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.

Poll: Californians like ballot initiatives but want process altered

Californians value the ballot initiative and want it to remain as a check on a political system they mistrust, but voters support major reforms in the process, according to a new poll from the Public Policy Institute of California.

The poll found that voters support several changes, including giving the Legislature an opportunity to respond to proposed initiatives and reach agreement with their sponsors, beefing up financial disclosure requirements for those engaged in ballot measure campaigns, increasing the role of volunteers in collecting initiative petition signatures, and placing time limits on ballot measures so that they can be revisited.

"These reforms are likely to have an impact beyond the initiative process," Mark Baldassare, PPIC's president, said in a statement as he released the report. "They hold considerable promise for increasing citizen engagement, encouraging voter participation, and building trust in state government."

The number of ballot measures has exploded in the past three decades, ever since Proposition 13 placed tight limits on property taxes and raised barriers to other tax increases. In the last decade alone, 68 measures have appeared on the statewide ballot, the PPIC report noted, but fewer than a third of them were approved even as proponents and opponents spent $1.8 billion on campaigns.

The Legislature's majority Democrats have pushed bills to change the initiative process, including one this year that would limit the role of paid signature-gatherers. Gov. Jerry Brown is now deciding whether to sign or veto it.

PHOTO: A man signs a ballot measure petition in Sacramento on Jan. 9, 2008. The Sacramento Bee/ Anne Chadwick Williams.

via http://blogs.sacbee.com/capitolalertlatest/2013/10/californians-like-ballot-initiatives-but-want-changes-poll.html

Read more here: http://blogs.sacbee.com/capitolalertlatest/2013/10/californians-like-ballot-initiatives-but-want-changes-poll.html#storylink=cpy

TAFT Correctional Facility to Reopen

TAFT, CA - Taft's Community Correctional Facility will reopen within the next two months. The city council approved a contract with L.A. County Tuesday to house its inmates. The agreement will bring back dozens of job and millions of dollars to the city of Taft.

Taft's Correctional Facility has sat empty for two years, but now it's about to reopen.

"This is a huge weight lifted off our shoulders," said Taft Mayor, Paul Linder.

In a unanimous vote, the Taft City Council approved a contract with L.A. County to house up to 512 low-level offenders for the next five years. 

"It's a relief. It's a big relief," said Taft Police Chief Ed Whiting. "Personally, I don't see why a jail should sit empty."

The state stopped housing inmates in the facility in November 2011, which cost the city money and jobs. Now, most of that is coming back.

According to the contract, Taft will add about 62 positions and get more than $11 million a year from L.A. County.

"This is good for them. It's good for us. It's also good for the inmates," said Chief Whiting.

Taft's Police Chief said it's good because the extra bed space will allow L.A. County to ease its jail overcrowding, and the inmates in Taft will have the option to work in the community like Kern County inmates, either picking up trash or doing road work.

"It gives the inmates something to do except sit in the cell all day," said Chief Whiting. "They'll get to work, and they'll get credit towards their release."

A work release Taft couldn't have done if they would have agreed to house the state inmates the California Department of Corrections wanted to send to Taft.

"It's just a better deal, and we're trying to the do the best for the community," said Mayor Linder.

"It took a lot of work on both ends and we're finally happy it's come together," said Chief Whiting.

Inmates could start coming to Taft as soon as November 18.

Check out video at: http://www.kget.com/news/local/story/Taft-correctional-facility-to-reopen/r6ZF7zgae0mQpcvOmv9xzQ.cspx

Jerry Brown OKs change to drug-law definition of 'transporting'

Gov. Jerry Brown has signed legislation easing penalties for people accused of carrying illegal drugs for their own use in California, his office announced Thursday.

Assembly Bill 721, by Assemblyman Steven Bradford, D-Gardena, will change the definition of "transporting" a drug to mean transporting it for sale, eliminating prosecutors' ability to bring an additional charge against someone who might otherwise be accused only of possession.

"Too many people are getting caught up in the prison system with nothing more than a small amount of drugs for personal use," Bradford said in a prepared statement. "The broad interpretation of existing law wastes resources going after users instead of dealers."

Opponents said the bill was unreasonably soft on criminals.

The bill was one of nearly 30 the Democratic governor announced action on Thursday. Brown has less than two weeks to sign or veto hundreds of more bills sent to him before the Legislature adjourned for the year.

PHOTO: Senate President Pro Tem Darrell Steinberg, left, Gov. Jerry Brown, center, and Assembly Speaker John A. Pérez, right, celebrate a budget deal with a formal announcement at the California Capitol on Tuesday, June 11, 2013. The Sacramento Bee/Randy Pench

Read more here: http://blogs.sacbee.com/capitolalertlatest/2013/10/jerry-brown-oks-change-drug-law-definition-transport.html#storylink=cpy

via http://blogs.sacbee.com/capitolalertlatest/2013/10/jerry-brown-oks-change-drug-law-definition-transport.html

Advocates urge Gov. Jerry Brown to veto gun bills

With Gov. Jerry Brown days away from deciding the fate of a stack of gun bills, Second Amendmentadvocates today delivered to the governor's office about 67,000 signed letters imploring him to veto the 14 prospective laws.

"California already has some of the strictest gun laws in the nation and these 14 measures are particularly onerous," said Craig DeLuz, a legislative advocate for the California Association of Federal Firearms Licensees.

Senate Bill 374 that bans detachable magazines in rifles and Assembly Bill 711 that prohibits the use of lead ammunition are among the measures the gun-rights groups want Brown to stop from becoming law.

SB 374 was authored by Sen. President Pro Tem Darrell Steinberg, D-Sacramento, and AB 711 was from Anthony Rendon, D-Lakewood.

While Brown has tipped his hand on a number of controversial bills, the governor has been decidedly tight-lipped on the gun bills, many of which grew out of the outrage following the Sandy Hook Elementary School shooting in Connecticut.

DeLuz and his colleagues suspect the governor will take a reasoned look at the bills and sign some and veto others.

"Politically, we want to make sure he understands there are a lot of voters out there who believe in the Second Amendment -- and that we are watching what he does."

PHOTO: Brandon Combs, managing director of the Firearms Policy Coalition, left, and Craig DeLuz, legislative advocate for California Association of Federal Firearms Licensees, deliver about 67,000 petitions urging the governor's veto of 14 gun bills. The Sacramento Bee/Christopher Cadelago

via http://blogs.sacbee.com/capitolalertlatest/2013/10/advocates-urge-gov-jerry-brown-to-veto-gun-bills.html

Read more here: http://blogs.sacbee.com/capitolalertlatest/2013/10/advocates-urge-gov-jerry-brown-to-veto-gun-bills.html#storylink=cpy

Read more here: http://blogs.sacbee.com/capitolalertlatest/2013/10/advocates-urge-gov-jerry-brown-to-veto-gun-bills.html#storylink=cpy

Gov. Brown signs 10 bills to help homeless and foster youths

SACRAMENTO -- Gov. Jerry Brown on Wednesday signed 10 bills that his office said will help protect “the most vulnerable Californians – homeless children and adults and foster youth.”

The measures include one that establishes "runaway and homeless youth shelters” as a new kind of group home and requires them to be licensed and overseen by the Department of Social Services.

There are an estimated 200,000 minors in California who are homeless, according to the California Research Bureau and the Council on Youth Relations' Homeless Youth Project.

Assemblyman Mark Stone (D-Scotts Valley) authored AB 346 to address that category of the homeless population.

Sen. Jim Beall (D-San Jose) introduced a bill that allows counties to transfer bond money approved for construction of shelters for abused or neglected children to instead be used for shelters for runaway or homeless youths. Beall’s bill, which was signed by Brown, is SB 347.

The governor also signed a bill that provides that the fact that a child is homeless or an "unaccompanied minor"  is not, in and of itself, a sufficient basis for triggering the mandatory child abuse or neglect reporting laws.

Assemblyman Tom Ammiano (D-San Francisco) said his bill gives those serving foster youths discretion in cases where youths might otherwise be taken into police custody or returned to a home from which they have  fled.

“Allowing  mandated reporters to not report solely based on homelessness allows the youths to access services and the service providers that specialize in homeless youth services to effectively do their jobs,” Ammiano said in arguing for his AB 652.

The governor also signed legislation requiring that when a decision is made to place a foster child who is medically fragile, priority consideration be given to foster parents who are nurse practitioners. That bill by Assemblywoman Holly Mitchell (D-Los Angeles) is AB 1133.

Brown also signed a measure by Sen. Leland Yee (D-San Francisco) that requires social workers to periodically visit foster youths in their home placements and provides for the  foster youths to request a private conversation with his or her social worker.

Yee said his SB 342 is needed because in-home visits by social workers “are an essential  component of our child welfare system and are critical for ensuring the safety of children placed in out-of-home care."

via http://www.latimes.com/local/political/la-me-pc-gov-brown-signs-10-bills-to-help-homeless-and-foster-youth-20131002,0,2061191.story

L.A. County leads California in poverty rate, new analysis shows

Los Angeles has the highest poverty rate among California counties, according to a new analysis announced Monday that upends traditional views of rural and urban hardship by adding factors such as the soaring price of city housing.

The measurement, developed by researchers with the Public Policy Institute of California and the Stanford Center on Poverty and Inequality, found that 2.6 million, or 27%, of Los Angeles County residents lived in poverty in 2011. The official poverty rate for the county, based on the U.S. Census' 2011 American Community Survey, is 18%.

The new analysis set California's poverty rate at 22%, the highest in the nation, compared with the official rate of 16%. Counties such as Placer and Sacramento, with more moderate housing costs, have lower poverty rates than those of metropolitan areas, researchers said.

"We always see maps of official poverty and think of the Central Valley as the most impoverished," said economist Sarah Bohn, a research fellow at the public policy institute and one of the study's authors. "This really turns that on its head."

The new model aims to present a fuller picture of poverty by taking into account living expenses and government benefits ignored in the official formula.

Social scientists have argued for decades that the federal definition of poverty, which dates to the early 1960s, falls short on two counts: ignoring the benefits of government aid, including food stamps, Social Security, subsidized housing and tax credits, and failing to account for regional cost differences in transportation, healthcare and housing.

The report released Monday found that although many Californians find it difficult to make ends meet, things would be much worse without state, federal and local safety net programs, including food stamps, CalWORKs and the earned income tax credit. Out-of-pocket medical costs, however, increase the hardship, particularly for Californians over 65, the report said.

The U.S. Census Bureau for the last two years has released its own alternative poverty rate that attempts to recalibrate the poverty threshold. The rate is for research purposes only, but if adopted nationally, it could lead to a dramatic redistribution of federal funding in state and local jurisdictions.

The new California estimates could add to the pressure for change.

"People in Los Angeles deserve more help from the federal government than people in Mississippi," said Dowell Myers, professor of policy, planning and development at USC.

Myers said there has been tremendous resistance to adjusting the poverty rate, "even when it makes total sense."

Daniel Flaming, president of the Economic Roundtable, cautioned the rural poor often have higher transportation costs and fewer social service agencies than their city counterparts.

The rural poor are isolated "and there are very few places to turn for help," he said.

gale.holland@latimes.com