Policy

Actions by people in power – lawmakers, regulators and the like – can make a difference to your health, for better or for worse. We keep you informed

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Some Employers Say Same-Sex Couples Must Get Married

(David Lucas/Getty Images)

(David Lucas/Getty Images)

By Julie Appleby, Kaiser Health News

Until recently, same-sex couples could not legally marry. Now, some are finding they must wed if they want to keep their partner’s job-based health insurance and other benefits.

Will companies eliminate benefit programs for unmarried partners?

With same-sex marriage now legal in 35 states and the District of Columbia, some employers that formerly covered domestic partners say they will require marriage licenses for workers who want those perks.

“We’re bringing our benefits in line, making them consistent with what we do for everyone else,” said Ray McConville, a spokesman for Verizon, which notified non-union employees in July that domestic partners in states where same-sex marriage is legal must wed if they want to qualify for such benefits. Continue reading

Kaiser Nurses Reach Agreement, Call Off Strike

Nurses carry signs as they strike outside of Kaiser Permanente hospital in San Francisco last week. (Justin Sullivan/Getty Images)

Kaiser nurses staged a two-day strike in November, citing concerns about Ebola preparedness. (Justin Sullivan/Getty Images)

The California Nurses’ Association has called off a two-day strike scheduled to begin Wednesday after reaching a tentative agreement with Kaiser Permanente on a new three-year contract.

The nurses’ bargaining team is recommending ratification of the proposed contract that would affect 18,000 registered nurses and nurse practitioners at 86 Kaiser sites throughout Northern and Central California.

“It’s really, really a good deal,” said Diane McClure, a nurse at Kaiser’s South Sacramento facility and a member of the bargaining team, adding that the strike threat strengthened the nurses’ position with Kaiser. “They saw the momentum the nurses had. They didn’t want us out in the public, because they knew the public was behind us.”

Kaiser issued a statement saying it was pleased with the economic priorities accomplished by the agreement, including “slowing the growth of our long-term liabilities,” and offering benefits to nurses that are “consistent with our commitment to affordability.” Continue reading

Gov. Brown: ‘Not A Lot Left in Budget’ to Cover Undocumented

(Justin Sullivan/Getty Images)

(Justin Sullivan/Getty Images)

Gov. Jerry Brown unveiled his $164.7 billion budget proposal Friday and while health figures big, the governor also stopped short of funding some key advocacy goals.

For starters, there’s no money set aside in the budget to provide health insurance to undocumented immigrants. The “Health for All Act” was re-introduced in December, after falling short in the legislature last year. But when Brown was asked specifically about covering the undocumented, he said “There’s not a lot of money left in the budget. … It’s very tight.”

Then there are the million undocumented immigrants in California estimated to be eligible for deferred action under President Obama’s executive order. Advocates say that these immigrants, once approved for deferred action, become eligible for Medi-Cal, as long as they qualify by income. Continue reading

Plenty of Responsibility, But No Required Training, for In-Home Caregivers

Oliver Massengale took over as his brother’s full-time caregiver six years ago. He says he hasn’t had time for himself in years. (Heidi de Marco/KHN)

Oliver Massengale took over as his brother’s full-time caregiver six years ago. He says he hasn’t had time for himself in years. (Heidi de Marco/KHN)

By Anna Gorman, Kaiser Health News

Born just a year apart, Oliver Massengale and his brother Charles grew up together. Now, in a two-story home in Compton, they are growing old together. But Charles Massengale, 71, can do little on his own.

The former tree trimmer has severe brain damage from a 30-foot fall, as well as dementia, diabetes and high blood pressure. Six years ago, Oliver took over as his brother’s full-time caregiver. He’s paid about $10.00 an hour by the state.

It was not a job he was trained to do.

“I didn’t have a clue,” said Oliver, a retired grounds manager at a college. “I was just so afraid of what I was doing.”

He constantly worried –- about giving Charles the wrong medication, about him getting bedsores, about his blood pressure. And he had no idea how easily his brother could fall over. One day, he was cooking and Charles was on a stool at the kitchen counter. Continue reading

Lack of Oversight for In-Home Caregivers Can Lead to Neglect and Death

Linda Maureen Raye at her sentencing at the Riverside County Hall of Justice. Raye pleaded guilty to elder abuse that led to the death of her mother. (Heidi de Marco/KHN)

Linda Maureen Raye at her sentencing at the Riverside County Hall of Justice. Raye pleaded guilty to elder abuse that led to the death of her mother. (Heidi de Marco/KHN)

By Anna Gorman, Kaiser Health News

Yolanda Farrell lay mostly paralyzed in a nursing home, unable to feed or dress herself, when her homeless daughter persuaded her to move out.

“Essentially neglected to death” by her own daughter.  

Linda Maureen Raye, who relatives say had been living in her car with her dog, used her mother’s Social Security to pay for a one-bedroom Riverside apartment and took over as Farrell’s sole caregiver in 2010.

Over the next two years, according to police and court records, Raye, 60, took her elderly mother to the doctor once. As her mother’s health declined, Raye stopped cooperating with a nurse sent to advise her on preventing bedsores.

Yet in 2012, Raye was hired officially: She began collecting about $900 a month from taxpayers under the state’s in-home care program for poor people, according to law enforcement authorities. Continue reading

Brown on Health Coverage: “Right Thing to Do. But It Isn’t Free.”

Gov. Jerry Brown is sworn in as California governor for the fourth time. (Andrew Nixon/Capital Public Radio)

Gov. Jerry Brown is sworn in as California governor for the fourth time. (Andrew Nixon/Capital Public Radio)

Jerry Brown was sworn into his fourth term as governor of California Monday morning. In a wide-ranging inaugural address (that doubled as a State of the State address), he included some brief remarks about the Affordable Care Act.

Here’s the text of what he said:

Along with education, health and human services constitute a major part of what state government does. And in the past few years we have made massive commitments in this area, which will require increasing levels of spending, the full extent of which is not yet known. For example, two years ago California embraced the Affordable Care Act, dramatically increasing its health insurance coverage under the Medi-Cal program. The state will enroll 12.2 million people during this new budget year, a more than 50 percent increase.

Providing the security of health coverage to so many Californians who need it is the right thing to do. But it isn’t free. Although the federal government will temporarily foot much of the bill, new state costs – now and more so in the future – will run into the billions.

Before we take a deeper look at his statements about Medi-Cal, let’s go back a year ago to last year’s budget. Then, Brown’s budget proposal included an additional $670 million for Medi-Cal, at least in part because of the expected additional costs due the expansion of Medi-Cal under the Affordable Care Act. Perhaps more importantly, “The Medi-Cal caseload is expected to be approximately 24 percent of the state’s total population,” the governor said when he released last year’s budget.

Speed forward a year. Obamacare sign-ups surged in California during 2014 and outstripped all estimates. Specifically in Medi-Cal, it’s not 24 percent of the population that is covered by the program, it’s closer to 33 percent.

While the ACA  pays for 100 percent of the people who are newly eligible for Medi-Cal, many people who signed up in 2014 were already eligible before the ACA expansion. They just had not enrolled. With all the hoopla around the ACA, plenty of those previously-eligible people signed up. Many refer to this as the “woodwork” effect.

Estimates are of the 2.4 million people who signed up for Medi-Cal by Mar. 31, about 800,000 of them were previously eligible. The federal government funds those people at the non-expansion rate of 50 precent. That’s why in the May revision of his budget, Gov. Brown included an additional $1.2 billion to fund the caseload.

Brown closed his brief remarks about health with a remark about the state’s costs “in the future.” The federal government is funding 100 percent of the Medi-Cal expansion only through 2016. Come 2017, the match will start to drift down and ultimately end at 90 percent. Yes, this is still a generous federal outlay. But 10 percent of billions of dollars is a lot of money.

The governor is expected to release his budget proposal on Friday.

Top 5 Stories on State of Health in 2014

President Obama took a victory lap on Apr. 1 as the first open enrollment of the Affordable Care Act came to a close and millions had signed up. A story about the ACA was in State of Health's top five posts this year. (Nicholas Kamm/AFP/Getty Images)

President Obama took a victory lap on Apr. 1 as the first open enrollment of the Affordable Care Act came to a close and millions had signed up. A story about the ACA was in State of Health’s top five posts this year. (Nicholas Kamm/AFP/Getty Images)

It’s been a big year in health: the launch of the Affordable Care Act, an ongoing Ebola epidemic and the first soda tax in the country, passed by Berkeley voters.

Here on State of Health, all those stories got plenty of attention from you, the readers. But the Top 5 might surprise you. We crunched the numbers and here are the posts that netted the most views this year.

1) What Philip Seymour Hoffman’s Tragic Death Teaches Us About Addiction

Philip Seymour Hoffman arrives for the Los Angeles premiere of 'The Hunger Games: Catching Fire' in Los Angeles, California, last November. Robyn Beck/AFP/Getty Images)

Philip Seymour Hoffman arrives for the Los Angeles premiere of ‘The Hunger Games: Catching Fire’ in Los Angeles, California, last November. Robyn Beck/AFP/Getty Images)

We all know the sad details. In February, Philip Seymour Hoffman died of a drug overdose. He had been an addict as a young man, but given up drugs and alcohol at 22. His relapse cost him his life. But what troubled me most after his death were the heartless social media attacks about his “selfishness” and “poor choices.” Continue reading

New Health Laws Set to Take Effect in California

(Justin Sullivan/Getty Images)

(Justin Sullivan/Getty Images)

The new year will bring in hundreds of new laws in California, including a landmark law that permits undocumented individuals to obtain a driver’s license and another requiring that all eggs sold in California come from chickens living in bigger spaces.

Many of those new laws have to deal with health. Some take effect on Jan. 1, others in July. Here’s a look at some of them:

Assisted Living Homes: A new law increases 100-fold the top fine for violations of state regulations by assisted living facilities for the elderly. The fine is jumping from a mere $150 to $15,000. AB2236 takes effect July 1 and was part of a package of bills signed by the governor that tighten state oversight of the 7,500 assisted living homes in California. It’s the most significant overhaul of the industry in almost 30 years. Continue reading

Toby Douglas Looks Back at 10 Years Heading DHCS

(Courtesy: California HealthCare Foundation)

(Courtesy: California HealthCare Foundation)

By Rachel Dornhelm, California Healthline

Toby Douglas has spent 10 years at the state’s Department of Health Care Services, the last four as director of the department. He has seen and instituted big changes in the department, changing the way health care is delivered to more than 11 million Medi-Cal beneficiaries.

During his tenure, the Affordable Care Act was passed and implemented; Douglas oversaw the expansion of Medi-Cal as well as a huge shift of more than 80 percent of the state’s Medi-Cal ranks from fee-for-service to managed care plans.

Douglas is set to retire in January. I sat down with him recently to ask about the changes he has seen — and overseen — in his time in office, starting with a look at what struck him as the most important development in health care during his time as the head of the agency.

“When I step back and I think of our time here in the department and what we’ve achieved,” he said, “it really centers around the Medi-Cal program. We have all of our populations now that are in coordinated systems of care.” He called the Medi-Cal managed care approach “a big change,” for all low-income populations eligible for Medi-Cal.  Continue reading

FDA Proposes Lifting Lifetime Ban on Gay Blood Donors

(Getty Images)

(Getty Images)

The Food and Drug Administration is proposing a policy change that would end a 31-year ban on blood donations from men who have sex with men. The ban was put in place at the dawn of the AIDS epidemic when little was understood about the disease. Under the proposed change, gay men who have not had sexual contact in a year would be allowed to donate blood.

In a statement, the FDA said that “it will take the necessary steps to recommend a change to the blood donor deferral period for men who have sex with men from indefinite deferral to one year since the last sexual contact.” Officials say the change is motivated by research. Australia, Japan and the United Kingdom already have similar policies in place.

The FDA has been considering the move for some time. Earlier this month, Ryan James Yezak with the National Gay Blood Drive told KQED that he thought that any ban was discriminatory, but said that the move toward one year, instead of a lifetime ban, was a step in the right direction. Continue reading