The clock ticking down on the last night in the California statehouse is always a lot like waiting for last call at a rowdy bar around 2 AM — you wonder how much damage will done before the last shot.

The clock ticking down on the last night in the California statehouse is always a lot like waiting for last call at a rowdy bar around 2 AM — you wonder how much damage will done before the last shot.

For years my colleagues and I have stood watch on the California legislature,into the wee hours of the morning, to make sure that politicians and companies didn’t a pull a fast one at the last moment. There have been a lot of close calls over the years, and some lost ones too.

Here’s the roundup from Friday night’s/Saturday morning’s last call in the statehouse before 2012:

•     Last day legislation to move all ballot initiative measures to the November 2012 ballot, and stop ballot measures on the June primaries, cleared both houses of the legislature. Senate Bill 202 passed every committee and both houses in a single day. It’s not clear whether Governor Brown will sign SB 202,  but if he did, the public would win big.  Special interest groups often target the low turn-out June primary to pass measures the majority of Californians would never approve of.  It’s better to have the real sentiment of the most Californians voting on ballot measures, rather than allowing corporations, for example, to target a much more friendly electorate in June, when Republicans will turn out big for their presidential primary.  Mercury Insurance CEO George Joseph is trying to qualify his insurance surcharge initiative in June, a repeat of the failed Prop 17 from June 2010, for this very reason.  He would stand even less a chance of pulling the wool over the eyes of the majority of real California voters in November.  Turns out SB 202 stands on strong principle.   For decades, prior to 1978, initiatives only went on the November general election ballot, which is what the California constitution requires.  Then the legislature officially changed the protocol.  If the legislature can change the definition of “general election” to include primary election, it can change the definition back.

•    Legislation requiring health insurance companies to cover behavioral therapy for autistic children went to the Governor’s desk, SB 694.  Consumer Watchog sued Governor Schwarzenegger’s Department Of Managed Health Care to force such continued coverage for autistic children in 2009, when the state started allowing insurance companies to deny the treatment as “educational.”  A 9th Circuit decision recently strengthened our legal case, which is still pending, that the Mental Health Parity Law requires behavioral therapy to be covered.   The insurance companies no doubt hope the new legislation will undermine our lawsuit and other pending cases against them, because they don’t want to have to pay for the therapy they have denied since 2009.  Senator Steinberg, however, testified that he believed such therapy was always required and the legislation was clarifying existing law.  We expect to prevail.

*  The bill to force health insurance companies to get prior approval from state insurance regulators before raising rates never came up for a vote on the Senate Floor. AB 52, authored by Assembly Member Mike Feuer,  was shelved for the year  because the legislation did not have enough votes in the insurance-friendly state Senate.  Consumer Watchdog is exploring a November 2012 ballot measure to regulate health insurance premiums, rollback rates by 20% and gives patients new options. Stay tuned for developments as our opinion research and drafting continues this fall.

Governor Brown hosted a kegger in his office for the legislature after it closed down in the early morning hours.  For the public, there wasn’t much to celebrate this session, other than that more damage wasn’t done.

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

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.

Health insurance companies apparently have no problem taking opposite sides of an issue when it serves their bottom line. When it comes to California law, they hate regulation and will spend any amount of money and credibility to kill it. But when it comes to protecting the profits of insurance brokers at the expense of consumers, insurance companies say (approvingly) that effective state regulation will protect consumers from premium increases. Both positions are public record, but health insurance companies apparently figured no one would ever notice.

Health insurance companies apparently have no problem taking opposite sides of an issue when it serves their bottom line. When it comes to California law, they hate regulation and will spend any amount of money and credibility to kill it. But when it comes to protecting the profits of insurance brokers at the expense of consumers, insurance companies say (approvingly) that effective state regulation will protect consumers from premium increases. Both positions are public record, but health insurance companies apparently figured no one would ever notice.

The California battle is highly public. The state is the biggest health insurance market in the nation and one of the least-regulated. So it’s no wonder tht the insurance industry is fighting a tooth-and-nail battle against state regulation that would protect consumers from premium increases of up to 86% in 12 months–as Blue Shield tried to impose in the last year. The insurance companies have clubbed doctors into submission, threatening to cut their reimbursement if decent regulation starts to squeeze record health insurance profits. They have also poured money into political contributions to key legislators, according to an Associated Press story this week.

The bill, AB 52 by Assemblyman Mike Feuer, has passed the state Assembly and is up for a vote today (Wednesday) in a key state Senate committee. Here’s a safe bet: Even if it passes and goes to the full Senate, insurers will twist every arm and make every threat to get the bill killed–or more likely, crippled by hostile amendments that would hogtie the state Insurance Commissioner.

The other side of the insurance company mouth is buried in the proceedings of the National Association of Insurance Commissioners, where only geeks go to read. Right now the organization is under pressure to back a legislative proposal in Congress that would kill a key consumer protection in the federal health reform. The bill, HR 1206 by Michigan Republican Mike Rogers, would allow insurance companies to pay brokers and agents without counting the payments as an overhead expense. This would trash the reform requirements that insurance companies spend more on health care, holding overhead and profits to 15% or 20% of insurance premiums. If they don’t have to count broker pay as overhead, health insurers wouldn’t have to lift a finger to become more efficient.

Of course, we consumer advocates have argued that if the Rogers bill passes, insurance companies will have a free pass to raise premiums.

The health insurance lobby’s response? Oh, that won’t happen because consumers are well-protected by state insurance regulations!

From a June 2 letter (see last page) by America’s Health Insurance Plans to the NAIC:

“Finally, we wish to comment on a concern we have heard that deserves a response. One commentator has expressed the concern, and assumption, that if commissions are removed from the MLR calculation, then insurers will only increase their premiums – leading to great harm to consumers. We believe this flawed assumption fails to recognize the standard of rate review prevalent in the states. Exempting commissions from the MLR calculation does not pull them from the rates, and certainly does not stimulate insurers to inflate their rates. And states are increasingly focused on assuring value for consumers in their rate review, in accordance with the ACA, making such an assertion even more unlikely.”

If states want to “assure value” in health insurance, they certainly do have to review and regulate rates, and that includes the power to approve or reject rates before they go into effect. Such prior approval is now “prevalent” in the majority of states–though not in California.

When a corporate lobby is as powerful as the health insurance industry’s, it apparently doesn’t have to worry about being consistent.

I hope state legislators weighing the California bill have a grip on how two-faced the industry deliberately is. At least the industry has admitted that regulation is the only barrier between consumers and the next flood of premium increases.

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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 quote of the week goes to Mark DiCamillo, director of the Field Poll, which is just out with a poll that shows Arnold Schwarzenegger with a 75% disapproval rating among voters and with 90% of Los Angeles residents rejecting him.

The quote of the week goes to Mark DiCamillo, director of the Field Poll, which is just out with a poll that shows Arnold Schwarzenegger with a 75% disapproval rating among voters and with 90% of Los Angeles residents rejecting him.

DiCamillo told the San Francisco Chronicle:  “He was going to be a … politician who really appealed to independent voters and who would reach across party lines,” DiCamillo said. The new poll shows that Schwarzenegger has “achieved the ‘post-partisan’ status.”

Republicans, Democrats, independents, Californians of all walks of life curse their former Governor. What’s made Arnold’s reign so disappointing is not that he betrayed his wife, but that he betrayed voters and their hopes.

Consumer Watchdog launched ArnoldWatch.org on Schwarzenegger’s gubernatorial inauguration day because we knew his talk about cleaning up Sacramento was phony.  At the time Schwarzenegger had a 65% plus approval rating.  We launched the blog ArnoldWatch.org to hold California’s new governor accountable to his pledge to clean up special-interest control in Sacramento and to chart the influence of big business over his administration.  By 2005 Californians came to learn the Gov did not live up to his word when they rejected a slate of reactionary ballot measures he proposed.  When Schwarzenegger left office in 2010, before the news of love child scandal, his approval rating was only 27%, tied with Governor Gray Davis at the moment of his recall.

What ruined Arnold wasn’t his infidelity to his family, but to his state.  The blogs at Arnold Watch stand as a reminder of the need to be ever vigilant in holding our politicians accountable.  The special interests he bedded while in the governor’s suite spawned some of the uglier moments of California governance.  Sometimes we stopped him, sometimes we shamed him, other times Schwarzenegger’s donors won more than they should have.  When Arnold was hurting, he was forced to take huge steps forward to rehabilitate his image — an increase in the minimum wage, a greenhouse gas emissions cap, support for gay marriage.

What matters to voters in the end, though, isn’t these strides forward for progress or the master marketer’s cosmetic remakes of himself.  The voter’s final verdict was cast about his character.

Other politicians across America would do well to learn the lesson that, in the end, reputation and trust are all that truly matter. Every vote, every decision should be based not on the power of the interest group of the moment, or the political winds of an insular world, but on what’s right and wrong for history and a public official’s place in it.  Until politicians are ready for that truth, Consumer Watchdog will be here to remind them of it.

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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.

Today California’s Democratic state lawmakers announced a budget plan to keep their paychecks coming that included one of the worst ideas Arnold Schwarzenegger had since impregnating his kids’ nanny.

If lawmakers don’t pass a budget today, they lose their pay tomorrow. So Assembly Democrats have included in their hastily-assembled budget plan Schwarzenegger’s political love child, selling off treasured state properties to a group of politically-connected investors.

Schwarzenegger tried to sell off 24 historic state buildings — including the San Francisco Civic Center and the California Supreme Court – to his big campaign contributors. The Los Angeles Times reported the investors behind the so-called “California First” group contributed hundreds of thousands of dollars to Schwarzenegger’s political campaigns (Maria L. La Ganga, “$500,000 `Success Fee` Revealed In Proposed Sale of State Buildings,  Los Angeles Times, December 7, 2010)   The shady deal also included a half million dollar ‘finders fee’ to a local official.

Schwarzenegger’s fire sale was stopped in the courts by legendary attorney Joe Cotchett. My group Consumer Watchdog recently feted Cotchett at our Rage for Justice Awards for the lawsuit and his lifetime of legal achievement.

This short video from the dinner about Cotchett’s role and his acceptance speech of the Phillip Burton Lifetime Legal Achievement Award expose the corruption, stupidity and infidelity to the state’s constitution behind the ploy to sell off state buildings only to pay investors to lease them back.

So what gives with the Assembly Democrats’ plan?   Is it just about passing any budget to get paid? Are the investors behind California First putting up more finder fees and political contributions?

Whatever the reason for this misstep, legislators should realize by now that following Schwarzenegger’s lead is a recipe for disaster.

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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.

Los Angeles Times business columnist Mike Hiltzik offers a stark choice to state legislators in his Wednesday column. What'll it be, has asks: the millions of dollars that the insurance industry pours into your campaigns and treasure chests, or the millions of Californians battered by health premiums that kill the family budget or company benefits account? Plus the 8.2 million Californians with no health insurance at all?

Los Angeles Times business columnist Mike Hiltzik offers a stark choice to state legislators in his Wednesday column. What'll it be, has asks: the millions of dollars that the insurance industry pours into your campaigns and treasure chests, or the millions of Californians battered by health premiums that kill the family budget or company benefits account? Plus the 8.2 million Californians with no health insurance at all?

The choice Hiltzik lays out is between legislation (AB52 by Mike Feuer) that would finally give the state insurance commissioner the power to deny or modify unreasonable health insurance rate increases before they go into effect, and the exaggerated or outright false charges being slung by the industry. That opposition campaign is just a  cover for the real issue: the power of industry campaign money and its lobbying force.

From 2007 through this year, for example, Anthem Blue Cross has made campaign contributions totaling nearly $5 million to candidates, parties and political action committees, according to state records. Blue Shield has contributed more than $2.3 million in the same period…..

Across the country, prior approval of healthcare rates is becoming more the norm, now effective in 34 states and the District of Columbia for at least some policies, according to the Kaiser Family Foundation. The procedure closes a gap left by federal healthcare reform that leaves rate regulation to the states and provides only loosely for premium review. Once again, AB 52 provides state legislators with a chance to declare whom they really represent — their voters or their campaign donors.

The insurance industry is going after legislators that it has contributed to, or who otherwise look susceptible. That helps explain why the legislation barely squeaked through a key committee vote last week after two Democrats voted against it.

The final vote in the Assembly has to come by Friday. Lobbyists will be swarming the halls outside the chamber, intending to ride the last-minute chaos of speed-voting to kill the rate regulation bill. Among the lies the lobbyists will be forcing down legislators' throats is that regulation will somehow raise, not lower, insurance premiums. Again, Hiltzik nails it:

Last year both Aetna and Anthem backed away from huge rate hikes after independent actuaries found glaring mathematical errors in their rate filings.

A study in 2009 by the New York state insurance department found that these sorts of errors, and worse, were rife under that state's then-deregulated system, which resembled California's toothless regime. New York found that insurers routinely under-reported such errors and refunded (retroactively) only about a third of the ill-gotten excess to policyholders. The study helped goad lawmakers there into reinstating prior approval after about 15 years without it.

As it happens, California's health insurance lobby has tried to use New York's experience as Exhibit A for the case against prior approval. The association contends that five of the 10 states with the highest individual healthcare premiums are subject to prior approval, with New York leading the list. There's a problem with this claim, however: New York's prior-approval rules went into effect only this year. In other words, New York's high individual premiums are the result, if anything, of the absence of prior approval.

When I asked a CAHP spokeswoman where the figures came from, she said they conducted "some unique research." That's one way of putting it.

Even if AB52 passes the Assembly, it still has to take the same tortured path through the state Senate. The outrageous rate-spiking by insurance companies last year and this ought to be the final shove for honest health insurance regulation in California, just like the state has for auto and homeowner insurance. But in today's legislature, nothing is sure. To take action with a message to your legislator, click here.

If you've read this far and want to know more,  Read Consumer Watchdog’s new report on how rate regulation works to hold down premiums. And see what Sen. Dianne Feinstein says about the need for regulation.

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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 health insurance industry's lobbying muscle in the California Legislature is legendary. It's the reason that the state's insurance commissioner remains all but toothless to reject outrageous spikes in health insurance premiums and rates, unlike in a majority of other states. So it's not a shock that a new version of a bill to let the state insurance commissioner reject or modify health insurance premiums barely squeaked through the state Assembly's Appropriations Committee late last week with the minimum 9 votes.

The health insurance industry's lobbying muscle in the California Legislature is legendary. It's the reason that the state's insurance commissioner remains all but toothless to reject outrageous spikes in health insurance premiums and rates, unlike in a majority of other states. So it's not a shock that a new version of a bill to let the state insurance commissioner reject or modify health insurance premiums barely squeaked through the state Assembly's Appropriations Committee late last week with the minimum 9 votes.

+++Take Action Here to Cut Insurance Premiums, Send a Message to Your Legislator+++

The bill will face another firestorm of industry lobbying when it comes up for a full Assembly vote in a few days.

This legislation ought to be a slam dunk, after Blue Shield tried to jam through premium increases of up to 86% in a single year. Aetna and Blue Cross weren't much better. The only reason any insurer backed down even a little was because of public rage, which is not a good regulatory tool in the long run. When every Californian is required to show proof of insurance as of 2014, Californians will be even more in need of protection from insurance industry greed. And nearly every major newspaper has supported health insurance regulation–the LA Times made its second strong editorial argument Tuesday. (text of editorial is below)

So what was up with the two Democrats–Charles Calderon and Jose Solorio–who voted against the rate regulation bill (AB 52, Mike Feuer)? First they reportedly tried to get author Feuer to accept last-minute substantive changes without a chance to examine what they meant–and Feuer rightly refused. Then Calderon and Soloio voted no. Hmm. Solorio is among the top five recipients of insurance industry money in the Assembly. And Calderon is the sponsor of a bill (AB 736)–strongly supported by the health insurance insurance and broker industries–that would remove consumer protections from health broker misdeeds or errors and indirectly raise health insurance premiums.

Two million Californians lost their insurance during the recession, bringing the state's total uninsured to 8 million. From the mail we get, a whole lot of people are right on the edge of having to drop Health insurance. It's long past time for the largest state in the nation to get a grip on health insurance spikes in the high double digits, even as overall medical inflation sinks to around 4% a year. Something is wrong with this picture, even if it's just right for insurance companies' record profits.

We hope Calderon and Solorio were just making a procedural protest and that they'll protect consumers, not insurance company profits, when the Assembly votes this week on AB52. It'll be close. Here's the button to Take Action.

A lid on health insurance rate increases

California regulators should be given the power to reject unreasonable increases in health insurance premiums.

May 31, 2011

Opponents of a bill that would allow state regulators to reject unreasonable increases in health insurance premiums are stepping up their attacks on the measure, contending that it would push premiums even higher and make healthcare less available. These arguments are a smokescreen, and lawmakers shouldn't lose sight of the need to give consumers of health insurance the same protection they have in auto and homeowners' policies.

One allegation is that the bill — AB 52, sponsored by Rep. Mike Feuer (D-Los Angeles) — would enrich the consumer advocates who challenge proposed rate increases. That charge is based on the bill's requirement that insurers cover the "reasonable" fees and costs incurred by advocates who make a "substantial contribution" to the ruling by regulators or the courts. The same perfectly sensible language is in Proposition 103, the initiative that empowered state regulators to reject excessive automobile, property and casualty insurance rates.

Giving consumers the opportunity to participate in rate reviews is a valuable counterweight to the shifting policies in Sacramento, where regulators' zeal often depends on who won the last election. And the "substantial contribution" requirement for getting fees reimbursed deters frivolous challenges. Consumer Watchdog, an advocacy group, says its interventions have reduced insurers' proposed auto, home and earthquake premiums by more than $2 billion since 2000; insurers have had to spend an additional $5 million to cover the consumer group's expenses.

Smaller premium increases might seem like a good thing to consumers, but evidently doctors and hospitals feel differently. Their trade associations are opposing AB 52, arguing that it could artificially reduce the rates insurers pay them. Such reductions, they say, could persuade more providers not to take Medicare and Medi-Cal patients because they count on reimbursements from private insurers to cover some of the cost of government-insured patients. But those cross-subsidies are precisely the sort of distortions and inefficiencies that policymakers should be trying to eliminate from the healthcare system, not prop up.

The healthcare reform law Congress passed last year tries to combat cross-subsidies, and it limits insurers' profit margins by tying them to the amount spent on medical care. That link, however, gives insurers a perverse incentive to grow their profits by inflating the amounts they pay doctors and hospitals. That's a good reason to give state regulators the power not just to review rates, as California law now provides, but to reject them when they're unreasonable. Here's another: As of 2014, the healthcare reform law will require all adult Americans to obtain health coverage. Regulators ought to have the power to stop insurers from gouging that captive market.

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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.