The public hearing scheduled for July 19 about Blue Cross of CA and its deceptive, anti-consumer practices will now be held on August 7.  Not only are they angering their subscriber base by going out of their way to deny claims and cancel policies for “discrepancies” as trivial as typos, but they’re starting to piss off hospitals as well.

Blue Cross of California’s latest antidote to rising healthcare costs isn’t going down very well with physicians. The state’s largest for-profit health plan is set to roll back its payments for about half the services and procedures provided by physicians next month.

And many of the 53,408 physicians in Blue Cross’ preferred provider organization (PPO) networks say that’s a prescription for disaster.

Doctors say the health plan imposed the new rates unilaterally. In most cases, they say, Blue Cross will get its way because it controls the lion’s share of their patient base. But other physicians say they’ve had it with Blue Cross. More than 300 of them have sent notices threatening to dump the insurer if the rates take effect as scheduled Aug. 6. Some say the new rates won’t even cover the cost of supplies. ‘I don’t know how anybody can afford to stay in practice and accept Blue Cross rates,’ said Dr. Charles Fishman, a San Luis Obispo dermatologist who sent a letter telling Blue Cross he would drop its contract if his rates were not improved. A spokeswoman for the insurer described the level of complaints over the new rates as routine, and she said the number of termination notices from physicians over the issue was negligible – less than 1% of the doctors in its PPO networks.

Surely, this will come up in the August 7 hearing, to be held at the Carmel Room Auditorium at the Junipero Serra Building, 320 West 4th St., Los Angeles, from 10 a.m. until 3 p.m.  And It’s Our Healthcare is amping up the pressure by demanding that Blue Cross return to the state millions in excess profits:

This year alone, Blue Cross has sent almost a billion dollars in profit out of California to its corporate headquarters in Indiana.

Blue Cross is able to amass such a profit because it currently relies on business practices that harm millions of Californians, such as:

–Spending less of California’s premium dollars on patient care than other larger insurers
–Denying coverage for pre-existing conditions?and instead seeking to insure only the healthy
–Selling insurance designed to provide limited benefits, coupled with high deductibles and co-pays
–Raising rates however and whenever it chooses

We urge the state enact meaningful reform to stop these practices and we urge the state to order Blue Cross to return the hundreds of millions of dollars in excess profit to California.

We, the undersigned Californians, ask the state to make Blue Cross reform its business practices to start putting people ahead of profits and stop using California as an ATM.

Blue Cross has already settled out of court on some of these issues, but there is no indication that they have curtailed their practices and cleaned up their act.  Blue Cross has also taken the lead in torpedoing meaningful health care reform in the state.  It is maybe the most unconscionable company in the state, and I don’t know what it takes to get a corporate charter revoked, but theirs ought to be.

At any rate, you can keep the pressure up by signing the petition.

And those priorities are…

Leaving poor people on their own to die:

After holding up the state budget nearly a month past deadline, Senate Republicans offered Tuesday to end the impasse if Democrats would move tens of thousands of poor families off welfare and make dozens of additional program cuts.

The linchpin of the plan, Ackerman said, is a $324-million cut in the state’s welfare program. The cut was initially proposed by the governor in January, but Schwarzenegger had not been aggressively pushing for its inclusion in the spending plan adopted by the Legislature […]

Advocates for the poor were alarmed to see the governor’s January proposal revived. They said it would result in as many as 40,000 families losing state assistance.

… and ensuring that the planet continued to be destroyed by man-made causes:

Several Republican Party Senators have threatened to block the entire state budget unless the California Legislature accepts a recent polluters’ plea to ignore global warming pollution when assessing a project’s environmental impacts under CEQA. This “ostrich exemption” would allow polluters to continue sticking their heads in the sand, pretending that projects like oil refineries, freeways, and suburban sprawl simply don’t create greenhouse gases. It’s dangerously loopy logic, but if they can convince the Senate to play along, we could see California’s bourgeoning fight against global warming come to a skidding halt.

Hey, at least we know where they stand…

Last night on Warren Olney’s Which Way LA?, which everyone should be podcasting, Dan Walters from the Sacramento Bee made a very interesting point about the budget that has been somewhat unremarked-upon to this point.  I’m not generally a fan of Walters, but it’s hard to argue with this.

The budget that passed the Assembly took $1.2 billion designed to go to transit and put it back into the general fund, with the reason given that the infrastructure bonds are financing transit improvements so there would be some duplication there.  That’s not what voters approved in November at all.  Not even close.  The infrastructure bonds on transportation were meant to be additional funds that the state could use to start new projects.  It was in no way meant to stand in for the regular finances received from the state regarding transportation.

So we now have a situation where bonds have been floated to finance existing projects and maintenance.  Is this a preview of things to come, a get-out-of-the-deficit-free card by using Arthur Andersen-style creative accounting tactics?  Voters approved those bonds because they wanted to see new mass transit options and new carpool lanes.  They did not approve an addendum to the state budget to solve the fiscal mess.

(We of course see this also in the cut to Prop. 36 funding for drug treatment in prisons, also approved by voters, which I guess doesn’t matter.  It’s a good thing nobody covers this state in the media, or there would be some howling going on)

Let me build on Brian’s post regarding the decision by two separate US District Court judges to convene three-judge panels to consider capping the California prison population.  This should have been completely expected to everyone in the state government.

There is a near-term and a long-term crisis in our state prisons.  So the Governor predictably offered a medium-term solution.  Prisons don’t build themselves overnight, so “adding 53,000 beds” which can only phase in over the course of a couple years does absolutely nothing to address the current situation.  Furthermore, the continued overcrowding, which impacts rehabilitation and treatment and the high recidivism rate, means that by the time those new beds are constructed, the problem will be bigger, and any additional capacity (which doesn’t even cover the CURRENT overcrowding numbers) will be only a temporary solution.  So with root causes unaddressed, there was no way any judge with any sort of conscience could sit idly by and watch as the prison system continues to spiral out of control.  A state government that has COMPLETELY FAILED TO LEAD forced his hand.

over…

This is the first time since the law was established in 1996 offering for this kind of option for federal judges that it has been invoked.  No other system in America is as out of control as the prison system in our state.  And so the judges stepped in because we are violating the Constitution:

First of all, this is not just one judge making findings and a ruling. There are two cases, one before Judge Henderson (Plata) on the prison medical system in which orders were stipulated to (agreed upon) by the parties which included the state of California in 2002 and 2004. The judge has found that those orders have not been complied with. He has based his ruling on the evidence presented, including reports of the Receiver he appointed, last year, Robert Sillen, that document in great detail the problems in the California Department of Corrections and Rehabilitation system.

The other case (Coleman) before Judge Karlton, concerns the medical treatment received by state prisoners with “serious mental disorders,” and has been going on since 1995. In that case, a Special Master, John Hagar, has been appointed by the Judge to investigate and report back to him on how the needs of these mentally ill prisoners have been met. After almost 12 years and 77 orders, the Special Master and the Judge have found the prisons to not be in compliance with the United States Constitution.

Gov. Schwarzenegger is talking about appeal, but there is a voluminous public record documenting this total failure in leadership that has brought our prisons to the crisis point.  But such an appeal will likely take close to a year.  That’s another year where root causes will not be addressed as everyone awaits this decision.

But there’s another way.  The judges have rejected that AB 900, which authorized the construction of the prisons, will be insufficient to deal with the problem.  But if Gloria Romero’s sentencing reform bill, SB 110, can offer a real sea change in empowering an independent commission to recommend and review changes to sentencing law, perhaps the judges can be persuaded that the state is finally moving in the right direction on understanding what needs to be done.  Romero is a lonely voice for sanity on this issue, and with her bill now in the Assembly, she needs to be joined by we the people.  The California Democratic Party has come out in support of sentencing and parole reform.  Every Democratic member of the Assembly needs to be made aware of that fact, and the fact that SB 110 is the ONLY vehicle to get a handle on this unconscionable state prison crisis.  It’s worth a call today.

The Royal and Ancient Hermetic Order of the Shrill has a new member, and he’s particularly amped up about some of the little goodies tucked away in the state budget, which is once again too heavily constructed on the backs of the poor:

Anyway, it was about the time of the wine-tasting that the legislative leaders hatched their plan to roll California’s most vulnerable.OK, maybe I’m guilty of a cheap shot. But it’s no more a cheap shot than picking the pockets of the poor in order to bring spending and taxes closer into balance.

The victims list includes 1.2 million impoverished aged, blind and disabled, plus 500,000 welfare families, mostly single moms with two kids.

Skelton is particularly shrill about the delay in the cost of living adjustment (COLA) for seniors on state and federal assistance, and the cuts to public transit, which for many who can’t afford cars is the only recourse to get around (although we need to sever that link between class and public transit, and soon).  Skelton is particularly disappointed in some so-called progressive leaders:

It was a sign of scandalized Los Angeles Mayor Antonio Villaraigosa’s loss of political clout that he didn’t personally fight for the transit funds, as he has for other L.A. causes in the past. “He has been AWOL,” says one leading Democrat. “He’s been wounded.”

Democrats, however, haven’t exactly been fighting for the aged, poor and disabled either. Republicans wouldn’t be expected to. But Democrats are supposed to be the defenders of the destitute. Instead, they suddenly surrendered to Republicans last week after vowing to hold their ground.

Any budget is going to be a mixed bag under the 2/3 requirement.  But it does appear to me that winners and losers were very clearly chosen based on their political clout.  The blind, the elderly, the poor, they all don’t donate to campaigns the way that teachers do (no slam on teachers, just reality).  Drug offenders who saw a cut in Prop. 36 treatment funds don’t host fundraisers at the halfway house.  Where you stood in this budget depended upon where you sat, and if you didn’t have a place at the table, forget it.

Maybe that has to do with the donations rolling in for the term limits initiative.  Or maybe it’s just easier to dismiss those who have little voice and little chance to mobilize.

It’s great that the netroots candidacy of Ron Shepston for Congress is getting so much attention.  His race against the unfathomably corrupt Gary Miller represents a progressive hope and a decided alternative, and people are so excited that, at press time, he’s raised over $5,300 dollars through ActBlue in just a couple days.

Superlative.  Outstanding.  Fantastic.

Now let’s really look at what he’s getting into.  The campaign has asked me to contribute a guest column to the rollout providing the lay of the land.  We’ll start with the bad news and move slowly into the good.

Previous diaries in the CA-42 campaign rollout series:
7/15: thereisnospoon’s CA-42: A Kossack is running for Congress
7/16: atdnext’s CA-42: The Case Against Dirty Gary Miller
7/17: Major Danby’s CA-42: I’m managing a netroots U.S. House campaign
7/18: CanYouBeAngryAndStillDream’s CA-42: Hi, I’m Ron Shepston and I’m running for Congress
7/19: hekebolos’s CA-42: A Netroots campaign– politics the way it should be.

Here is a map of the 42nd District of California:

As you can see, it covers three counties, starting in San Bernardino County at Chino, moving into LA County with Whittier and Diamond Bar, and then Orange County with Brea and La Habra, snaking all the way down to grab Mission Viejo in the southern portion of the county.  Seems like a strange shape, doesn’t it?  It should.  California’s districts were gerrymandered to the extreme for incumbent protection after the 2000 Census.  Democrats and Republicans made the deal to lock in a set number of seats.  Between the 2000 Election and the 2002 Election, Miller gained 8 points from his challenger because the district was made more Republican.

Now, it doesn’t always work: Richard Pombo was forced out of office by Jerry McNerney last year.  But he is literally the ONLY incumbent to be deposed since this Congressional map was put into place.  More on McNerney later.

So this is a very Republican seat. George W. Bush beat Kerry 62%-38% in 2004, and Gore by 58%-38% in 2000 (when it was more Democratic). The district has a Cook Partisan Voting Index score of R +10 (meaning the district votes 10 points more Republican that the nation at large).  Only a few California districts are higher.  It’d be great to have a metric of Gary Miller’s most recent election, but in 2006 he was one of only 10 Republicans to run unopposed.  So we have to go back to 2004 and 2002 to look at results in this newly configured district.  They ain’t pretty.

United States House election, 2004: California District 42
Republican Gary Miller 167,632 68.2
Democratic Lewis Myers 78,393 31.8

United States House election, 2002: California District 42
Republican Gary Miller 95,737 67.6 +8.6
Democratic Richard Waldron 41,306 29.2 -8.2

So since this district has had its current configuration, Gary Miller’s opponent has never received more than 31.8% of the vote.  We’ll call that Ron’s baseline of support, since I’m not sure Lewis Myers or Richard Waldron offered up anything but token opposition.  The question is where to get the other 19%.

Let’s look at the demographics of the district (linked from Gary Miller’s House website!  Thanks Gary!  You can return to your regularly scheduled ripping off of America now!).

About 57.5% of the district is in Orange County, including the largest population center, Mission Viejo (no wonder they snuck it into the district).  The registration edge here is 55-27 Republican, and no area has a Democratic advantage (La Habra is the closest, at 45-37, which stands to reason because it’s close to the LA County part of the district).  The area of the OC in the district is 20% Latino and about 11% Asian.

LA County needs to be Shepston Country.  The registration edge here is lower (43R, 36D), and Rowland Heights is actually plurality-Democratic.  Of course, it’s only 21% of the district.  It’s heavily Asian (40%) and Latino (23%).  I don’t know if sprawl goes out this far and if these are Los Angeles bedroom communities for those priced out of the more expensive areas, but it’s certainly possible.

Finally, San Bernardino County is the final 21.5% of the district, and it’s also closer (45R, 38D).  In Chino there’s a 42%-41% advantage for Democratic registration.  The Latino population is strong out here; 37%.

The final numbers for the district are about 50% registration total, with a 21-point registration advantage for Republicans (51R, 30D).  The district is very diverse, 44% nonwhite (23.8% Latino, 17.5% Asian, 3.4% African-American).

So the key would appear to be to raise registration rates in Democratic areas, bring in big numbers in LA and San Bernardino County, and make sure the Latino vote turns out.  A tall order.  And did I mention that Gary Miller has $800,000 Cash on Hand after raising $137,000 in the most recent quarter?

But there’s more of the story to be told, points that argue in Shepston’s favor, and in favor of a strong challenge in a district some would call unwinnable.

• CORRUPTION: This was considered the number one issue according to exit polls in 2006.  Miller hasn’t been tested on this, since the revelations about his dirty dealings didn’t come out until the 2006 election, when he was unopposed.  And if anything, they’ve grown worse since then.  So there is a case to be made that voters will reject someone who appears to be doing the business of profit-taking instead of legislating.

• IRAQ: Gary Miller has voted in lockstep with the President on an issue that has scant support in the country, even in a district as red as this.  I assume that the netroots team running this race will not run away from the issue of Iraq as many consultants have the knee-jerk reaction to do.

• THE ALBATROSS: Ron Brownstein makes the case:

Unpopular departing presidents, though, have consistently undercut their party in the next election. Democrats lost the White House in 1952 and 1968 after Harry Truman and Lyndon Johnson saw their approval ratings plummet below 50%. Likewise, in the era before polling, the opposition party won the White House when deeply embattled presidents left office after the elections of 1920 (Woodrow Wilson), 1896 (Grover Cleveland), 1860 (James Buchanan) and 1852 (Millard Fillmore). The White House also changed partisan control when weakened presidents stepped down in 1844 and 1884. Only in 1856 and 1876 did this pattern bend, when the parties of troubled presidents Franklin Pierce and Ulysses S. Grant held the White House upon their departure […]

It’s true that Republicans in 2008 should perform slightly better among voters who disapprove of the president than George H.W. Bush and Gore did, because their nominee, unlike those men, won’t be the retiring president’s vice president. But another pattern underscores how hard the challenge will remain: On average, 80% of voters who disapproved of a president’s performance have voted against his party’s candidates even in House races since 1986, according to the respected University of Michigan post-election polls. When a president takes on water, in other words, everyone in his party flounders.

This tracks with the idea that “there is no safe district” in the post-Bush era, and that any partisan numbers over the past several years are somewhat irrelevant to the landscape today.

• DEMOGRAPHIC SHIFTS: Getting the Latino vote out in a year where the Republicans have done absolutely everything to present themselves as the biggest brown-haters on the block is crucial.  You don’t have to have that long a memory to remember the anti-immigrant Prop. 187 fights out here in California, which set back Republicans to this day.  So making sure there’s a high turnout among the substantial Latino base would seem to me to be a key.  And I would gather than even more are in the district now, being priced out of LA County.

• STOPPING THE GRAVY TRAIN: Gary Miller has been using his money gained in fundraising from his rich buddies to reward Republicans in close races:

Miller’s expenditures are listed at OpenSecrets, and you can see that he spent his money (in 2006) enriching the coffers of Republican candidates in close races all over the country.  He didn’t need the ill-begotten money for himself, so he gave it to his most endangered colleagues.  A list:

Anne Northrup $1,000
Barbara Cubin $1,000
Deborah Pryce $1,000
Dave Reichert $1,000
Geoff Davis $1,000
JD Hayworth $1,000
Jim Gerlach $1,000
Keith Butler (MI Senate challenger) $1,000
Joe Knollenberg $2,000
Mary Bono $1,000
Mike Fitzpatrick $1,000
Mike Sodrel $1,000
Rob Simmons $1,000
Thelma Drake $1,000

That’s 14 candidates to the tune of $15,000.  A lot of those Republicans lost, but the recipient of the biggest expenditure from Miller’s campaign was the NRCC, the committee dedicated to re-electing Congressional Republicans, which sent mailers and put up attack ads and made robocalls all over the country.  They benefited from $112,000 from one Gary Miller.  All of the sleazy developer money he’s received over the years helped re-elect some of the worst Congressmen in the country by the skin of their teeth.  That’s $112,000 we wouldn’t be likely to see in the NRCC’s coffers if Miller were actually challenged and forced to run a campaign.

It’s not like Miller is going to run out of money any time soon; he’s rich beyond reason and can self-fund.  But he wouldn’t be as likely to fund others if challenged.

In conclusion, there are many signs out there that Ron Shepston does have the opportunity to be competitive and offer the voters in the 42nd a real alternative.  The best comparisons we can use for California are the aforementioned Jerry McNerney in CA-11, and Charlie Brown in CA-04.  Both went up against corrupt politicians in red areas.  Both excited grassroots and netroots activists to donate to and work on the campaigns.  Both engaged in bottom-up campaigning, with the big dollar money not coming in until later.  And despite the warped political landscape and the partisan gerrymander, McNerney is a Congressman and Charlie Brown is about to join him.  If he’s diligent and bold and unyielding, Ron Shepston can do the same thing.

The Capitol Weekly did their first annual legislative scorecard of members of the State Assembly and Senate.  They go into detail about their methodology and recognize that devising these types of scores is more art than science.  In addition the voting sample size is fairly small.  But I still believe there’s some value to them.

The full list (PDF) is here.  Some interesting tidbits on the flip:

You can pretty obviously see that we have an ideologically rigid legislature.  8 Republican Assemblymen have a “perfect” 0 score on legislation (fully conservative), and 13 Democrats have a 100 (fully liberal).  In the Senate, there are 2 Republicans with a 0 score and 5 Democrats with a score of 100.

The Republicans, however, are FAR more unified.  There are no Assembly Republicans with a score above 20, and no Senate Republicans above 30.  Put it this way, the 2nd-most “moderate” Republican in the legislature is right-wing loon Tom McClintock, I guess because he is occasionally libertarian.

By contrast, a handful of Democrats dip into the other side of the ocean.  Here are the Democrats with scores under 50.

Assembly:
Cathleen Galgiani 20
Nicole Parra 20
Juan Arambula 50

Senate:
Lou Correa 40
Mike Machado 45

All 3 Assembly Democrats live in the Central Valley (Galgiani’s from Stockton, Parra’s from Bakersfield and Arambula’s from Fresno).  Mike Machado is also from this area (Stockton, Tracy).  Correa is the only exception to this rule.

Galgiani’s election site features the line “I’ll never raise your taxes.”  Machado endorsed Steve Filson in last year’s Congressional primary against Jerry McNerney.

I’m not making value judgments, this is all just somewhat interesting stuff and I’m trying to make sense of it, particularly in the context of yesterday’s discussion about the Central Valley.  The spotlight is not usually shined on this area; is that how we end up with Democrats like this?

Let’s face it.  This blog – and to an extent, politics in this state in general – is heavily tilted to the large population centers in the Bay Area and Southern California (including Orange County and down to San Diego).  But to continue in this fashion would be shortsighted, because it’s clear that the population patterns are moving away from two all-powerful hubs and toward a more widely spread pattern.  What has been getting most of the ink from the recent study by the state Department of Finance is that the Inland Empire will soon become home to the second-largest county (Riverside) in all of California.  But what has been less remarked upon is the expansion of the Central Valley:

With a new state forecast predicting that California’s population growth will tilt ever more toward the Central Valley, Southern California’s Inland Empire and fast-growing areas around Sacramento, experts say the state’s political center of gravity may shift, too – away from the more urbanized, coastal metropolitan areas that dominate the state’s political and economic life today.

The Central Valley “will clearly gain heft compared with the other metropolitan regions,” said Carol Whiteside, president of the Great Valley Center and the former mayor of Modesto. “It won’t be the baby cousin any more.”

The Central Valley will grow from 10 percent of the state’s population in 2000, to 16 percent of all Californians by 2050. The Bay Area is projected to gain about 3.5 million new residents by 2050, but its share of California’s population will drop to 17 percent, from 20 percent in 2000, an analysis of new state Department of Finance projections shows.

This is something important for political groups to internalize.  The traditional structure of Democratic election efforts has been to raise turnout in LA and SF, and hope to do half-decent everywhere else, and walk away a winner.  That’s not going to work as we go forward.  With 1 in 6 Californians living in places like Modesto and Fresno and Stockton and Bakersfield and Merced and the numerous towns throughout the San Joaquin Valley, Democrats must build and grow their presence outside of the urban metropolises, to a level where they were in the recent past before giving up practically all of that ground to the Republicans.

Some stats on the flip:

Here’s the spread of population in 2000:

Coastal Southern California: 47%
Bay Area: 20%
Central Valley: 10%
Inland Empire: 10%
Other (High Desert, Sierras): 13%

Here’s the projections for 2050:

Coastal Southern California: 39%
Bay Area: 17%
Central Valley: 16%
Inland Empire: 14% (3x the size in 50 years!)
Other (High Desert, Sierras): 14%

The “big 2” go from 67% of the population to 56%.  That’s significant in a statewide election.  It will also likely affect reapportionment, with the Bay Area potentially losing seats in Congress or the state legislature as early as the 2010 Census.

We have to start thinking about this and planning now.  What are the concerns of the Central Valley?  Obviously agriculture and water concerns would weigh heavily, one would think, but the Valley is also urbanizing and developing rapidly.  These aren’t all cow towns anymore; there are at least 5 cities with over 100,000 inhabitants.  The San Joaquin Valley is also the primary oil-producing region in our state.  Culturally this is likely to be a more classically Western libertarian area.

We have a 3-2 deficit among the Congressional delegation in this area.  Dennis Cardoza and Jim Costa are Democrats, and George Radanovich, Kevin McCarthy and Devin Nunes are Republicans.  By 2050 there could be up to 10 seats in this region.  Are Cardoza and Costa helping grow the Democratic brand in the Central Valley?  Are they promoting policies that can help Democrats win?  This is a diverse area as well, with not just Hispanics but lots of Asian and European communities.  How are they being served?

I hope people are asking these questions.  The Central Valley could hold the key to continued Democratic dominance in California.

UPDATE: Here’s an example of a Central Valley issue that simply doesn’t get a lot of attention.  From our friends at the California Teachers Association:

The California Teachers Association is part of a coalition of education groups fighting Assembly Bill 1403 that is winding its way through the legislature. The bill would disrupt implementation of a new law helping schools of greatest need in the Central Valley and take control away from local school boards to help improve student learning in their districts. 

AB 1403 by Assemblyman Juan Arambula, D-Fresno, gives the Fresno and Tulare county superintendents authority over local schools and districts that do not meet the state Academic Performance Index (API) or the federal Adequate Yearly Progress (AYP) requirements.  Currently the local school boards, State Superintendent of Public Instruction and the State Board of Education have these powers. The bill also disrupts new efforts already under way to help 39 schools of greatest need in these counties as part of the Quality Education Investment Act (QEIA). QEIA, sponsored last year by CTA, provides $2.9 billion over seven years to help hundreds of schools across the state with proven intervention reforms such as reducing class sizes, hiring more counselors and providing quality training for teachers and principals.

This is kind of Antonio Villaraigosa’s school takeover effort, ported into the Central Valley.  I would think that Democrats could earn a lot of goodwill among the grassroots in Fresno and Tulare by scuttling this effort to centralize control in the county superintendents.  Maybe a Central Valley reader could give their impression of this issue; to me it seems like a no-brainer to let the schools determine what’s best for their schools and their students.