In May the Board of Supervisors for the City and County of San Francisco approved an ordinance banning the use of facial recognition technology by all city departments. It’s the only major U.S. city to have taken such action against the emerging technology. But the measure is part of a larger and growing movement among localities and states to increase oversight of the use of surveillance technologies by government entities.
San Francisco’s ban on facial recognition technology is just one provision of an ordinance restricting the city’s use of surveillance technologies in general. Among other things, the law will require city departments to obtain approval from the Board before acquiring any type of surveillance equipment - from closed-circuit TV cameras to software for monitoring social media - or obtaining information acquired through the use of such technology. Departments that obtain Board approval, through a process involving a public hearing, will have to file a report each year on the use of the applicable technology.
The ordinance doesn’t apply to private entities, which as the Atlantic pointed out, “introduces some ironies.”
San Francisco’s police department “will be barred from using Amazon’s Rekognition software to scan video footage for suspects after a shooting - but a grocery store will be permitted to do the same thing to analyze shopper behavior,” the publication said.
San Francisco isn’t the first locality to pass such sweeping restrictions on government surveillance. Santa Clara County, encompassing much of California’s Silicon Valley, approved an ordinance like San Francisco’s - minus the ban on facial recognition technology - in 2016. And unlike previous laws dealing with the issue, it didn’t just apply to a particular surveillance technology that raised privacy concerns but to all such technologies, including those that hadn’t been developed yet.
“Silicon Valley’s local lawmakers made sure the law passed today was future-proof by creating consistent rules for all the surveillance technology that currently exists and those we know will come,” Nicole Ozer of the American Civil Liberties Union of Northern California said at the time.
In 2017 Nashville; Seattle; and Somerville, Massachusetts passed ordinances similar to Santa Clara County’s. And in 2018 Lawrence and Cambridge, Massachusetts; Yellow Springs, Ohio; and the California cities of Berkeley, Davis, Oakland and Palo Alto all did the same.
There are some significant variations among the laws, such as San Francisco’s ban on facial recognition technology and whistleblower protections in Oakland. But they all broadly restrict the use of surveillance technology by government agencies.
The laws came after a decade-long, federally-subsidized expansion of surveillance technology use by local law enforcement agencies across the country, spurred by the 9/11 terrorist attacks. Often those technologies, including automated license plate readers, biometric (e.g., face, voice, gait, etc.) identification systems, cell phone tracking devices, drones, and software for predicting criminal activity, have been deployed without notification of impacted residents or local governments. The New Orleans Police Department used predictive policing software to identify potential perpetrators and victims of crimes for six years without the city council knowing about it.
In response to this surveillance tech boom, the ACLU launched an effort in 2016 to ensure adequate oversight of municipal surveillance. The organization’s Community Control Over Police Surveillance (CCOPS) campaign included a model law requiring city council approval for the acquisition of surveillance technologies and annual reporting on the use of such technologies to the council and the public, among several other things.
According to the ACLU’s CCOPS webpage, the surveillance ordinances passed in Santa Clara County, Nashville, Seattle, Somerville, Lawrence, Cambridge, Yellow Springs, Berkeley, Davis, Oakland, Palo Alto, and San Francisco were all CCOPS efforts.
There hasn’t been much formal action on the issue this year in major U.S. cities other than San Francisco, according to a new local government service provided by LexisNexis State Net. That service, which currently covers major jurisdictions in 37 states, shows San Francisco, Santa Clara County and Seattle recently passed ordinances related to the government surveillance restrictions they’d previously approved. But most of the ordinances in the database, including those proposed or approved in Atlanta, Houston, Kansas City and Phoenix, authorize rather than restrict the use of surveillance technologies.
According to the CCOPS webpage, however, there are more than a dozen cities, large and small, working on their own CCOPS ordinances. They include Boston; New York City; Muskegon, Michigan; and Hattiesburg, Mississippi. The webpage also indicates California and Maine are working on statewide CCOPS legislation.
What’s more, ACLU Senior Advocacy and Policy Counsel Chad Marlow, who leads the CCOPS campaign, told SNCJ the localities and states identified on its webpage as “Working on CCOPS legislation” are just the ones where the process is far enough along to make it public. He said CCOPS efforts are also underway in “quite a few other places.”
In addition to the state CCOPS efforts, at least nine state legislatures have considered bills this session aimed at restricting government use of surveillance technologies, according to the National Conference of State Legislatures and LexisNexis State Net’s legislative tracking system (see Bird’s Eye View). At least 13 states have also considered measures dealing with government use of biometric data, one of which, New Mexico HB 98, has been enacted.
Pam Greenberg, who tracks technology issues for NCSL, said she’s “seen an increase in all types of privacy legislation this year” and expects “that trend to continue.”
As with other privacy-related issues, much of the debate over the government surveillance measures - in city halls and statehouses - revolves around the balance between security and civil liberty.
“This is really about saying we can have security without being a security state,” San Francisco Supervisor Aaron Peskin said of the city’s new government surveillance ordinance, which he wrote, as the San Francisco Chronicle reported.
Peskin and others say surveillance technologies raise serious societal concerns. Among them is the threat they pose to citizens’ ability to freely exercise their civil rights, such as attending a political protest. They also subject individuals simply going about their daily lives to the same scrutiny as those with criminal intent.
“When you have the ability to track people in physical space, in effect everybody becomes subject to the surveillance of the government,” Marc Rotenberg, executive director of the Electronic Privacy Information Center, told the New York Times.
Surveillance technologies also make mistakes. A test of Amazon’s Rekognition system last year by the American Civil Liberties Union misidentified as criminals 28 members of Congress, a disproportionate number of whom were people of color, including six members of the Congressional Black Caucus.
And critics say the technologies can too readily be used to intentionally target specific populations, such as African-Americans or immigrants, as China - a country with an estimated 200 million surveillance cameras – has been doing with the Uighurs, a largely Muslim minority in its western region.
But others argue that technologies like facial recognition make the public safer.
“It is ridiculous to deny the value of this technology in securing airports and border installations,” said Jonathan Turley, a professor of public interest law at George Washington University, as the Times reported. “It is hard to deny that there is a public safety value to this technology.”
And as Tony Montoya, president of the San Francisco Police Officers Association, noted, according to the Times, facial recognition technology has also “been successful in at least providing leads to criminal investigators.” One recent example is the use of the technology to help identify the suspect in a mass shooting at an Annapolis, Maryland newspaper in June.
For those and other reasons some oppose the idea of banning such technologies.
“We agree there are problems with facial recognition ID technology and it should not be used today,” the group Stop Crime SF said in a statement. “But the technology will improve and it could be a useful tool for public safety when used responsibly and with greater accuracy. We should keep the door open for that possibility.”
Some have also taken issue with the cost of complying with the surveillance ordinances. According to the Chronicle, the SFPD estimates it will take two to four full-time employees to carry out the compliance responsibilities associated with San Francisco’s new ordinance.
But more ordinances like it appear to be on the way. The ACLU’s Marlow said he thinks the momentum of the CCOPS campaign will not only continue but increase.
“Having passed 13 laws in 2 1/2 years - a startling average of one new law less than every 3 months - the question has gone from asking new cities if they would pass a CCOPS law, to asking them why they don’t have one,” he said. “In the next 12 months, I expect we will see quite a few more major U.S. cities adopting CCOPS laws, which will just add to the campaign’s ongoing strength.”
-- By KOREY CLARK
If you live in Detroit, Cleveland or Newark, odds are good the stress level in your world is pretty high. Conversely, if you reside in Fremont, California or Bismarck, North Dakota, life is likely a much smoother ride. Those conclusions are according to research by the personal finance website WalletHub, which compared 182 US cities across a number of criteria, including work stress, financial stress, family stress and health/safety stress. Detroit finished among the top three cities in three of the four categories, earning it the overall top – or bottom if you prefer – ranking as the most stressed out city in America. Which I’m guessing is not what Motown would prefer to be known for.
-- By RICH EHISEN
A bill working its way through the California Capitol that would make most gig workers into employees has got the major rideshare companies all a tither. So much they’ve been pushing their drivers to publicly oppose the bill. That effort took an interesting turn last week when said companies gave said drivers a little financial incentive to come to Sacramento to lobby against the measure. As the LA Times reports, Uber and Lyft promised any drivers who came to the Capitol to howl protest at the measure (AB 5) between $25 and $100 for their effort. Not to be outdone, the 500 or so drivers who showed up to support the bill also got some “cost offsets” sent their way, courtesy of the big labor interests who support the legislation. Because of course they did.
Famed evangelist Billy Graham might be dead, but his grip on Magnolia State politics is apparently still pretty strong. As Mississippi Today reports, a second gubernatorial candidate – former state Supreme Court Chief Justice Bill Waller Jr. – says he also adheres to the so-called “Billy Graham rule” by not allowing himself to ever be alone with a woman who is not his wife...such as MT reporter Larrison Campbell. Loyal readers will recall that another candidate Rep. Robert Foster, also citing Graham, made news last week by refusing to allow Campbell to shadow his campaign for a day unless she was chaperoned by a male colleague. The rationale being that should someone take a photo of him and a woman with no other men in the photo, then that there sneaky woman will blackmail him by claiming they were doing bad, bad things together. Fellas, after this I highly doubt any woman will want to be within 100 yards of either of you.
The BERKELEY, CALIFORNIA City Council unanimously approves an ordinance to bar the use of natural gas in new buildings. The law takes effect on Jan. 1 2020 (BERKELEYSIDE).
The SAN DIEGO City Council gives initial approval to an ordinance that would require gun owners to store guns in a locked container or disable them with a trigger lock when not in use or being worn on their person. One more vote is necessary before the proposal could become final (KPBS [SAN DIEGO]).
NEW HAMPSHIRE Gov. Chris Sununu (R) signs SB 103, which allows cities and towns to issue multitown bonds for any kind of municipal project (NEW HAMPSHIRE GOVERNOR’S OFFICE).
The OAKLAND City Council unanimously bans the use of facial recognition technology by city departments, including police (SAN FRANCISCO CHRONICLE).
-- Compiled by RICH EHISEN
NEW HAMPSHIRE Gov. Chris Sununu (R) signs HB 399, which allows anyone who convicted of possession of a small amount of weed before Sept. 16, 2017 to petition the court to have that conviction removed from their record. The governor conversely vetoes SB 88, which would have eliminated the requirement that a patient have at least a three-month relationship with a provider before being certified to receive medical marijuana (CONCORD MONITOR).
NEW JERSEY Gov. Phil Murphy (D) signs a quartet of gun-related bills, including SB 101, which will establish a state commission to approve smart guns – personalized firearms that can be fired only by authorized users – and requires retailers to offer personalized guns for sale as they become available, and AB 3896, which requires the attorney general and state health officials to establish a suicide prevention training course and informational materials for firearm retail dealers (NJ.COM, NEW JERSEY GOVERNOR’S OFFICE).
NEW JERSEY Gov. Phil Murphy (D) signs a trio of opioid-related bills: AB 3292, a bill that makes the Garden State the first to require opioid prescriptions to have a warning label to inform patients of the possibilities of addiction and overdose; AB 4744, which allows Medicaid recipients to receive opioid addiction treatment without prior authorization; and SJR 35, a resolution that authorizes and annual “Knock Out Opioid Abuse Day.” The laws take effect in February (NJ.COM).
NEW HAMPSHIRE Gov. Chris Sununu (R) signs SB 4, which enshrines into state law a requirement that health care insurers not be allowed to reject consumers for having pre-existing health conditions (NEW HAMPSHIRE PUBLIC RADIO).
Also in NEW HAMPSHIRE, Gov. Sununu signs SB 59, which adds post-traumatic stress disorder and acute stress disorder to the definition of injury for purposes of workers’ compensation for first responders (MANCHESTER UNION LEADER).
CALIFORNIA Gov. Gavin Newsom (D) signs SB 322, which provides Golden State health care workers whistleblower protections when they issue a complaint or initiate an investigation about their employers (CALIFORNIA GOVERNOR’S OFFICE).
MISSOURI Gov. Mike Parson (R) signs HB 260, an anti-poaching measure that significantly raises fines for those convicted of illegally taking game species and other native wildlife. Fines will range up to $5,000 for each black bear, elk, or white-tailed buck killed illegally, up to $1,000 for each wild turkey, and $500-$1,000 for each paddlefish. The new penalties go into effect at the end of August (SPRINGFIELD NEWS-LEADER).
The FLORIDA Board of Education enacts new rules that require Sunshine State schools to provide students with at least five hours of mental health instruction, beginning in the 6th grade. The instruction will require students to take courses aimed at helping them to identify the signs and symptoms of mental illness, find resources if they are battling with depression or other issues, and teach them how to help peers who are struggling with a mental health disorder. The start date is still to be determined (ORLANDO SENTINEL).
MISSOURI Gov. Mike Parson (R) signs HB 604, which among many things will require Show Me State public schools to perform criminal background checks on certain volunteers before they’re left alone with students or can access student records. The new law, which takes effect next year, also requires schools to share information on former employees who violate local policies against abuse of students (FOX4KC [KANSAS CITY]).
OREGON Gov. Kate Brown (D) signs SB 663, which requires that coursework on the Holocaust and other global cases of genocide be taught to age-appropriate students, starting at the beginning of the 2020 school year (KATU [PORTLAND]).
NEW HAMPSHIRE Gov. Chris Sununu (R) signs SB 142, a bill that will require public schools to provide female students with free menstrual products. Those items will be made available in female and gender-neutral restrooms at public middle and high schools, with the cost borne by school districts (USA TODAY).
MINNESOTA Gov. Tim Walz (D) signs HF 2a, an omnibus jobs and economic development package that will also make it a felony in some cases for employers to withhold workers’ wages. The new law, which went into effect immediately, also doubles the number of state inspectors assigned to investigate wage theft claims (MINNEAPOLIS STAR-TRIBUNE, MINNESOTA GOVERNOR’S OFFICE).
NEW HAMPSHIRE Gov. Chris Sununu (R) signs HB 480, which legalizes sports wagering in the Granite State. The new law requires players to be at least 18, creates a Division of Sports Wagering within the New Hampshire Lottery to oversee betting, allows for mobile wagering and prohibits any wagering on college games (NEW HAMPSHIRE GOVERNOR’S OFFICE).
NEW YORK Gov. Andrew Cuomo (D) signs AB 558, which raises the legal age to buy tobacco products in the Empire State to 21. Retailers who violate the new law face fines up to $500 (NEW YORK GOVERNOR’S OFFICE, LEXISNEXIS STATE NET).
Also in NEW YORK, Gov. Cuomo signs AB 8419, which grants Empire State farm workers overtime pay, a day of rest each week, disability and paid family leave coverage, unemployment benefits and other labor protections. The bill will take effect on January 1, 2020 (NEW YORK GOVERNOR’S OFFICE).
OHIO Gov. Mike DeWine (R) signs the state budget bill, which contains a provision raising the legal age for buying tobacco products to 21. The measure takes effect immediately (ADVANCE OHIO MEDIA [CLEVELAND]).
Questioning “his sincerity to work with us in a cooperative manner,” the leaders of five major OKLAHOMA-based tribes rejected Gov. Kevin Stitt’s (R) call to renegotiate their gaming compacts. In a letter to Stitt, the heads of the Cherokee, Choctaw, Creek, Seminole and Chickasaw nations, acting as the Inter-Tribal Council of the Five Civilized Tribes, said it is their position that the compacts will automatically roll over on Jan 1, 2020, a contention Stitt does not agree with. (TULSA WORLD)
Calling diversity the Empire State’s “greatest asset,” NEW YORK Gov. Andrew Cuomo (D) signed legislation that reauthorizes for five more years the Minority and Women Owned Business Enterprises (MWBE) program, which seeks to ensure those companies have greater access to state contracts. The law makes several changes designed to make more businesses eligible to participate in the program. (NEW YORK GOVERNOR’S OFFICE)
Responding to a media report that more than 4,500 of the Bay State’s approximately 42,000 elevators did not comply with annual inspection requirements, MASSACHUSETTS Gov. Charlie Baker (R) said his inspectors are working to get through the backlog as fast as they can. Baker noted the state’s building boom is complicating the issue, but also said, “That’s not an excuse. We need to get it done.” (MASSLIVE, STATE HOUSE NEWS SERVICE [BOSTON])
KENTUCKY Gov. Matt Bevin joined two fellow Republican lawmakers to propose legislation that would bar Bluegrass State cities and towns from becoming so-called “sanctuary cities,” municipalities that limit or ban police cooperation with federal immigration authorities. (COURIER-JOOURNAL [LOUISVILLE])
After initially saying he had no plans to try changing a state law that requires the governor to annually issue a proclamation honoring an early Ku Klux Klan leader, Tennessee Gov. Bill Lee (R) reversed course and said he would seek to change the law. Under Volunteer State law, the governor must decree July 13th as “Nathan Bedford Forrest Day” in honor of the Confederate general who also served as the hate-group’s first Grand Wizard.
Forrest’s birthday was a state holiday until 1969, when lawmakers amended the law to instead require only the governor’s proclamation. In a social media post last week, Lee said, “Our state's history is rich, complex and in some cases painful” and that he wanted residents to “know where my heart is on this issue.” In that regard, he said, “I will be working to change this law.”
A Lee spokesperson said the governor would work with lawmakers on the issue next session. (TENNESSEAN [NASHVILLE], CNN)
Faced with the imminent threat of litigation from her own attorney general, Kansas Gov. Laura Kelly (D) has dropped her effort to allow thousands of Show Me State residents to continue receiving food stamps without meeting state-mandated work requirements.
Kelly announced in June she would allow approximately 5,500 childless Kansans to keep receiving food assistance in July even though it would be in violation of a 2015 Sunflower State law that limits able-bodied adults ages 18 to 49 without dependents to three months of assistance within a three-year period if they aren't working at least 20 hours per week or enrolled in job training. The federal government, however, does grant states the discretion to waive the work requirements for some recipients.
Citing humanitarian motivations, Kelly said she was prepared to do just that, allowing the assistance to continue into August and September. Kelly said the exceptions were being made to help two specific groups: the state’s homeless population and foster children who were aging out of the system and would be left to mostly fend for themselves.
But critics note that the Department for Children and Families was planning to use a total of 16,500 exemptions over the next few months, more than necessary for just those populations.
That prompted state Attorney General Derek Schmidt (R) to threaten a lawsuit to stop it. Although Kelly felt her plan was on firm legal footing, she opted against fighting it out in court.
“While my team believes the policy we put in place is legally defensible, we have determined that it isn’t worth the cost to Kansas taxpayers to engage in a protracted court battle,” Kelly said during a press conference, adding, “How unfortunate that the attorney general saw fit to embrace such a mean-spirited position, rather than acknowledge the good we were trying to achieve in helping those less fortunate.”
Schmidt, however, called her decision “a victory for the rule of law.”
GOP lawmakers also lauded the decision. Senate President Susan Wagle (R) called Kelly’s effort “repulsive,” while House Majority Leader Dan Hawkins (R) said Kelly “was breaking the law and the Attorney General deserves our thanks for holding her accountable.”
Kelly, however, vowed to keep up the fight by other means.
“I don’t have anything in mind right now,” she said. “But you can trust that we are looking, doing a deep dive on all policy. And where there are things that we can change by executive order, we’ll do that if it’s in the best interest of Kansans.” (WICHITA EAGLE, ABC NEWS)
The CALIFORNIA Legislature has passed a bill (SB 27) that would require candidates for president to release five years’ worth of tax returns before their name could appear on the state’s primary ballot. The measure is similar to one passed by the state’s lawmakers in 2017 (SB 149), which was vetoed by then-governor Jerry Brown because he doubted its constitutionality. But unlike the 2017 measure, SB 27 also applies to gubernatorial candidates, which Gov. Gavin Newsom’s (D) has suggested could be enough to earn his support. (SANTA BARBARA INDEPENDENT, LEXISNEXIS STATE NET)
According to a lawsuit brought last year by the leadership of Rapides Parish, LOUISIANA, in 2017 the district attorney’s office for the parish took in $2.2 million in fees from pretrial intervention (PTI) - a common criminal justice reform program that allows nonviolent offenders to get their charges dropped by paying money - which the office reportedly used for office supplies, computers and “fringe” expenditures, among other things. That sum is over 10 times more than the previous DA had generated each year in PTI fees. (POLITICO)
PENNSYLVANIA Gov. Tom Wolf (D) vetoed a bill (SB 48) this month that would have provided $90 million to help the state’s 67 counties upgrade their voting machines before the 2020 presidential race. The veto comes about a year after the governor said his administration would decertify all of the state’s existing voting machines and require counties to purchase new ones. (YORK DAILY RECORD, PATRIOT-NEWS [HARRISBURG])
-- Compiled by KOREY CLARK
After two weeks of resistance, President Trump abandoned his plan to get a citizenship question on the 2020 census. But that doesn’t mean he’s given up on the idea of collecting information about the citizenship status of everyone living in America.
Trump issued an executive order on July 11 directing federal agencies to turn over to the Department of Commerce all citizenship data they have, which he said would “greatly inform a wide array of public policy decisions,” including the drawing of new legislative districts in 2021.
“Some states may want to draw state and local legislative districts based upon the voter-eligible population,” he said.
According to research by the National Conference of State Legislatures, 21 states explicitly require the use of census data for drawing legislative districts, presumably excluding them from using the aggregated federal agency data for that purpose. But with redistricting based on the number of citizens instead of total population expected to shift political power away from urban areas that tend to vote Democratic and toward rural areas that tend to vote Republican, it seems likely that at least some blue states would choose that option if it was available.
That would probably start a legal battle that could end up in the U.S. Supreme Court. The court has ruled that total population is an acceptable basis for drawing legislative districts that ensure one person’s vote is equal to another’s but not necessarily the only acceptable basis. (FIVETHIRTYEIGHT, NATIONAL CONFERENCE OF STATE LEGISLATURES)
NEW JERSEY has joined CONNECTICUT and NEW YORK in a lawsuit challenging a new IRS rule barring taxpayers from circumventing the $10,000 cap on state and local tax deductions imposed by the GOP-engineered federal tax overhaul in 2017. The states allege the tax law and the IRS action disproportionately impact high-tax blue states. (NJ.COM)
Sherwin-Williams Co., ConAgra Grocery Products Co. and NL Industries Inc. have agreed to pay CALIFORNIA’s largest cities and counties $305 million to settle a 19-year-old lawsuit over lead paint. The local governments sued the former lead paint suppliers in 2000, seeking billions to remove the dangerous paint from hundreds of thousands of homes, but an appeals court ruled in 2017 that the companies only had to pay to remove the paint from homes built before 1951. (ASSOCIATED PRESS, REUTERS)
WASHINGTON state’s Transportation Commission is expected to vote at the end of the year on a proposal that would move the state toward replacing its gas tax with a mileage-based system. The current timeline calls for the commission to receive a report on the new system in October and vote on a recommendation to the state Legislature on Dec. 17. (NEWS TRIBUNE [TACOMA])
--Compiled by KOREY CLARK
New York’s politically influential real estate industry suffered a surprising defeat last month when Gov. Andrew Cuomo (D) signed SB 6458, which among other things closed loopholes in the state’s rental laws that allowed building owners to raise rents.
Now two real estate groups - the Rent Stabilization Association, which represents about 25,000 landlords, and the Community Housing Improvement Program, which represents roughly 4,000 building owners - and several landlords have filed a federal lawsuit to block the new law.
The suit claims the law violates the due process clause of the U.S. Constitution’s Fourteenth Amendment and the Fifth Amendment’s takings clause, which holds that private property can’t be appropriated for public use without adequate compensation of the property owner.
Rent controls have faced numerous legal challenges over the years, but the U.S. Supreme Court has always upheld them. The plaintiffs in the new suit, however, are hoping the court’s new conservative majority will rule differently.
Although a recent Supreme Court decision has allowed the plaintiffs to file their suit in federal court instead of having to go through the state courts first, it could still take years for the case to reach the Supreme Court, if the justices actually agree to consider it at all.
“We’re going into the court system clearly with an eye of getting to the Supreme Court,” said Joseph Strasburg, president of the Rent Stabilization Association. “And we recognize that this is a long journey.” (NEW YORK TIMES, LEXISNEXIS STATE NET)
This month California Gov. Gavin Newsom (D) announced the state would be paying off $10.5 million in school loan debt for 40 dentists and $58.6 million in school loans for 247 doctors. The debt relief, provided through a loan repayment program established last year (SB 849) that received additional funding in the state budget passed in June, is aimed at addressing the state’s health care provider shortage. To receive a grant from the CalHealthCares program, dentists and doctors have to pledge to devote at least 30 percent of their caseloads to enrollees of the state’s Medicaid program, Medi-Cal, for five years.
“If you support providing quality care to Medi-Cal patients, we are going to support your journey by providing a little bit of relief on these loans,” Newsom said at a press conference highlighting healthcare investments in the budget.
The spending plan allocates $120 million for the loan repayment program, bringing the total appropriated for that program to $340 million, all of which is being funded by tobacco tax increases approved by voters in 2016 (Proposition 56). Nearly 1,300 providers have applied for CalHealthCares grants, which cover up to $300,000 in dental or medical school loans.
Loan forgiveness programs have grown in popularity among state and local governments as competition for physicians has increased nationwide. The situation is particularly challenging in California, with one of the lowest ratios of medical school students to overall population in the nation (18.4 per 100,000 people, compared to the national average of 30.3), with a third of the state’s practicing doctors approaching retirement age and a state Medicaid program that is growing rapidly, now covering about a third of the population. (LOS ANGELES TIMES, KTLA 5, CALIFORNIA MEDICAL ASSOCIATION)
The Centers for Medicare and Medicaid Services has approved waivers allowing the imposition of work requirements for Medicaid enrollees in nine states, according to the National Academy for State Health Policy. Approved waivers have been blocked by legal challenges in two states - Arkansas and Kentucky - and by executive and legislative action in New Hampshire. Waivers are also pending in seven states.
Source: National Academy for State Health Policy
As the fate of the Accordable Care Act (ACA) hangs in the balance in a federal court, states are experimenting with myriad policies affecting health care coverage and insurance costs.
In a hearing in New Orleans on July 9, two Republican-appointed members of a three-judge panel of the 5th District U.S Court of Appeal suggested that the ACA, often called Obamacare, may have become unconstitutional when Congress eliminated a requirement that nearly all Americans have health insurance or pay a penalty.
A ruling is not expected for several weeks in this case, known as Texas v. United States. Democratic governors and the Democratic-controlled U.S. House of Representatives are appealing a conservative Texas federal judge’s decision striking down the law, which was challenged by 18 Republican state attorneys general.
Overturning the ACA would upend coverage for nearly 30 million people and make health care a momentous issue in the 2020 elections.
“States would lose significant federal funds if the ACA was overturned,” said Jennifer Tolbert of the Kaiser Family Foundation (KFF).
A key provision of the law has promoted expansion of Medicaid, the federal-state program that provides health coverage for low-income families and the disabled. Thirty-three states have expanded Medicaid, and expansion is pending in three other states.
Most of the expansion has been financed by the federal government, and few states would be able to afford it on their own, Tolbert said.
If the ACA is struck down, it would deprive coverage to 17.1 million people added to the Medicaid rolls through expansion and 11.4 million people who obtain health insurance through the ACA’s on-line federal or state exchanges. A million people in Minnesota and New York have coverage through another feature of the ACA, putting the total who would be affected at 29.5 million, according to KFF data.
But the Supreme Court has twice upheld the constitutionality of the ACA. States are proceeding on the premise that the law will survive the latest legal challenge and are experimenting with competing Democratic and Republican visions of health care.
Democrats are testing a public health insurance option to compete with private insurance in Washington state. Public options are under study in Colorado at the behest of Gov. Jared Polis (D) and in New Mexico at the direction of the legislature.
California recently extended health coverage to unauthorized immigrants below the age of 25. Five other Democrat-controlled states and the District of Columbia provide coverage for unauthorized immigrants 18 and younger.
California is also on track, beginning in 2020, to become the first state to offer state-funded tax credits to middle-class enrollees in the ACA. They will be financed by a new tax penalty on Californians who don’t have health insurance.
Meanwhile, in many states, Republicans are offering cut-rate insurance plans to compete with more comprehensive health insurance policies offered on the ACA exchanges. In some of these states Republicans are also trying to impose Medicaid work requirements.
So far, both Democrats and Republicans in the states have fallen short of their expectations. President Donald Trump also was thwarted when a federal court ruled he lacked authority to compel drug manufacturers to disclose the prices of their products on television.
In Washington state, a public option proposed by Gov. Jay Inslee (D) was watered down to win legislative passage in the face of fierce opposition from hospitals, doctors and insurers. The bill that emerged from a legislature the Democrats narrowly control guarantees payments to hospitals and doctors at 160 percent of Medicare rates, makes participation voluntary and turns over day-to-day operation to private insurers.
“This bill is important, but it’s also relatively modest,” Sen. David Frockt (D), the measure’s sponsor, told the New York Times. “When I see candidates talking about the public option, I don’t think they’re really grasping the level of opposition they’re going to face.”
The power of that opposition was demonstrated this month in Connecticut where a proposal by Gov. Ned Lamont (D) to create new public plans for individuals and small businesses that had been expected to pass died in the legislature after intense opposition from Cigna and other insurers.
In California, Gov. Gavin Newsom (D) signed the nation’s first bill extending Medicaid coverage to unauthorized immigrants between the ages of 19 and 25. This is estimated to cover 90,000 low-income residents at a cost of $98 million. Since Medicaid covers only U.S. citizens, the cost will be borne by the state.
But while California is extending coverage to young adult immigrants, enrollment among unauthorized immigrant children under 18 is declining.
The Golden State has covered such children since 2016. In February of this year, the latest month for which data is available, 127,848 immigrant children were enrolled in Medi-Cal, the California version of Medicaid. This is a five percent drop from the program’s high point of 134,374 in April 2017.
Analysts attribute much of the reduction to anti-immigrant rhetoric and federal crackdowns on unauthorized immigrants, who are reluctant to become involved with any government program.
On the Republican side of the political spectrum courts and legislatures have blocked or slowed GOP initiatives.
Early this year a federal judge prevented Arkansas and Kentucky from imposing work requirements. New Hampshire work requirements were scheduled to begin this month but on July 8, Gov. Chris Sununu (R) signed a bill passed by a Democrat-controlled legislature that scaled back work requirements in the Granite State. Sununu postponed implementation of any work requirements for 120 days.
The Centers for Medicare and Medicaid Services (CMS) has approved waivers allowing work requirements for nine states, but the only state currently imposing such requirements is Indiana. A program that began in the Hoosier State on July 1 will require an estimated 72,000 people to report their work hours or other activity.
Republicans failed last year to repeal Obamacare despite multiple attempts in the U.S. Senate. But the Trump administration has since made rules changes that challenge several of the ACA’s premises. The most controversial of these changes was the introduction of cut-rate insurance plans that do not include many of the benefits guaranteed by Obamacare. Many of these cut-rate plans are not available to persons with pre-existing medical conditions in contradiction to the ACA, which requires that insurers provide coverage to everyone regardless of medical history.
Four states — California, Massachusetts, New Jersey and New York — ban plans that are not compliant with the ACA. Fourteen other states limit the duration of the cut-rate plans to three or six months.
When the ACA was approved by Congress on March 23, 2010, it was expected to join Medicare as part of the safety net that protects Americans who need medical assistance. Unlike Medicare, however, the ACA has been partisan from the outset. It passed on a party-line vote when Democrats controlled both Houses of Congress. Republicans have been trying to kill or cripple the law ever since.
They’re still trying, but there was a rare encouraging note from the White House on July 10 when President Donald Trump announced what Kaiser Health News called “a bold plan to improve care to patients with kidney disease, which he claimed would save thousands of lives each year and billions of dollars for taxpayers.”
Trump signed an executive order that boosts incentives for doctors and dialysis centers to treat patients at home in contrast to the current system, which focuses on in-patient dialysis center treatment.
Dr. Mark Rosenberg, president of the American Society of Nephrology, praised Trump’s action. “I have been a kidney doctor for 35 years, and this is the most game-changing thing ever to happen,” he said.
The irony of this important change is that Trump’s authority for making it without congressional approval comes from the Centers for Medicare and Medicaid Innovation (CMMI), which was created by Obamacare.
The day before this happened, administration lawyers joined Republican state attorneys general in an appellate court in New Orleans, in arguing that the entire ACA, including the CMMI, should be scrapped.
-- By Lou Cannon
It used to be that getting caught in a lie was a bad thing. But with the patron saint of fibbery in the White House these days, lying is in vogue even when your lie can be easily disproved. Case in point comes from Arizona, where Gov. Doug Ducey last week said he never told the state Commerce Authority to rescind a $1 million incentive package to Nike after the shoe company opted to not produce a new “Betsy Ross flag” shoe. But as the Arizona Republic notes, the governor himself took to Twitter to say he had ordered the agency to pull the incentives back, something the agency confirmed they did at his behest. When questioned about his walk back, the gov told reporters to “re-read the tweet” in which he announced his order. We did, governor. And you did. Maybe his vision is obstructed by his rapidly growing nose.
By the time you are reading this, North Dakota’s blue laws, the most restrictive in the nation, will be no more. After years of slow but steady erosion, the Flickertail State Legislature this year passed a bill to eradicate them once and for all. With Gov. Doug Burgum’s signature, the clock started ticking, and on Sunday August 4 time officially ran out. And it wasn’t just booze that has been banned from sale on Sundays. As the Bismarck Tribune reports, at least 40 different items were on the thou-shalt-not list, including jewelry, mattresses and even mirrors. Because comfortable sleep or gazing upon yourself must be sinful to someone somewhere.
Things are certainly different for kids these days. As NBC News reports, Oregon Gov. Kate Brown signed a bill last month that allows students to take “mental health days” the same way they would for a case of the flu. Now hold your nasty emails – I’m aware this is aimed at helping ease the stigma of mental illness among young people. That said, it’s hard not to recall my own experiences with mental health days back in high school, which was more commonly known then as cutting school. Or as my spiritual adviser Ferris Bueller once put it, “Life moves pretty fast. If you don’t stop and look around once in a while, you could miss it.”
If you happen to be perusing the many fine things to see and do in Berkeley, California and come upon a street access point to the city’s sewer system...please don’t call it a manhole cover. As Curbed San Francisco reports, the City Council recently voted to remove gender-specific terms from the city code, meaning manhole covers no longer exist in The People’s Republic of Berkeley. Additionally, craftsmen are now “craftspeople” or “artisans,” “manpower” becomes “human effort and “firemen” are now “firefighters,” and so on and so on. Oh, and the sewer access? That would be a “maintenance hole.” And if you really want to be sure you’re getting it right, you can always check this here list before you speak. Because Berkeley.
The CLEVELAND City Council approves new regulations that require landlords to pay for private inspections and obtain lead-safe certificates for rental units. Property owners will also be required to inform buyers about identified lead hazards (ROUTE FIFTY).
The LOS ANGELES City Council reinstitutes a rule barring people from living in their cars. The rule stays in effect until January, when it will be reconsidered (LOS ANGELES TIMES).