New Data Shows Importance of Targeted Outreach in Languages Other than English

On Wednesday July 16th, Covered California released self-reported data on the written and spoken languages of its enrollees in each of the 19 rating regions across the state. The new data reinforces the importance of reaching out to the remaining uninsured in culturally and linguistically appropriate ways (particularly in languages other than English) in order to ensure robust enrollment in 2015.

It is estimated that at least 40% of Californians eligible for subsidies in Covered California speak a language other English; however only 17% of enrollees statewide reported a language other than English as their preferred written or spoken language. These numbers vary greatly between regions. For example, close to half (47%) of enrollees in Region 13 (Mono, Imperial, and Inyo Counties) reported Spanish as their preferred written and spoken language. Similarly, around a third of enrollees in Kern County and Northern Los Angeles County (Regions 14 and 15, respecitvely) and roughly 1 in 4 enrollees in the Central Valley (Regions 10 and 11) reported a language other than English as their preferred written and spoken language.

The data includes regional break-outs for Spanish as well as the other Medi-Cal Managed Care threshold languages: English, Vietnamese, Chinese, Korean, Farsi, Tagalog, Cambodian, Russian, Arabic, Armenian, and Hmong.

There is an opportunity to improve outreach and enrollment in languages other than English. Covered California is planning to award up to $16.9 million in grants, including to community-based organizations, for enrollment assistance during the next enrollment period slated to start November 15, 2014. A portion of the funds will be awarded specifically for targeted outreach and enrollment of hard-to-reach populations including young adults and Limited English Proficient Californians. Covered California’s new language data highlights the importance of continued targeted funding for culturally and linguistically appropriate outreach and enrollment of the remaining uninsured.

Visit Covered California's Open Enrollment Data Book for more detailed enrollee data.

© 2014 | California Pan-Ethnic Health Network | info@cpehn.org MAIN OFFICE: 1221 Preservation Park Way, Suite 200, Oakland, CA 94612 Phone: (510) 832-1160 | Fax: (510) 832-1175 SACRAMENTO OFFICE: 1225 8th Street, Suite 470, Sacramento, CA 95814 Phone: (916) 447-1299 | Fax: (916) 447-1292

California health insurance enrollment spikes as deadline nears

More than 150,000 people have signed up for Covered California health insurance in the past week, bringing total state enrollment to roughly 1.2 million and slowing the online portal to a crawl as residents rush to beat a midnight deadline. 

Meanwhile, Medi-Cal has enrolled approximately 1.5 million new members though mid-March.

Covered California Executive Director Peter V. Lee said the number of household accounts opened since last week totaled about 390,000, including 123,787 on Saturday and Sunday.

"We are seeing more accounts open than any day ever. And we are seeing that today with a huge amount of interest on the site, and it is causing the website to be quite slow," Lee said.

The exchange is working on several ways to accommodate the spike. With about 12 hours left in the first open-enrollment period, the state exchange is placing a high priority on allowing people to begin their applications and then return to complete them by April 15.

Some customers will get a "congratulations" note telling them they have started the application process but because of the high demand they will not be able to finish the process Monday, Lee said. Officials have switched off the "preview plan" tool because of lagging performance but will retain the "shop and compare" function.

Despite hiring on 250 additional people, wait times at customer service call centers averaged 42 minutes in the last week and about 70 minutes over the weekend. A number of enrollment events are taking place across the state, including in Sacramento, Oakland and Los Angeles.

The SEIU-United Healthcare Workers West union is hosting two "enroll-a-thons" Monday at its Sacramento office, 1911 F St., from 7 a.m. to midnight.

Affordable Care Act sign-ups: Where to get help before March 31 deadline

Covered California's website and call centers also will have extended hours, from 8 a.m. to 8 p.m.

In addition, consumers can call a licensed insurance agent or go to health care websites, such as eHealthInsurance.com, which is extending its call center hours through midnight Monday (800) 977-8860.

What You'll Need: Whether enrolling by phone, online or in person, every individual family member should have: proof of identity (photo ID, driver's license, passport); proof of address (utility bill or postmarked mail); income information (two paystubs or recent tax return); proof of citizenship (birth certificate, permanent resident card, or naturalization certificate).

Each person enrolling also must provide date of birth, Social Security number and ZIP code.

PHOTO: Karla Sanchez, 31, of North Highlands holds her son, Luis Marcial, 4, who naps in her arms while she makes her choice for insurance coverage at the SEIU union hall on Monday. The Sacramento Bee/Randy Pench

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California senator unveils bill to give health care to undocumented immigrants

A plan to provide undocumented immigrants in California access to subsidized health care has been spelled out in Senate Bill 1005 by Sen.Ricardo Lara, a Democrat from Bell Gardens.

Undocumented immigrants are excluded from the federal Affordable Care Act that is now offering legal residents the ability to purchase health insurance through government-run marketplaces.

Lara's bill would create two avenues for Californians who are in the country illegally to seek health care. The state would expand Medi-Cal to include undocumented immigrants whose incomes are under 138 percent of the poverty level -- about $32,000 a year for a family of four. And for undocumented immigrants who make more than that, the state would create a marketplace to sell insurance products.

The marketplace would be similar to Covered California -- the state's exchange that was created to sell insurance under the federal Affordable Care Act, also known as Obamacare.

The bill does not spell out a cost for California to extend health insurance to undocumented immigrants.

"We are doing the number crunching now," said Anthony Wright, executive director of the Health Access advocacy group that is supporting Lara's bill.

He said the goal is to provide health insurance for roughly 3 million Californians who don't have health insurance and cannot get it under the federal health program because of their immigration status.

"The idea under this bill is to extend the same level of help that the Affordable Care Act provides but to all Californians," Wright said. "It's about fairness and inclusion for all Californians."

Currently some California counties provide health care to undocumented immigrants but the offerings vary greatly among counties.

PHOTO: Senate President Pro Temp Darrell Steinberg, D-Sacramento, speaks with Senator Ricardo Lara, D-Bell Gardens, in the Senate chambers in March 2013. The Sacramento Bee/Hector Amezcua

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Covered California offering ratings to most health insurance plans

Most health insurance plans offered on the state exchange will now feature quality ratings, giving consumers a better idea about their past performance.

Covered California, the state exchange, announced Tuesday that it recently incorporated the quality-rating system in its website, with marks ranging from four stars for the highest performers down to one star for the lowest.

Federal law requires the rating of plans, but officials here noted that the rating system's California debut comes about two years ahead of the mandate. Executive Director Peter V. Lee said his exchange is among the first in the nation to offer consumers a quality-rating system.

"We want to give consumers all the available tools to help them assess and choose plans in their regions," Lee said. "We are proud of the ratings in each of the exchange plans and recognize this is a preliminary look at exchange health plans."

Lee previously expressed concern that incorporating the ratings for some plans and not others would dissuade people from enrolling. His original recommendation called for implementing the ratings system for all plans offered on the exchange during open enrollment in 2015.

Health policy groups and highly-rated plans suggested the exchange simply add language to those plans explaining they had yet to receive any ratings. They sided with exchange board members who strongly recommended adding the ratings as soon as possible.

"We are pleased that those are in place and that folks can take advantage of it," said Anthony Wright, executive director of Health Access California. He also expressed gratitude that the exchange "didn't go down the path that everybody got four stars."

Ratings are a key tool for customers and an important signal to insurers, Wright said. As the exchange and insurers begin negotiations for next year's plans, insurers know that the exchange will look at consumer ratings as well as price, he said.

The ratings, based on consumer experiences, will be familiar to users of Amazon and Yelp where customers assign grades to products, movies and restaurant experiences. In this case, each insurance plan in the marketplace is compared with plans across the western region of the country.

Scores come from the Consumer Assessment of Healthcare Providers and Systems. Four-star plans placed in the top 25 percent of all of those rated. Three, two and one stars were awarded to plans ranking 50-to-75 percent, 25-to-50 percent and 0- to-25 percent, respectively.

PHOTO: The executive director of Covered California, Peter V. Lee, speaks to members of the media during the launch of Covered California in Rancho Cordova on Oct. 1, 2013. The Sacramento Bee/Randall Benton.

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Obamacare Met With Confusion, Relief At Start Of New Year

SACRAMENTO, Calif. (AP) — The new year brought relief for Americans who previously had no health insurance or were stuck in poor plans, but it also led to confusion after the troubled rollout of the federal health care reforms sent a crush of late applications to overloaded government agencies.

That created stacks of yet-to-be-processed paperwork and thousands — if not millions — of people unsure about whether they have insurance.

Mike Estes of Beaverton, Ore., finally received his insurance card on Dec. 27 after applying in early November. Still, the family was thrilled to have insurance through the Oregon Health Plan, Oregon's version of Medicaid, because their previous $380-a-month premium "literally crushed our family's finances," Estes said.

Obama administration officials estimate that 2.1 million consumers have enrolled so far through the federal and state-run health insurance exchanges that are a central feature of the federal law. But even before coverage began, health insurance companies complained they were receiving thousands of faulty applications from the government, and some people who thought they had enrolled for coverage have not received confirmation.

Tens of thousands of potential Medicaid recipients in the 36 states relying on the federal exchange also are in limbo after the federal website that was supposed to send their applications to the states failed to do so.

Reports of complications were scattered around the country.

In Burlington, Vt., the state's largest hospital had almost two dozen patients seek treatment with new health insurance policies, but more than half of those did not have insurance cards. Minnesota's health care exchange said 53,000 people had enrolled for coverage through its marketplace, but it was unable to confirm the insurance status of an additional 19,000 people who created accounts but did not appear to have purchased the plans.

In Connecticut, officials were pleading for patience as call centers fielded calls from people who are concerned because they had yet to receive a bill for premiums or an insurance identification card.

"This is an unprecedented time, because there are a record number of people who have applied for coverage with an effective date of Jan. 1," said Donna Tommelleo, a spokeswoman for the Connecticut Department of Insurance.

This Christmas, give the gift of ... health insurance?

Forget the Xbox One, Ugg boots or that "Keep calm and kill zombies" hoodie.

California officials are urging you to consider gifting that special young adult in your life something a bit less tangible: Obamacare.

Covered California, the state health insuranceexchange, on Thursday launched its "Give the Gift of Health" campaign aimed at families, principally mothers and grandmothers (for the latter, apparently a $5 bill no longer cuts it).

Officials estimate roughly 1.8 million residents aged 18 to 29 are eligible to obtain health insurance through the exchange or qualify for free or reduced Medi-Cal, the government program for the poor and disabled. About 2.6 million Californians - many of them under 30 - will qualify for a federal subsidy reducing their monthly premium.

The holiday campaign - Wednesday was the last night of Hanukkah - includes a website atCoveredCA.com/pledge, where one can "pledge" to cover the cost of insurance; e-cards containing information about covered options and tips for starting a discussion about the importance of getting insured.

Claire Lipschultz, the mother of two twenty-somethings, acknowledged parents can't force medical decisions on their adult children. But they can help get them affordable insurance, said Lipschultz, the state policy advocate for the National Council of Jewish Women-California.

"Young adults tend to think that nothing will harm them," she said. "Moms know you are healthy until you are not. So, be sure your loved ones are covered."

Editor's Note: Post updated at 3 p.m. to reflect the last day of Hanukkah.

PHOTO: Emanuel Jumatate of Chicago, hugs his new Xbox One after he purchased it at a Best Buy in Evanston, Ill on Nov. 22, 2013. Microsoft is billing the Xbox One, which includes an updated Kinect motion sensor, as an all-in-one entertainment system rather than just a gaming console. AP Photo/ Nam Y. Huh

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Dianne Feinstein pushing for customers to keep their health plans

Sen. Dianne Feinstein believes if you like your current health insurance plan you should be able to keep it.

Feinstein, D-Calif., said Tuesday she was cosponsoring legislation honoring President Barack Obama's oft-repeated pledge allowing individuals who buy their own health plans to retain their current rates and health providers.

The bill by Sen. Mary Landrieu, D-La., would let those who purchased coverage after the passage of the federal health care reform to hold onto the plans unless their insurer pulls out of the individual market.

Feinstein's support, the first from a senator representing a deep blue state, underscores the discomfort among some Democrats with the health law's uneven roll-out, including computer glitches that have hobbled early enrollment in several states. Earlier Tuesday, former President Bill Clinton was quoted saying he believed Obama should stand by his original commitment.
In her statement, Feinstein said the bill "provides a simple fix to a complex problem."

"The Affordable Care Act is a good law, but it is not perfect," she said. "I believe the Landrieu bill is a commonsense fix that will protect individuals in the private insurance market from being forced to change their insurance plan. I hope Congress moves quickly to enact it."

Keeping the Affordable Care Act Promise Act would require that renewal notices inform customers of their options, including shopping for a new plan on the federal or a state insurance marketplace such as Covered California as well as mandate insurers to state why a plan does not meet new minimum standards established by the law.

Millions of Americans, including nearly 1 million in California, have been notified that their plans were being terminated Dec. 31 because they don't meet the minimum standards. Nearly 600,000 of the customers here can expect to pay more for coverage.

Feinstein said that in the last three months her office has received nearly 31,000 calls, emails and letters from constituents with many of them distressed by the cancellations and facing steep out-of-pocket monthly increases. A man from Rancho Mirage told the senator he would have to pay about $400 more a month through the exchange for essentially the same coverage.

"Too many Americans are struggling to make ends meet. We must ensure that in our effort to reform the health care system, we do not allow unintended consequences to go unaddressed.

A similar version to the bill is expected to be taken up in the GOP-led House later this week.


PHOTO: US Sen. Diane Feinstein talks to the Sacramento Metro Chamber of Commerce at the Sacramento Convention Center, Tuesday Aug. 12, 2008. The Sacramento Bee/ Brian Baer 

Uninsured Find More Success via Health Exchanges Run by States

WASHINGTON — Robyn J. Skrebes of Minneapolis said she was able to sign up for health insurance in about two hours on Monday using the Web site of the state-run insurance exchange in Minnesota, known as MNsure. Ms. Skrebes, who is 32 and uninsured, said she had selected a policy costing $179 a month, before tax credit subsidies, and also had obtained Medicaid coverage for her 2-year-old daughter, Emma.

“I am thrilled,” Ms. Skrebes said, referring to her policy. “It’s affordable, good coverage. And the Web site of the Minnesota exchange was pretty simple to use, pretty straightforward. The language was really clear.”

The experience described by Ms. Skrebes is in stark contrast to reports of widespread technical problems that have hampered enrollment in the online health insurance marketplace run by the federal government since it opened on Oct. 1. While many people have been frustrated in their efforts to obtain coverage through the federal exchange, which is used by more than 30 states, consumers have had more success signing up for health insurance through many of the state-run exchanges, federal and state officials and outside experts say.

Alan R. Weil, the executive director of the National Academy for State Health Policy, an independent nonpartisan group, credited the relative early success of some state exchanges to the fact that they could leap on problems more quickly than the sprawling, complex federal marketplace.

“Individual state operations are more adaptable,” Mr. Weil said. “That does not mean that states get everything right. But they can respond more quickly to solve problems as they arise.”

In addition, some states allow consumers to shop for insurance, comparing costs and benefits of different policies, without first creating an online account — a barrier for many people trying to use the federal exchange.

The state-run exchange in New York announced Tuesday that it had signed up more than 40,000 people who applied for insurance and were found eligible.

“This fast pace of sign-ups shows that New York State’s exchange is working smoothly with an overwhelming response from New Yorkers eager to get access to low-cost health insurance,” said Donna Frescatore, the executive director of the state exchange.

In Washington State, the state-run exchange had a rocky start on Oct. 1, but managed to turn things around quickly by adjusting certain parameters on its Web site to alleviate bottlenecks. By Monday, more than 9,400 people had signed up for coverage. TheWashington Health Benefit Exchange does not require users to create an account before browsing plans.

“The site is up and running smoothly,” said Michael Marchand, a spokesman for the Washington exchange. “We’re seeing a lot of use, a lot of people coming to the Web site. If anything, I think it’s increasing.”

Other states reporting a steady stream of enrollments in recent days include California, Connecticut, Kentucky and Rhode Island.

In Connecticut, a spokesman for the state-run exchange, Access Health CT, said users have generally had a smooth experience with the Web site other than “a couple of bumps and hiccups on the first day.”

By Monday afternoon, the Connecticut exchange had processed 1,175 applications, said the spokesman, Jason Madrak.

Daniel N. Mendelson, the chief executive of Avalere Health, a research and consulting company, said: “On balance, the state exchanges are doing better than the federal exchange. The federal exchange has, for all practical purposes, been impenetrable. Systems problems are preventing any sort of meaningful engagement.”

“By contrast,” said Mr. Mendelson, who was a White House budget official under President Bill Clinton, “in most states, we can get information about what is being offered and the prices, and some states are allowing full enrollment. All the state exchanges that we have visited are doing better than the federal exchange at this point.”

In California, Peter V. Lee, the executive director of the state-run exchange, said that more than 16,000 applications had been completed in the first five days of open enrollment. Mr. Lee said that while the consumer experience “hasn’t been perfect,” it has been “pretty darn good.”

Some state-run exchanges have run into difficulties because they rely on the federal marketplace for parts of the application process, like verifying an applicant’s identity. Minnesota, Nevada and Rhode Island are among the states that have reported problems with the “identity-proofing” process, which requires state-run exchanges to communicate with the federal data hub.

Brandon Hardy, 31, of Louisville, Ky., was one of the first to sign up for health insurance through Kentucky’s state-run exchange, working with an application counselor who guided him through the process last Wednesday. Mr. Hardy, who is uninsured and has epileptic seizures that land him in the hospital every few months, spent about 45 minutes filling out the online application, and learned that he would be eligible for Medicaid under the health care law.

“It was pretty easy,” Mr. Hardy said of the process. “What I really need is a neurologist, and now hopefully that will happen. This is like a huge relief.”

Attempts to sign up for coverage through the federal marketplace have often proved more frustrating.

Bruce A. Charette, 60, of Tulsa, Okla., said he had been trying to log onto the Web site for the federal exchange since last Wednesday, but had not been able to see the available plans or their rates.

Mr. Charette said he was asked verification questions that did not appear to match his identity. One question, he said, asked about the name of a pet for which he had purchased health insurance two years ago. “I don’t have any pets,” he said.

“It’s obvious that the site is overloaded,” said Mr. Charette, an electrician who works in the aviation industry and said he did not have health insurance. “I am not going to stare at a computer screen for 45 minutes, waiting for a response. It looks as if the Web site is freezing up.”

Still, some groups helping people sign up for insurance through the federal marketplace said they were finally able to complete applications on Tuesday, a week into open enrollment.

“This was the first day that I have been able to get onto the Web site and sign people up,” said Laura Line, corporate assistant director for Resources for Human Development in Philadelphia, which has a contract to help people in Southeastern Pennsylvania enroll in health plans through the federal exchange. “We have been setting appointments and answering a ton of phone calls now that we are able to do something.”

Katie Thomas and Jennifer Preston contributed reporting from New York.

Shutdown, or not - California launching health law Tuesday

California will forge ahead with the launch of its health insurance marketplace Tuesday, regardless of whether Congress fails to reach a last-minute deal to avert a federal government shutdown.

A possible shutdown would not stop the state because it has already received federal funding to implement the law. Much of the health care law, including federal subsidies for lower-income customers, was established through mandatory spending and not tied to annual appropriations.

On Friday, President Barack Obama promised that the insurance exchanges would open for business even if there's a government shutdown.

"That's a done deal," he said.

Indeed, Covered California - the state's version of the federal health care law - is preparing to begin enrolling customers in its health insurance exchange on Tuesday. Parts of the government would close on the same day if lawmakers in Washington don't act on legislation to extend discretionary spending.

Congressional Republicans have been working to stop the health law in its tracks.

On Monday, Senate Democrats tabled two House-approved amendments to a spending bill that would delay for one year implementation of the health law as well as repeal a medical-device tax designed to help pay for its implementation. Obama and Senate Democrats are urging the House to pass the Senate-approved spending bill with no provisions on the health care law.

California, one of 14 states rolling out its own marketplace, will mark opening day with a series of events in Sacramento, Fresno, San Francisco, Los Angeles and San Diego. The federal government will oversee the launch in the remaining states.

Photo: Samuel Butler inquires at a Covered California booth last weekend at the George Sim Center in Sacramento. Lezlie Sterling/The Sacramento Bee

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Covered California Open Enrollment

News Bulletin Covered California Open Enrollment Begins October 1, 2013 Covered California will begin open enrollment on October 1, 2013, with coverage beginning January 1, 2014. This is an exciting time, as communities of color represent two-thirds of the 2.7 million individuals who will be eligible for tax credits to purchase affordable coverage in Covered California. Additionally, more than one million eligible adults will speak English less than very well, making language access a priority. We need to spread the word about available resources to maximize enrollment among those eligible in our communities: ·         Covered California's website is currently available in both English and Spanish ·         Fact sheets about Covered California are available in 13 different languages ·         Covered California's telephone help line: 1-800-300-1506 will provide interpreters in any language. ·         The new application for coverage will be available in 12 different languages and will have dedicated, toll-free numbers for telephone assistance in each language. If your organization is interested in helping to get people enrolled in either Covered California or Medi-Cal, visit Covered California's Enrollment Assistance Program, where you can complete an online application to become a Certified Enrollment Entity. Upcoming Convening Provides Information on Outreach and Enrollment For more information on outreach and enrollment efforts, be sure to attend our upcoming convening, A New Era of Coverage: Maximizing Participation in the ACA. At this event, you can get updates on the state's outreach and enrollment efforts and hear about how local organizations are enrolling communities of color in available coverage opportunities. Register today and join us in Fresno (10/3), Oakland (10/8), Los Angeles (10/15), or San Diego (10/16). If you have further questions, email Cary Sanders at csanders@cpehn.org. If you would like to change your contact information, please email info@cpehn.org. If you would like to unsubscribe from CPEHN's Action Alerts, please email unsubscribe-actionalerts@cpehn.org. If you would like to unsubscribe from ALL CPEHN email communications, please email unsubscribe-all@cpehn.org. GET INVOLVED ·         Share With a Friend ·         Subscribe to our Newsletter, Action Alerts, or Event Invites ·         Join Our Network ·         Follow Us on Twitter @CPEHN ·         Like Us on Facebook ·         Donate

© 2013 / California Pan-Ethnic Health Network / info@cpehn.org MAIN OFFICE: 1221 Preservation Park Way, Suite 200, Oakland, CA 94612 Phone: (510) 832-1160 / Fax: (510) 832-1175 SACRAMENTO OFFICE: 1225 8th Street, Suite 470, Sacramento, CA 95814 Phone: (916) 447-1299 / Fax: (916) 447-1292

Covered California delays offering 'embedded' dental plans

Board members of the California Health Benefit Exchange voted Thursday to delay soliciting bids for medical plans that include pediatric dental care until next year.

Covered California, the state's health insurance exchange, has said it will offer five stand-alone pediatric dental plans for 2014 as well as what's called a "bundled" plan in which insurers pair a stand-alone dental plan with a medical plan.

Critics have argued that Covered California should also offer so-called "embedded" pediatric dental plans that are included in medical plans.

But Leesa Tori, senior adviser for plan management, told the board at its special meeting that too many questions remain for the exchange to offer embedded pediatric dental plans before 2015.

The exchange still must decide whether to make purchasing dental insurance mandatory, and for whom it would be necessary. Until Covered California makes this decision, Tori said, staff members will not know which types of plans to include in the exchange.

"There is no silver bullet for 2014," said Tori, as board members considered final recommendations on pediatric dental plans. "What we are suggesting here is that we go back, we do the proper policy analysis, look at the various products and then put it into a portfolio for 2015."

Tori also said that six of the eight health insurance firms with the ability to provide embedded dental plans said they could not develop a bid for next year.

"If we thought we could, we would," said Susan Kennedy, one of the board members. "We don't believe it's technically feasible or in the best interests of consumers to do so right now."

The board's plan to solicit multiple options for children's dental plans in 2015 comes in response to concern from children's advocates and families about the affordability of pediatric dental care. Monthly premiums for the pediatric dental plans to be offered in 2014 start at $10 per child, depending on the plan. The plans cover children up to age 19.

A coalition of children's health advocates sent a letter on Monday to the health exchange's board members urging them to request bids for embedded pediatric dental plans in addition to the stand-alone and bundled plans the exchange has already solicited.

The coalition -- which includes Children Now, United Ways of California, California Coverage and Health Initiatives, The Children's Partnership and Children's Defense Fund California-- called for the board to give the public the opportunity to choose their dental coverage.

"Consumer choice is important, and we recognize that for some families the option to select a stand-alone plan will be attractive," the letter read. "But stand-alone plans must not be the only choice."

PHOTO: Tribal dentist Gurminderajit Sufi works on Jonathan Jesus Lomeli, 10, of Arbuckle at the Colusa Casino's Wellness Center on April 23, 2013. The clinic offers subsidized medical care for low-income families. The Sacramento Bee/ Randy Pench.

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Background Check Bill May Affect Exchange Deadline

by: Angela Hart
Covered California board members say the timely rollout of the health insurance exchange relies heavily on two bills in the state Legislature spelling out the details of hiring 20,000 health reform workers. The board expressed concern about controversy surrounding one of the bills that excludes felons.

The bills — SB 509 and AB 1428 — would require new employees to undergo background checks and fingerprinting and disqualify any applicant with a felony conviction.
Though both are expected to pass this summer, AB 1428, authored by Assembly member Connie Conway (D-Tulare), is being met with resistance. Health policy experts and civil rights groups are taking issue with the provision in the bill prohibiting the state from hiring new employees with a felony conviction, arguing that it violates potential employees’ equal opportunity employment rights.

“The reason we got involved in the background check issue in the first place is because there are great job opportunities under the new health exchange,” said Carla Saporta, health policy director at the Greenlining Institute, a racial justice and advocacy organization based in Berkeley. “We work with many people who may have committed a crime in their past, but since have become a valuable member of their community, have contributed to society and have been rehabilitated. We believe these people should have access to these employment opportunities.”

Saporta said her organization is actively speaking out against Conway’s legislation, arguing that it violates the U.S. Equal Opportunity Employment Commission and specifically, the Civil Rights Act of 1964, a law enforced by the commission.

“We want to make sure the background checks are fair and equitable,” Saporta said. “AB 1428 does not take into account the time passed since the person’s offense, the conduct thereafter, completion of the sentence and nature of the job sought — which is required under the Civil Rights Act.”

Proponents of the legislation say fingerprinting of new employees and conducting background checks are critical to ensure consumer protections. Conway went further, noting that her law is important because health benefits exchange workers, called “assisters,” will have access to sensitive data, such as health records and financial information.

“We must ensure that California’s strong privacy protections are applied to those who are working with sensitive data about citizens,” Conway said in a news release. “Passing our legislation is essential to protecting Californians from becoming victims of identity theft when they sign up for health coverage and ensure that there are no incidents of fraud in our new state health care program.”

There seems to be consensus that the second bill — SB 509, which is co-authored by Assembly members Mark DeSaulnier (D-Concord) and Bill Emmerson (R-Redlands) — will pass without amendments. It would require health exchange officials to submit fingerprint images and related criminal background information for each prospective Covered California employee to the Department of Justice for review. The law would apply to anyone who could have access to confidential consumer data, including employees and independent contractors.
Legal and advocacy organizations clarified that their concern lies with the potential disqualification of employees with a criminal past.

Both bills require a two-thirds vote. If passed by the Legislature and signed by Gov. Jerry Brown (D), the laws would take effect immediately, officials said. Both are “urgency” bills.

‘We’ve Got a Deadline To Meet’
Robert Ross — a Covered California board member and CEO of California Endowment — said he and other health experts deliberated the details of AB 1428 for months before deciding to move forward with the proposal.

“We’ve got a deadline to meet, and the clock is ticking,” Ross said. “We on the board are managing a few different tensions — one is speed. We’ve never been asked to implement something as big as the health care law so quickly, so we’re working as hard as we can to get thousands of workers hired and trained by Oct. 1.”

Ross said delaying the passage of the bills could derail rollout of the state’s health insurance exchange, where an estimated 5.3 million Californians will be eligible to purchase health insurance later this year.

Ross said he raised questions in early March about disqualifying some populations from being eligible for work in the exchange.

“My concern was that we didn’t impede on the job opportunities for someone who may have had trouble with the law but who has turned their life around,” Ross said. “It’s clear that many of these communities — whether they’re in East Los Angeles, or Central Fresno, or East Oakland, or the Iron Triangle in Richmond — need access to decent jobs. Career pathways are already severely limited for many of the people who live there.”

Maurice Emsellem, co-director of policy for the National Employment Law Project’s Oakland office, echoed the concerns of Covered California’s board, noting that balancing employment rights with concerns about patient privacy is critical. His top concern, he said, is ensuring that AB 1428 meets legal requirements under the state’s equal employment laws and that there are job opportunities for populations who need them most.

“The Equal Opportunity Employment Commission, the federal agency that enforces discrimination laws, has said that criminal background checks have a disparate impact on people of color and that employers can’t have blanket restrictions on who they hire,” Emsellem said. “They have to look at the nature of the offense. That’s why we think it’s important to have stronger standards and an appeal procedure for someone who has a record, so they have the opportunity to show they’ve been rehabilitated.”

Emsellem pointed to higher unemployment rates in underserved communities. The most recent employment data show that in Oakland, for example, the city’s jobless rate is 10.8%, compared to the Alameda County average of 7%. A few miles north in Richmond, the city is experiencing an 11.6% unemployment rate, compared with Contra Costa County’s 7%.
“We’re still struggling with high unemployment rates in lower income communities of California,” Emsellem said. “There’s a real opportunity to create some good jobs where they’re desperately needed.”

Conway said ensuring privacy for the state’s residents trumps the need for jobs, adding that many private companies require employees to go through criminal screenings.

“While I understand the challenges of finding employment following incarceration, consumer protection must come first,” she said. “We need to be sure that these employees, who will handle sensitive personal and health data, have no criminal histories.”

Both Arguments Have Merit, Experts Say
Outside experts say concerns raised by the Greenlining Institute and others are fair. Nadereh Pourat — director of research for the UCLA Center for Health Policy Research who is familiar with the details of Conway’s bill — said both arguments have merit.

She and others pointed out that the people who are going to be enrolling Californians in the health exchange will often come from the very population the exchange is trying to reach — the unemployed or underemployed.

“The problem is Covered California is trying to gain support and participation from underserved populations who often times have had negative experiences with the health care system and the government in general,” Pourat said. “So I can see concerns on both sides.”

Pourat said, however, that the state must guard against risk for fraud and abuse when it comes to patients’ confidential information.

“Asking people for their Social Security number, for example, is a very sensitive issue,” she added. “It is very important that people understand that there is some form of oversight and supervision, so I think it is reasonable to ask for background checks.”

The Assembly Committee on Health approved Conway’s fingerprinting and background check legislation. It must pass the same committee in the Senate before it makes its way through both Appropriations Committees, to the Legislature and finally to Brown for final approval. Meanwhile, SB 509 passed through the Senate Committee on Health last week, and now must pass the health committee in the Assembly.

The bills have until the close of the legislative calendar year this September to become law. Policy analysts said they expect SB 509 and AB 1428 to pass early this summer.

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