January 21, 2014
Area(s) of Interest: Licensing & Regulatory Issues MICRA Payor Issues and Reimbursement
CMA Capitol Insight is a biweekly column by veteran journalist Greg Lucas, reporting on the inner workings of the state Legislature.
For the Record
At a recent sit-down with reporters, Senate President Pro Tempore Darrell Steinberg – who’s getting more tempore every day – fielded a question about whether he would introduce legislation this year related to the Medical injury Compensation Reform Act (MICRA) of 1975. Obviously, the impetus for the inquiry is the trial-lawyer backed Troy and Alana Pack Patient Safety Act of 2014, which would end the $250,000 cap on pain and suffering damages under the law and immediately increase it to roughly $1.1 million with annual cost-of-living adjustments thereafter. Supporters have until March 24 to collect 505,000 valid voter signatures to place it on this year’s ballot. Said Steinberg, a lawyer: “Initiatives should be a last resort” and that if filing one is a “goad” to legislative action, “that’s great.” But never said he planned to help find a compromise to avoid a pitched – and costly – initiative battle.
A Happy Correction
There are few things less enjoyable than admitting a mistake. But Capitol Insight is pleased to report that a sizable portion of the financial sting of the Brown Administration’s stance regarding reimbursement for services rendered through Medi-Cal has been removed in the governor’s budget for the fiscal year beginning July 1. As of January 3, the governor’s Department of Finance told Capitol Insight that as part of a prospective 10 percent reduction in reimbursement rates signed into law by the Democratic governor in March 2011, there would be more than $270 million in retroactive payments owed the state by doctors and other providers, like dentists and ambulance services. Although the prospective 10 percent reduction stays, Brown’s budget says to forget the retroactive payments. The Department of Finance says it wishes it could have said as much on January 3 but…. While fewer cuts are always better, it’s curious why the state would bother going through the hassle of the retroactive payments in the first place. Between now and June 30, dunning doctors, dentists and ambulance services would have saved the state less than $6 million and $136 million – out of $151 billion – in the budget for the next fiscal year. Whatever the reason, like the old country song says: “It’s all over now.”
A Buried Gem
Even a somewhat thorough reading of the budget, which is the most important policy utterance made by lawmakers and the governor each year, can yield some fascinating discoveries. Here’s a few paragraphs buried on page 153 of the governor’s budget that seem like (given their impact on state spending priorities and social programs) they deserve a spot a bit close to front and center:
“In past decades, baby boomers have posed multiple challenges to the state beginning with building classrooms and training enough teachers, to developing a higher education system that would accommodate the infusion of young adults, to growing the economy fast enough so they could find employment. Even now, baby boomers continue to reshape society as they begin to leave the labor force.
“In the next 15 years, well over 1,000 Californians will turn 65 each day. California’s future generations will face a new set of challenges. While California’s baby boomers were considered culturally diverse and highly skilled compared to the rest of the nation, the next generation will be even more internationally and culturally complex, and will face employment in a technological future unimaginable in decades past. Sustaining economic progress will require that all components of the workforce be prepared for the jobs that will drive California’s economic future.
“There are over 10 million foreign-born residents living in California, representing over one-fourth of the nation’s total foreign-born population. Most are long settled in the state, with nearly three-quarters having arrived before 2000. Although historically the majority of California immigrants came from Mexico and Latin America, twice as many new arrivals came from Asian countries compared to Latin America in 2011. Throughout California’s history, immigrants have provided major contributions to the state’s labor force and fueled economic growth. Most immigrants arrive in California as young adults. While a significant proportion of the foreign-born have a college degree, nearly half of the non-citizen foreign born have not completed high school.
“Despite contributions of the foreign-born to California’s economic growth, the foreign-born population represents a disproportionate share of those living in poverty. Two factors that contribute to the higher poverty for immigrants include the lack of ability to speak English and lower educational attainment. Poverty is not only an issue for the foreign born, but also for their native-born children. Nearly half of all children in California have at least one foreign-born parent and among those children, more than one-fourth live in poverty.”