Mark Leno Archives — San Francisco Bay Guardian Archive 1966

Pricing women out of health care

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March 24, 2009

OPINION While California faces some of the most challenging economic times in recent history, many residents are losing their jobs — and as a result, their health insurance. And businesses of all sizes are struggling to make ends meet, which often means slicing employee benefits.

As more people are forced to turn to the individual market for their health insurance, women in California are at a distinct disadvantage. Under a practice known as gender rating, health insurers are allowed to charge higher premiums based on a person’s gender. Consequently, many women pay higher premiums than men for identical coverage. This unfair and discriminatory practice affects more than 1 million California women who currently purchase their health plans on the individual market — and undoubtedly prices many more women out of health coverage altogether.

A recent survey by the National Women’s Law Center showed huge variations in premiums charged to women and men for the same health care coverage. In some cases, women paid premiums that were slightly higher than what men paid for the same policy. But in other cases, women were charged more than 50 percent more — and as much as 140 percent more — for identical health plans.

Gender rating violates the California Constitution’s equal protection guarantees and goes against the state’s good public policies that favor preventive health care and affordable health coverage for all Californians.

While insurers argue their insurance rate differentials are based on the actual cost of providing health care to women (even for plans that do not include maternity care), gender rating is a relatively new phenomenon. Gender rating was not significantly used by the state’s top insurers until mid-2007, according to a preliminary analysis from the California HealthCare Foundation. Surely the cost of caring for women has not increased exponentially in the past two years, while medical expenses for men have remained stagnant.

In pricing women out of affordable health care coverage in the individual market, we set in motion a series of events that harm women, children, families, and entire communities. Uninsured women are less likely to receive preventive care. They’re most likely to discover, and seek treatment for, serious disease in the later stages of an illness. One serious disease or illness could potentially bankrupt an entire family and pose a health risk to the community. In addition, the costs of caring for uninsured women ultimately fall to either the local or state government, draining already strained public resources.

More than 40 years ago the insurance industry voluntarily abandoned the practice of using race as a rating factor for setting health insurance premiums, despite their arguments that those premiums were also based on actual health care costs. Ten states across the country have already outlawed gender rating, with no negative consequences to the rest of the insured in those states. Without a doubt, it’s time to do the same in California. *

Sen. Mark Leno represents the third Senate District, which includes Marin and parts of San Francisco and Sonoma counties. He is the author of Senate Bill 54, which would prohibit the practice of gender rating in California.

The governor’s spending addiction

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February 5, 2008

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OPINION Just five months after boasting that California’s "budget deficit is zero," Gov. Arnold Schwarzenegger recently came back to tell us the state is facing a staggering $14.5 billion shortfall over the next 18 months.

To deal with this amazing turn of events he is now proposing that we slash funding for our court system; virtually close down our state parks system; cut more than $4.5 billion from K–12 education; decimate our AIDS Drug Assistance Program; further reduce reimbursement rates for health care providers; put the children of mothers on state assistance at risk of homelessness; deny the blind, the elderly, and the disabled even a minimal cost-of-living adjustment; and continue to underfund our higher education systems.

Voters should rightfully be bewildered and seriously concerned. How and when did this crisis happen? How could the state go from a budget deficit of zero to one of $14.5 billion in just five months?

The governor’s earlier boast about our nonexistent budget deficit was a great line from a great showman. But it failed to tell the real story.

The fact remains that Schwarzenegger created the beginnings of this budget catastrophe on his very first day in office, when he followed through on a campaign pledge he made during the 2003 recall election. His promise was to rescind the restoration of the vehicle license fee.

The VLF was created in 1935 as a 1.5 percent tax on the purchase price of every automobile sold in California. Iconic Republican governor Earl Warren raised it to 2 percent in 1948. VLF revenue does not go to the state’s General Fund. Rather, it goes to local governments to pay for fire and police protection, keep libraries and parks open, and keep our streets clean.

In 1998, at the height of the dot-com boom, when California had surplus tax revenue, the Stage Legislature offered car owners a temporary relaxation on the VLF. The average 2 percent VLF was then $300. The "good times" tax break lowered the amount car owners paid to just $100. The state picked up the remaining $200 so local governments would continue to receive the entire $300. At the time this cost the GF around $5 billion annually. The deal was to continue as long as there were "sufficient general funds" to make up the difference.

In 2003, after the boom went bust, we faced a $38 billion state budget deficit. Then-governor Gray Davis’s finance director correctly determined that there were no longer sufficient general funds to continue the good times tax break. The VLF was restored to where it had been for 50 years.

Candidate Schwarzenegger seized on the issue, and the rest is history. Unfortunately, the $6.15 billion that Schwarzenegger is now spending annually on the VLF tax break is money we don’t have. Neither are the billions he’s spending to cover that debt, which stands at more than $20 billion over the past four years. Combined, the cost of the VLF tax break and the debt to service it account for almost 90 percent of our current budget deficit.

Without the governor’s reckless and profligate spending habit, our state would have no budget crisis and there would be no need to dismantle essential governmental services.

We need to finally have an honest conversation with the voters of California. One can debate whether or not the VLF spending program is a good idea. What is not debatable is that the ongoing GF cost of the VLF spending program is the main cause of our budget woes.

An immediate intervention is necessary. We must break the governor’s spending addiction to correct the course of our state.

Mark Leno

Mark Leno represents Assembly District 13 in Sacramento.

The poison in your sofa

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August 14, 2007

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OPINION If your sofa was purchased in California after 1975, chances are its interior foam and cushions contain either brominated or chlorinated fire retardants. These toxic chemicals have been shown to cause cancer, reproductive problems, learning disabilities, and thyroid disease in laboratory animals and house cats. At the same time, these chemicals are climbing the food chain in increasing concentrations and are found in fish, harbor seals in San Francisco Bay, polar bears, bird eggs, and the animal at the very top of the food chain — breast-fed human babies.

A little-known California regulation known as Technical Bulletin 117 requires that the polyurethane foam in furniture withstand an open flame for 12 seconds without catching fire. This 30-year-old regulation is well intended, and upholstered furniture fires are a serious concern. However, since 1975 no other jurisdiction in the world has followed California’s lead, and other states have achieved similar or greater reductions in fire-related deaths without this standard.

Because brominated and chlorinated fire retardants don’t react chemically with foam, their molecules have a tendency to attach to dust particles in furniture. Each time someone sits on a sofa cushion, the dust particles escape into the air and can be inhaled or settle on the floor, where toddlers and house cats live and play.

These fire-retardant molecules mimic thyroid hormone, which in pregnant women regulates the sex and brain development of the unborn child. This mimicking is called endocrine disruption, and brominated and chlorinated fire retardants in even infinitesimal amounts can cause harm to human and animal health through this process.

Many national furniture manufacturers distribute only California-compliant furniture, which means that up to 10 percent by weight of foam cushions are composed of toxic chemicals. California’s standard is poisoning the whole nation, one sofa at a time.

The good news is that there are safer chemical and construction-based alternatives already in the marketplace that can provide an equivalent level of fire safety without the use of brominated and chlorinated fire retardants. The institutional-furniture industry and the mattress industry already comply with tough fire standards and do so without the use of these toxic chemicals.

Residential-furniture manufacturers could do so as well, except that state law and TB 117 prevent it. That’s why I have authored Assembly Bill 706, which would modify our outdated foam test. A modern residential-furniture standard, such as the one developed in California for mattresses, should address how the various components of furniture can together achieve equal or better fire safety without using the most toxic fire retardants.

AB 706 would establish a comprehensive process for weighing the issues of fire safety and chemical exposures. It would rightly rest the responsibility for assessing toxicity with state toxicologists, require the fire-retardant industry to prove that its products are safe, and leave the final decision on whether to prohibit a particular chemical to the state’s fire-safety scientists.

Soon the decision of whether California will continue to poison our kids and the rest of the nation will be made by Gov. Arnold Schwarzenegger. Thus far, state agencies have been directed from the top to oppose AB 706. The question for Gov. Schwarzenegger is, how loudly must our babies cry before toxic, cancer-causing, endocrine-disrupting chemicals are removed from our furniture?<\!s>*

Mark Leno

Mark Leno represents San Francisco in the State Assembly.