on negotiating with the failed and heartless insurance companies who are the cause of our healthcare crisis-something they should not be rewarded for.

Introduced by Rep. Dennis Kucinich of Ohio, the amendment would remove the potential “ERISA” legal impediments for states to pass single-payer bills by waiving federal exemptions that apply to employer-sponsored health plans.

The amendment passed on a bi-partisan vote of 25-19, with the support of both progressive, single payer Democrats and many Republicans who endorsed the ability of individual states to pass their own versions of health care reform.

“This is a historic moment for patients, for American families, and for the tens of thousands of nurses and other single payer activists from coast to coast who can now work in state capitols to pass single payer bills, the strongest, most effective solution of all to our healthcare crisis,” said Rose Ann DeMoro, executive director of the California Nurses Association/National Nurses Organizing Committee.

“There are many models of health care reform from which to choose around the world – the vast majority of which perform far better than ours. The one that has been the most tested here and abroad is single-payer,” said Kucinich in urging passage of the amendment.

“Under a single payer system everyone in the U.S. would get a card that would allow access to any doctor at virtually any hospital. Doctors and hospitals would continue to be privately run, but the insurance payments would be in the public hands. By getting rid of the for-profit insurance companies, we can save $400 billion per year and provide coverage for all medically necessary services for everyone in the U.S.,” Kucinich said.

The nurses noted there is a long road ahead for the amendment. It will still need approval from the full House and in a final version from the Senate. Nurses and other healthcare and community activists made numerous calls to legislators in support of the amendment, and will continue to press for its enactment in the final bill.

For those who have opposed the proposal, DeMoro called it “a very modest amendment that simply protects choice for residents of individual states who favor more comprehensive reform.”

Recent reports from both the Department of Health and Human Services and the prestigious medical journal Health Affairs have documented that compared to people with private insurance, Medicare enrollees have greater access to care, fewer problems with medical bills, and greater satisfaction with their health plans and the quality of care they receive.

The reason for improved access, quality, and lower costs under Medicare, said DeMoro, “is that under Medicare, insurance companies, whose central focus is profits for their shareholders not delivery of care,  don’t have the ability to deny care, limit coverage, or continually raise prices that endanger the health and financial security of patients.”

“The successes and standards of Medicare should be the model for reform for all Americans,” said DeMoro. “If the final national bill will not meet that test by establishing Medicare for all, then let’s give Americans the tools to pass it in individual states.”

Currently, if states were to pass single-payer laws, as California, for one, has twice, only to have the bill vetoed by Gov. Arnold Schwarzenegger, it could be subject to immediate legal challenge due to the federal Employee Retirement Income Security Act (ERISA) which applies to all employer-paid health plans. The Kucinich amendment would provide an ERISA waiver.

For the past few months I have been holding town hall forums across California and no matter where I go, the issue of health care is front and center. These concerns are getting more pronounced and more passionate as the weeks wear on and unemployment continues to rise. People are losing their employer-based health care and COBRA is a temporary and expensive stopgap measure that is stressing already maxed-out family budgets.

The need for bold programs addressing the health care crisis was brought into focus by a new UC Berkeley report showing that more than 500,000 Californians have lost their health care since the start of the recession.

In the past five years, we have worked hard to provide universal health care in San Francisco through our Healthy San Francisco program. We have now enrolled over 38,000 of our city’s estimated 60,000 uninsured. It’s a great start but there is still much work to do here in San Francisco and across California as the new UC Berkeley report clearly lays out.

On my Green 960 radio show this week I talked with Lloyd Dean, the head of Catholic Healthcare West, Mitch Katz, Director of San Francisco Department of Public Health and Tangerine Brigham, Director of Healthy San Francisco about how to bring the “Healthy SF” model to other cities and towns throughout California.

As we discuss on the show, a critical next step for any city or town looking to replicate Healthy SF is to start organizing their community health clinics. Community clinics have historically provided services to uninsured and underserved populations. It’s important for any health care effort at the local, state or federal level to include these crucial providers.

I hope you will listen to the show and let us know your thoughts and suggestions in the comment section as we work to create better health care service here and universal health care across California. As the President and Congress move to reform the health care system in Washington – the time is now to let your voice be heard.

Listen to Mayor Newsom’s Green 960 radio show online or subscribe to his weekly policy discussions on iTunes.  Join Mayor Newsom on Facebook. You can also follow him on Twitter.

(Perhaps this will shed a bit more light than heat on the issues around health care reform.  Play nice in the comments, people   – promoted by jsw)

A new comparative analysis shows that the pending California Health Security and Cost Reduction Act, AB x1 1, takes major steps in health reform far beyond the much-discussed Massachusetts reform of 2006. A full copy of the 8-page analysis is available HERE at the Health Access website.

The analysis, entitled “Health Reform in California and Massachusetts: Different from Start to Finish,” concludes that AB x1 1 would provide a broader benefit to California consumers than what was passed in Massachusetts. The report lists “top ten” major differences between the California ‘s AB x1 1, and the health reform law, Chapter 58, passed in 2006. In contrast with Massachusetts, the California proposal includes:

1) New, Broader Financing, including a Tobacco Tax

2) A More Meaningful Employer Contribution

3) General Fund Protection

4) Significant Cost Containment

5) Subsidies up to and above 400% of the federal poverty level

6) Key Differences in the Individual Mandate, Affordability and Enforcement

7) A Transition to Guaranteed Issue

8) Medical Loss Ratios and Increased Insurer Oversight

9) Not Just a Connector, but a Negotiator

10) New and Improved Public Health Care Options

WHERE ADVOCATES STARTED IN MA: Probably most interesting to the progressive readers of Calitics is the comparison of AB x1 1, not with what passed in Massachusetts, but with advocates first proposed. Many consumer and community groups (www.massact.org) originally proposed a 5-page ballot measure as leverage to force health reform, and to influence its content. They collected all the signatures needed, but they ultimately decided not to file, given the deal passed in the legislature.

Their ballot measure included subsidies for not just low-income but middle-income families up to 400% FPL, financed by minimum contributions for large employers of 5-7% of payroll, and a 60-cent tobacco tax–none of which made it in the final Massachusetts package, but is included (if not more robustly) in the pending California plan.

More…

WHERE CA IS NOW: California advocates ended up where Massachusetts advocates started–although now we have to wage the ballot campaign those in Massachusetts didn’t. At the same time, if the effort succeeds, then California will have a reform that goes further and is much better financed and stable over the long term.

The conclusion of the report is that Massachusetts and California start from different places, and the plans are different enough, that they will end up having different results. Critiques of the Massachusetts plan simply do not apply to California’s effort.

But it’s notable that the California conversation has been largely been about doing more than MA, rather than doing less. That’s positive momentum for the national reform effort.

(Absolutely. Pushing a rushed reform compromise in two weeks would be a travesty, and it speaks to how deeply broken the legislative process is, because it creates all of these bottlenecks that, deliberately IMO, stifle debate. Sen. Kuehl makes a ton of sense here. However, I would be open to a special session to get something done if the process were made more open. – promoted by David Dayen)

Health Reform and the Year of Magical Thinking

The Year of Magical Thinking is the title of a memoir by Joan Didion detailing her state of denial, inexplicable behaviors and, finally, coming to grips with, the death of her husband. It’s also an apt description of the Governor’s 2007 approach to reforming our broken healthcare system, with the glaring difference that he still hasn’t come to grips with the truth. (After all, if a complicated movie plot could be resolved in less than two hours, who not fix healthcare in California in nine months?)

Beginning in January, the Governor ordered his health advisors to sketch the outlines of a plan that would magically “cover” all Californians by simply requiring them to buy health insurance.  To this moment, he has refused to negotiate any of his major points with the Legislature.  The language for his plan was finally drafted five months later, and shown, under wraps, to a few, select people.  Not one legislator agreed with it, and no one would carry the bill as legislation. 

More on the flip…

To fill the void raised by the Governor’s magical “we must do something this year” drumbeat, the Democratic leaders began crafting their own reform plan.  To date, however, the Governor and the Legislative leadership have remained oceans apart on the broad policy strokes of health care while public support for the current insurance-company controlled system has plummeted and support for the reforms contained in SB 840, the Medicare-like fix for California, has grown.

Now, with less than two weeks remaining in the first half of the two-year legislative session, there is still no “something” on the table and the Governor, like a Barnum and Bailey’s ring leader, continues to announce that he will, assuredly, pull a rabbit out of a black hat.  Actually, there is no way of knowing if the result would really be a rabbit; it could just as easily be an albatross. 

The Governor has further limited discussion by announcing that he would veto both of the legislative proposals that have actually been introduced as real bills. SB 840, by far the most carefully crafted, transparent and fully vetted bill, will remain in the Legislature until next year, since sending it down to him for a veto would end any consideration of single payer until 2009.  The individual mandate provisions in the Governor’s pronouncement are being emphatically rejected by virtually all stakeholders representing the people who would be forced to pay uncapped premiums.  The percentages to be paid by employers and individuals, hospitals and doctors, people in a “pool” and those outside, those above differing percentages of the poverty scale and those below, are so far apart in the Governor’s pronouncements and the Speaker’s bill, you could drive trucks through the gaps.  The Governor’s lynchpin financial mechanism of a provider tax remains submerged under the very murky water of a 2/3 vote.  What convoluted compromise might be devised in a last-minute attempt is anyone’s guess.

Nonetheless, we are told that, unless we agree to pass a yet-to-be hastily drafted bill that incidentally may be the biggest reform proposal ever attempted in health care, and pass it in two weeks, thus completely bypassing the entire political process and any semblance of open public input, we’ve completely failed and health reform is doomed forever.  Please.

The prospect of legislative staff, sitting behind closed doors, hastily crafting a 100-page health reform “compromise”, to be pushed through the legislature with little or no public input over the course of the next 14 days, is deeply irresponsible.  Frankly, given the example of the energy deregulation bill, we ought to know better.

Moreover, we lose nothing by taking advantage of the fact that the sessions of the California legislature are two year sessions.  Many of our major accomplishments, most recently, AB 32, the bill related to greenhouse gas, took more than one year to achieve.  Next year’s Presidential campaigns will ensure that health reform stays as the top of the agenda.  More importantly, the issue of health reform will continue to dominate because the people need it and want it.  What they want, and deserve, however, is responsible health reform, not a new debacle that benefits the health insurance companies the way the electricity bill benefited Enron.

Finally, we must not forget the reason that we are in this crisis to begin with.  Health care premiums changed by insurance companies continue to grow 3-4 times faster than wages.  A solution is needed that pays attention to adequate funding, affordability, cost controls and quality.

Even if the Legislature should pass a last minute convoluted experiment in health reform, there will still be a need to continue the work to enact a fully vetted, Medicare-like single payer system that replaces the insurance companies with a plan for all Californians, allows each person to choose their own providers, and protects affordability, comprehensive coverage and quality.  Such a solution is the only sensible and tested way to achieve universal health care responsibly.  Whatever happens in the next two weeks, the movement for single payer universal health care is continuing to grow, and SB 840 will continue as its focal point, the only legislation that establishes the kind of truly universal, modern and affordable health care system the people of California need and deserve.