Author: Site Staff

California Gov. Arnold Schwarzenegger signed legislation into law Monday, October 12, that prohibits the denial of a workers’ compensation claim filed by an employee attacked because of race, sexual orientation or religious creed.

The legislation, A.B. 1093, also known as Taneka Talley’s Law, was introduced after the death of a black employee who was stabbed to death in 2006 while on the job at a Dollar Tree store.

The employer’s insurer initially denied death benefits for the woman’s 8-year-old son. The insurer argued that because the perpetrator said he sought to kill a black person, there was a personal connection between the attacker and the employee unrelated to Talley’s employment.

The new law, which takes effect January 1, 2010, also bars denying coverage because of a personal connection when someone is killed or injured on the job due to their national origin, age, disability or gender.

Filed by Roberto Ceniceros of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

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Employers that authorize workers’ compensation medical care cannot rescind or modify the authorization for treatment already provided, according to legislation California Gov. Arnold Schwarzenegger has signed into law.

Assemblywoman Bonnie Lowenthal, D-Long Beach, introduced A.B. 361 on behalf of the California Chiropractic Association, according to a legislative analysis of the bill that the governor signed into law during the weekend.

The governor also signed a bill removing a December 31 sunset date from a law that allows employees to designate in advance the doctor who would treat their workers’ comp injuries.

Some employers opposed S.B. 186, introduced by state Sen. Mark DeSaulnier, D-Concord, because it allows a pre-designated physician to refer injured workers to specialists outside employers’ provider networks.

Schwarzenegger also signed A.B. 483, introduced by Assemblyman Joan Buchanan, D-San Ramon. It requires the California Workers’ Compensation Rating Bureau to establish a Web site that allows the public to identify whether an employer is insured for workers’ comp claims.

Filed by Roberto Ceniceros of Business Insurance, a sister publication of Workforce Management. To comment, e-mail editors@workforce.com.

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Even after a successful vote in the Senate Finance Committee on Tuesday, October 13, that attracted one Republican, Democrats face challenges in putting together enough support to push abroad health care reform bill through Congress this year.

The Senate panel approved a measure, 14-9, that addresses most aspects of the health care system—mandating that individuals obtain health insurance and ensuring that it cannot be denied because of illness or pre-existing conditions.

Sen. Olympia Snowe, R-Maine, the only committee Republican to support the bill, cautioned that she was only trying to move the legislative process forward.

“My vote today … doesn’t forecast what my vote will be tomorrow,” Snowe said.

Observers were hanging on Snowe’s decision because she has been the only congressional Republican so far to indicate willingness to support any of the health care measures that have come through three House and two Senate committees.

Several Finance Committee Democrats also outlined reservations about the panel’s bill, which had been in development for months and required eight legislative days of committee markup. They supported the measure in order to advance to Senate floor debate, where they plan to offer amendments to shape a final bill.

Most Finance Committee Republicans asserted that the measure was too costly and represents a government takeover of health care.

“We can now see clearly that the bill continues its march leftward,” said Sen. Charles Grassley, R-Iowa and ranking Republican on the panel.

The House labor, tax and commerce committees as well as the Senate health committee all approved bills over the summer that feature an employer mandate and so-called public option, or government-run health care plan for people under 65. The Senate Finance bill does not include either provision.

The bills contain similar insurance market reforms. Each House measure tallied more than $1 trillion over 10 years, according to the Congressional Budget Office.

The Senate Finance bill would cost $829 billion and reduce the deficit by $81 billion, the CBO said. In a September speech to Congress, President Barack Obama said that a health care bill must not add “one dime” to the federal deficit.

The successful Finance Committee vote was a breakthrough for the issue of comprehensive health care reform, which has now made significantly more progress than an attempt early in the Clinton administration 15 years ago.

But the biggest obstacles remain, as Democratic leaders now meld their various bills into one measure in each chamber.

That process gives Snowe pause. Over the course of the 4½-hour Senate Finance meeting, she emphasized that the combined Senate bill must adhere to the deficit-reduction parameters of the Finance Committee’s measure in order to maintain her vote.

She urged that the CBO conduct a cost analysis of the merged bill before the Senate takes final action, a demand that could push Senate floor debate off until late October.

The omnibus Senate bill will be cobbled together largely by Senate Majority Leader Harry Reid, D-Nevada; Sen. Max Baucus, D-Montana and chairman of the Finance Committee; and Sen. Christopher Dodd, D-Connecticut, of the Senate health committee.

Snowe will be watching closely. “I’m going to take it step by step every day,” she told reporters after the Finance Committee vote.

In addition to keeping Snowe on board to maintain at least minimum bipartisan support, Democrats must hold their own side together. The Senate Democratic caucus totals 60, exactly enough to squelch a filibuster.

But Democratic health care fissures surfaced during the Finance Committee vote. Sen. Charles Schumer, D-New York, said that he will fight to add a public option on the Senate floor.

“To cut costs, we must have a public option in the final bill,” he said. “It will hold the feet of insurers to the fire.”

Schumer also said that he will work to change the excise tax on high-cost insurance plans contained in the Finance Committee bill. That 40 percent levy is one of the primary ways that Baucus seeks to contain health care costs.

Sen. John Kerry, D-Massachusetts, expressed concern about the lack of an employer mandate in the committee’s bill and said that he would push for one during debate in the full Senate.

But Baucus said his bill is balanced and provides the best chance to achieve a filibuster-proof majority.

“We need 60 votes,” he told reporters after the Finance Committee meeting. “That’s the real imperative here.”

—Mark Schoeff Jr.  

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Though she was the only Republican to vote for the Senate Finance Committee’s health reform bill, Sen. Olympia Snowe of Maine sounded a note of ambivalence that reflects the feelings of many employers.

“My vote today is my vote today,” she said. “It doesn’t forecast what my vote would be tomorrow.”

That reserved endorsement could summarize the caution many employers also are taking toward the Finance Committee’s bill.

“It’s a very mixed product,” said Neil Trautwein, vice president of the National Retail Federation. “We want reform, but we are extremely concerned by what’s currently on the table.”

Even health insurance industry association America’s Health Insurance Plans offered a tepid endorsement of the finance bill.

“While we agree with the objective of the current proposal, we are concerned about its workability and cost,” said AHIP president and CEO Karen Ignani.

While employers cite admiration for much in the bill, they too have criticized the committee’s decision to water down the requirement that all individuals carry health insurance.

Health insurers have agreed to stop their longstanding practice of denying people coverage based on pre-existing health conditions on the basis that all individuals be required to purchase insurance. The effect would be that policies for young and healthy individuals would offset the cost of caring for sicker and older patients.

The Finance Committee bill, however, includes a reduced penalty for individuals who decide not to carry insurance.

As it stands, the penalty would be phased in over five years beginning in 2013, when there would be no penalty. By 2017, the penalty would be $750 per adult. Most experts say that is not enough to compel young people to buy insurance.

A report this week by PricewaterhouseCoopers and funded by the health insurance industry said the Finance Committee proposal would increase health care costs faster than under the current system. The report said that between 2010 and 2019, the cumulative increase in the cost of a typical family policy under the current proposal will be about $20,700 more than the current system would cost.

While the report has been criticized by Democrats, health economist Jon Gabel said it is correct in pointing out the impact a weak individual mandate could have on health care costs. A weak mandate, he said, will encourage people to game the system.

“It would be better legislation if we do have stronger penalties on people who choose not to buy health insurance,” said Gabel, a senior fellow at the National Opinion Research Center. “If I’m healthy, I can wait until I’m sick to buy health insurance.”

If the Senate does not strengthen the requirement that all individuals purchase insurance, employers may view the Finance Committee’s plan in the same light as the House’s health reform bill, which includes a public plan option that has been maligned by the health care industry and many employers.

Referring to the House bill, James Gelfand, senior manager for health policy at the U.S. Chamber of Commerce, said, “We want that bill to die.”

—Jeremy Smerd

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The following scenarios are strictly prohibited by Internal Revenue Service rules implementing the Genetic Information Nondiscrimination Act:

• Any group health plan that provides a premium reduction to employees who complete a health risk assessment prior to enrollment that includes questions about family medical history.

• Any group health plan that requests employees to complete a health risk assessment prior to enrollment that includes questions about an individual’s family medical history, but does not offer a reward.

• Any group health plan in which certain individuals completing the health risk assessment become eligible for a disease management program based on their answers to questions about family medical history.

• Any group health plan that waives its annual deductible for individuals who complete a health risk assessment after enrollment that does not include any direct questions about family medical history but asks, “Is there anything else relevant to your health that you would like us to know or discuss with you?”—the answers to which may divulge genetic information.

The following scenarios are permissible under the IRS rules:

• Any group health plan that requests enrollees to complete two distinct health risk assessments after and unrelated to enrollment: one that doesn’t include questions about family medical history but offers a reward; and one that includes family medical history questions but offers no reward.

• Any group health plan that waives its annual deductible for individuals who complete a health risk assessment after enrollment that includes the question, “Is there anything else relevant to your health that you would like us to know or discuss with you? In answering this question, you should not include any genetic information. That is, please do not include any family medical history or any information related to genetic testing, genetic services, and genetic counseling or genetic diseases for which you may be at risk.”

• Any group health plan that normally provides coverage for mammograms only for women 40 and older may choose to extend coverage to younger women who demonstrate they are at increased risk of getting breast cancer, such as through genetic testing or a family history of the disease.