- Associated Press - Thursday, November 12, 2015

Nov. 7

Santa Rosa Press Democrat on a report of Covered California:

Covered California, the state’s health insurance exchange, is headed into its third year. With open enrollment underway, it’s a good time for a checkup.

Let’s look at participation and price.

Although enrollment slowed considerably in the second year, 1.3 million people have purchased insurance through Covered California, including almost 22,000 people here in Sonoma County. Four million more have enrolled in Medi-Cal, the state’s health insurance program for the poor, which expanded as part of the Affordable Care Act or, as it’s frequently called, Obamacare.

The result: a 70 percent reduction in the ranks of the uninsured in just two years.

Among the 4 million California residents who remain uninsured, as many as half are in the country illegally and don’t qualify for coverage under the Affordable Care Act.

Of the remainder, an estimated 1.4 million are eligible for Medi-Cal but haven’t signed up, leaving a target group of about 750,000 for Covered California. Not bad in a state with about 38 million residents.

That brings us to price - which may be the biggest obstacle for many of those who haven’t purchased health insurance.

For 2016, the average monthly premium for policies purchased through Covered California will be $384 in Northern California and $296 in Southern California. Premiums are going up an average of 4 percent for the third year of the program.

That’s a smaller increase than last year, and it’s much better than the double-digit increases reported for some employer-provided health plans. But there are trade-offs, including a steep increase in maximum out-of-pocket costs in 2016 for many of the least-expensive plans.

Sliding-scale subsidies reduce the cost of premiums to $100 a month or less for about half of Covered California’s enrollees.

However, for those whose earnings exceed 400 percent of the federal poverty level - $47,080 for an individual and $97,000 for a family of four - there is no subsidy for premiums.

Some of the uninsured say they object to the insurance requirement. We have little sympathy for them, as we doubt many of them would refuse treatment for themselves or their loved ones in the event of serious illness or catastrophic injury. Others say they simply haven’t got the financial resources to pay for health insurance, and they’re choosing instead to risk a tax penalty of at least $695.

Given rising housing costs and stagnant wages, it’s easy to understand their quandary.

The Affordable Care Act has gone a long way in expanding access to health care, at least in those states that have taken full advantage of the law. It did not, however, control the extraordinary cost of health care in the United States. There’s ample room for Congress to act on, among other things, rising prices for prescription drugs and declining access to less expensive generic drugs.

At the state level, where there is a correlation between the number of health care providers and the price of Covered California policies, proposed sales and mergers that could further reduce competition require careful scrutiny.

It will take more than two years to take a full measure of the Affordable Care Act, in California and across the country. But there’s no denying that it is accomplishing its primary objective: making health insurance more readily available to millions of citizens.

____

Nov. 9

Fresno Bee on the rights of transgender inmates:

When it comes to the fight for basic rights and acceptance, few people have it tougher than transgender Americans. They are marginalized, mocked and misunderstood. Evidence of their struggle shows up in frighteningly disproportionate statistics about depression, anxiety and suicide.

And yet, change is happening. Last month, responding to successful lawsuits by two transgender state prisoners and rumblings about transgender rights from the U.S. Justice Department, California became the first state to allow transgender inmates to qualify for taxpayer-funded sex reassignment surgery.

The decision, unimaginable a few years ago, underscores as a matter of state policy that such surgery is not frivolous or cosmetic. Rather, for some people diagnosed with severe gender dysphoria, it’s a necessary and appropriate medical treatment of the sort that states, by law, must provide to prisoners. Corrections officials declined to speculate about how many prisoners might get the surgery. But given the rigorous standards to qualify for it, it’s likely to be a small number and, therefore, a drop in the bucket of the state’s $10.2 billion corrections budget.

California fought this decision for years. But by being forced to go first, the state is likely to wind up providing a path for other states that incarcerate transgender prisoners.

Nationally, transgender Americans are locked up at six times the rate of the general population, according to San Francisco’s Transgender Law Center. Transwomen in male prisons are disproportionately targets of sexual assault. Generally, more than 40 percent of transpeople try to kill themselves at some point. And yet many states have resisted making even the smallest accommodations for transgender inmates.

Part of the reason is there’s confusion about what being transgender actually means. Clinically, it’s being diagnosed with gender dysphoria, which, according to the American Psychological Association, is the distress, ranging from the tolerable to the acute, caused by a discrepancy between someone’s gender identity and gender assigned at birth. It is not being a cross-dresser, which is more about “gender expression” and, possibly, “gender nonconformity.”

California long has understood - or at least accepted - this distinction. The Department of Corrections and Rehabilitation has been providing transgender inmates with hormone therapy medication for years. Other states had to be forced into it, the latest being Georgia, which chose to release an inmate on parole rather than administer the medication as ordered by the U.S. Justice Department.

But even here, there has been confusion over what constitutes “necessary and appropriate medical treatment” for gender dysphoria. California, with the recent policy change, is using a model based on widely accepted guidelines from the World Professional Association for Transgender Health.

Only prisoners with more than two years left before they’re eligible for parole will be considered - and only inmates who consistently have demonstrated a desire to live and be accepted by a different gender identity, including asking for the surgery for at least two years. Most important, prisoners must be on hormone therapy and live as a member of the opposite sex for at least one year - a real test of a person’s resolve given that, much to the displeasure of transgender advocates, California houses prisoners by their biological sex, not their gender identity, before reassignment surgery.

The final decision in each case will be made by committees of physicians and psychologists. The state will cover mastectomies and surgeries to remove and reconstruct reproductive organs. It won’t pay for cosmetic surgeries, such as laser hair removal or breast implants. Once you add the cost for security, each surgery could cost $100,000.

How many people will ask for it is unclear, in part because sex reassignment is only one treatment available among many for gender dysphoria. The level and type of treatment often depend on the patient’s level of distress over the mismatch of their body and gender identity. Many decide to stick with counseling or hormone therapy, while others can integrate their feelings into the gender they were assigned at birth. Others are so distressed they need surgery to feel sane.

It’s also unclear how many people in California’s prison system have gender dysphoria. About 400 inmates are receiving hormone therapy, most of them transwomen. Hormone therapy costs up to $3,000 per inmate per year.

It’s an expensive proposition, even if we’re only talking about a few hundred prisoners out of more than 112,000 in the state’s 34 prisons. There’s no guarantee hormone therapy or sex reassignment will work. Neither treatment is a cure-all.

People who make the transition often still get abandoned by friends and family, and ostracized by society, in this case, by prison staff and other inmates. Because of that, they may still find themselves wracked with depression and suicidal thoughts, even if their bodies better match their gender identity.

But medical trade groups agree that most transgender people who truly want the surgery and get it are better off. This is particularly true if they continue to receive counseling. So it is critical that the state corrections officials follow through with plans to provide such services for prisoners who undergo sex reassignment.

Broadly, however, Californians can be proud to be out in front in advancing the humane treatment of a group that has been doubly shunned by society, as people and as prisoners. Constitutional rights apply to us all, and California should make the most of this chance to show the rest of the country how to do the right thing, even for those who are behind bars for doing the wrong thing.

___

Nov. 9

San Francisco Chronicle on access to learning in California classrooms:

In a national first, the state of California has settled with students in a class-action lawsuit over unequal access to learning time. The suit cited cases at two high schools in Oakland and four schools in Southern California in which students had been assigned to bogus courses or assigned to do chores instead of meaningful coursework.

It’s appalling that this case had to be filed in the first place.

Castlemont and Fremont high schools in Oakland are both underperforming schools with many low-income students. The officials and instructors there should have been doing everything in their power to ensure that their students have access to a quality education.

Instead, according to the suit, students were assigned to service classes wherein they did administrative tasks or nothing at all, or placed in classes that never had a permanent teacher.

The lack of learning time prevented some students from earning the credits they needed for college.

The state has to help the six high schools fix their scheduling problems and eliminate the fake classes. The state will also have to create an investigatory process for schools when students are assigned to courses that are suspiciously thin on educational content. It also has to pay the plaintiffs $400,000 for their attorneys’ fees.

Unfortunately, there’s no way to compensate those plaintiffs for wasting several of their prime learning years.

Oakland Unified School District spokesman Troy Flint said the district has started the hard work of cleaning up its role in this mess.

“We haven’t done enough, and we apologize for that,” he said. “There’s no excuse why we haven’t done more for the students. What I can say is that we’ve embarked on a path to improvement for these schools that’s clear and unequivocal.”

Flint also pointed out that Oakland’s not alone. “What happened is something that’s been chronic not only in Oakland but in urban school districts throughout the country.”

He’s absolutely right. It’s an open secret that the nation’s poor, minority students rarely get the high-quality public educations they need to create better futures for themselves. But this is egregious even under the sad terms of the status quo. The state needs to make sure these schools improve as quickly as possible.

___

Nov. 9

Los Angeles Daily News on the future of California’s solar industry:

Those shiny solar panels you’ve seen blossom on your neighbors’ houses throughout California? If the state’s investor-owned utilities get their way, you’ll be seeing a lot less rooftop black silicon in the future.

That’s because big utilities are petitioning to radically alter the rules about net metering, the system by which homeowners, schools and businesses that generate excess electrical capacity on a sunny day sell their unused power back to the grid, the same as the utility companies sell it to the rest of us.

Our big power suppliers have the same right to operate under a fair business model as the small homeowner who makes an investment in solar. Few of the latter, except isolated cabin owners and the like, are ever really “off the grid” entirely. They make use of electricity sold to them by Southern California Electric, PG&E; and the state’s other large private firms as well, or buy it from the city-owned utilities in cities such as Los Angeles, Pasadena, Burbank and others that operate municipal, taxpayer-owned nonprofit power companies. It’s the big utilities that have to operate the grid - the complex system of power lines, from the big ones coming down from Tehachapi wind farms, Utah coal plants, dams with hydro plants and the like to the small wires that come into your own homes.

But even though those big firms still control 97 percent of the electrical power market in California, they are worried about the tiny but growing group of homeowners and businesses in the state that have chosen to generate some of their own power. So they have a proposal before the California Public Utilities Commission targeting net metering by making it more than twice as expensive for the little guy through fees and smaller payments.

Those electrons are sold back to the rest of us at the same rate as electricity made by the utilities. So even though it’s true all of us have an interest in maintaining the grid, the proposals are not only not fair - the solar-panel installation industry says it would deeply harm their own business model. And this is not just about staying in business. As U.S. negotiators prepare to head to the Paris talks on climate change next month, all of us have an interest in creating a country with fewer carbon emissions that lead to global warming.

When a similar measure to the one before the PUC was approved in Arizona recently, the solar industry said it saw an immediate 95 percent decline in its business. Homeowners said that it no longer penciled out for them to invest the $15,000 or so it costs to go solar and recoup their investment through energy savings over 10 or so years. Hawaii just passed an anti-solar bill after intense lobbying by that state’s largest utility, and big condos that were on the verge of going solar dropped their plans. Two of the sunniest places in the nation are now seeing dramatic drops in individuals going solar.

The good news is that two other states, New Mexico and Wisconsin, recently prevented their utility commissions from siding with the big utilities by making small solar power less economical.

About 130,000 Californians signed petitions to the PUC asking it to protect net metering, and big wheelbarrows of the petitions were delivered last Thursday. In the future, the formula may need tinkering with to protect the grid. But the time to change the model, just as solar is taking off, is not now.

___

Nov 10

Oakland Tribune on transparency of campaign records:

The staff of the state Fair Political Practices Commission deserves credit for backing away from a misguided proposal to limit availability of key records.

Now it should go future and ensure the documents are permanently preserved online in a format that members of the public can easily analyze so they can connect the dots between politics and money.

It’s appalling that more than 20 years into the Internet age, candidates and ballot measure campaigns across the state continue to file at least some - and in many cases all - of their disclosure documents on paper, and that the data from them is not available in searchable format.

The current disclosure system traces back to an initiative passed by voters in 1974, the decade before personal computers. Under the 41-year-old law, known as the Political Reform Act, state candidates file contribution statements with the Secretary of State’s Office and financial conflict of interest declarations with the FPPC.

Secretary of State Alex Padilla, who took office this year, deserves credit for improving his end of it. His office provides searchable data, although until this year the system was difficult to navigate.

At the FPPC, however, documents are still filed on paper, just as they often are at the local level for offices such as city council, school board or county supervisor. The FPPC takes the documents it receives and posts copies online, but the data cannot be searched or analyzed.

The solution is simple: We should have one centralized electronic repository for all the data, state and local. For that, candidates, donors and campaign organizations should be required to provide the information via computer.

Statewide electronic filing would enable cost-effective permanent storage, sparing the need for thousands of filing cabinets in city and county offices across the state. Instead we have a hodge-podge of labor-intensive local systems.

To its credit, the FPPC is trying to upgrade its systems. But, at the same time its staff proposed rules setting the online life of the data at seven years. There’s no rational reason for that limit.

Today’s technology allows for inexpensive permanent storage of that information. Moreover, candidates often hold office for far more than seven years.

Voters deserve a historical perspective on who has been influencing policy-makers.

Fortunately, the FPPC staff dropped the plan as the agency began receiving questions from us and others. However, that’s not enough. The organization created by voters to ensure political transparency should make sure it really happens.

LOAD COMMENTS ()

 

Click to Read More

Click to Hide