Flexible Savings Accounts Threatened by Obamacare Cadillac Tax

Healthcare costsFlexible Spending Accounts could soon be a thing of the past due to the Affordable Care Act’s high-cost plan tax (HCPT), also known as the Cadillac tax.

Employers across the country are reassessing their current benefit plans due to a 40 percent nondeductible excise tax, set to take effect in 2018, on insurance premiums set above $10,200 for single-employee plans and $27,000 for family coverage.

Millions of people who use FSAs, which allow users to save money tax-free for medical expenses, will likely face paying more out-of-pocket for their health care expenses not covered by insurance.

According to the Kaiser Family Foundation, one in four employers will be affected by the looming tax increase since insurance premiums are expected to rise quicker than inflation.

“They’ll [FSAs] be one of the first things to go,” said Rich Stover, a health care actuary and principal at Buck Consultants, told Politico. “It’s a death knell for them. If the Cadillac tax doesn’t change, FSAs will go away very quickly.”

The tax was intended to generate $87 billion over the course of 10 years to expand government healthcare.

“In addition to raising revenue to fund the cost of coverage expansion under the ACA, the HCPT was intended to discourage employers from offering overly-generous benefit plans and help to contain health care spending,” Kaiser said in the report.

The Washington Examiner reports labor unions, once strong supporters of Obamacare, have teamed up with insurance companies and other employers, creating the “Alliance to Fight the 40,” in an attempt to push Congress to repeal the tax.

On Monday, the group sent members of the House a letter urging lawmakers to change the legislation to avoid employers potentially dropping or lowering coverage.

“The stated goal of health reform was to build upon employer-based coverage and lower costs. This tax will do neither,” they said. “Instead, it will erode an important source of quality coverage and compel a shift of costs to workers – something neither employers, nor employees want to see happen.”

Follow Juliegrace Brufke on Twitter

Originally published by the Daily Caller News Foundation

On Health Care, Obama worked the Refs and Got His Way

Former Lakers coach Phil Jackson says he finds referees “a very interesting group of people.”

If you’re a basketball fan, you’ll remember that Jackson has used plainer words about referees, and this has cost him a lot of money over the years. During the 2009 NBA Finals he was fined $25,000 for complaining about “bogus” calls. The following year he was fined $35,000 twice in two weeks.

Why did he complain so publicly?

Jackson may have hinted at the answer in a recent video for a youth sports organization. “It’s an impossible game to referee,” he said. “It’s totally impossible. There’s a foul on every play. You have to decide what you’re going to call and what you’re not going to call, who you’re going to attack and who you’re not going to attack.”

So those costly criticisms may have been an investment in helping the officials make better decisions in the future.

The president of the United States happens to be a basketball fan. Maybe he’s seen this trick work a few times.

Speaking in Germany after the G7 summit on June 8, President Obama lectured the U.S. Supreme Court on how to interpret the Affordable Care Act. “It should be an easy case,” he said, “Frankly, it probably shouldn’t even have been taken up.”

The next day the president spoke again about the law, describing a pre-Obamacare America where parents who didn’t have money could only “beg for God’s mercy” to save their child’s life. But thanks to the health care law, he said, a woman has thrown away her wheelchair, an autistic boy now can speak, a barber was cured of cancer. The president said miracles are happening in hospitals every day. “This is now part of the fabric of how we care for one another,” he concluded. “This is health care in America.”

On June 25, the U.S. Supreme Court upheld the administration’s interpretation of the health care law, which Chief Justice John Roberts said was necessary to avoid “a calamitous result.” Who would want to be blamed for preventing “miracles”?

Although the justices are insulated from politics by lifetime appointments, they strive to maintain the public’s respect for the institution of the Supreme Court. They can’t put their orders into effect without the aid of elected officials. The judiciary has “neither force nor will, but merely judgment,” Alexander Hamilton explained in the Federalist Papers.

It’s this vulnerability—the Supreme Court’s reliance on the esteem of the public—that Obama attacked in 2010 during his nationally televised State of the Union address. The president slammed the justices, some of whom were seated right in front of him, for their ruling in a campaign finance case.

Longtime political experts were startled by the breach of protocol, but basketball fans would not have been.

With his remarks in Germany, Obama signaled that he was ready to denounce the Supreme Court, perhaps for decades, if the justices blew the whistle on the IRS rule that went around the literal wording of the Affordable Care Act. Sure enough, the call went his way.

Presidents have done this kind of thing before. Franklin Roosevelt famously threatened to pack the court with more justices in order to get the majority he needed to uphold the New Deal. But it was the other Roosevelt, Teddy, who best explained this Progressive technique.

“I may not know much about law,” TR thundered in 1912, “but I do know one can put the fear of God into judges.”

Phil Jackson would have been fined a million dollars for that remark.


Reach the author at [email protected] or follow Susan on Twitter: @Susan_Shelley.

March of the Medical Interlopers Threatening Patient Care

Interlopers are government personnel who impose regulations that take me away from my work in order to check boxes, collect meaningless data, or fill out forms that address “nothing” about “something.”  Interlopers are vendors, insurers or bureaucrats who have something to gain in dollars and power at the expense of the health of America’s patients.

I am a physician and my job was to manage the health and medical care of my patients. That was the basis of my very extensive training and the focus of my life until the invasion of the interlopers. The schizoid attempt by the interlopers to confound me and other physician professionals is driving the health industry into an expensive civil war.

According to the Physicians Foundation there are already 2,167 quality metrics demanding a physicians’ time and attention. The individual private practice is overwhelmed by the increasingly irrelevant paper work while larger groups find it easier to purchase staff to assist.

Further, productivity has decreased by an estimated 30 percent with the implementation of the electronic medical record. The utility of the EMR should be the opportunity to provide patient data at the point of service. That has not been accomplished because the 2 major EMR vendors (Epic and Cerner) don’t integrate with each other or doctors’ offices. Every EMR is a silo of data: data collected so that doctors or hospitals might collect a bonus from the payer (government or insurer). This data is administrative, not clinical, data nor is it an accurate representation of a physician’s work. It is, however, readily available to hackers.

Ms. Faulkner, the multibillionaire CEO of Epic also sits on the government panel that recommends IT standards. Typical of an interloper, Epic has found a way to create a need for itself while supervising his or her own work.

ICD is an administrative coding system attempting to translate a patient’s clinical condition into a code. ICD 10 is the 10th iteration of this code set and increases the codes available to 87,000 from the 14,000 codes in the ICD 9 code set. While this is the coding set used by the World Health Association as a means of documenting diagnosis, in the U.S., these codes are used as a means of validating payment. In either case, the data is useless as a means of legitimately documenting a patient visit or ongoing care. Our patients’ medical history doesn’t fit into a box created by a bureaucrat.

Physicians throughout the country have attempted to explain to our legislators what this latest interloper will do to our ability to manage our patients’ health and well-being. In an attempt to explain to Congress why this billion-dollar opportunity for third party vendors will only suck more energy out of the exam room and force many in private practice out of business we have met a wall of pushback.

The American Medical Association estimates that small practices could spend between $56,639 and $226,205 to implement the coding system: money that is just not available to most small businesses particularly when the return on investment is negative.

When a patient seeks help in an Emergency Room, the American Hospital Association (AHA) reports that for every hour of patient care there is a full hour of questionably productive paperwork. And yet, the AHA has endorsed the evolution of yet more regulation in its support of the implementation of the ICD-10 code set. Why would hospitals oppose the doctors who work with them?

As private practitioners face bankruptcy, the hospitals are there to buy us out. It would seem to be the easy answer but there is an inherent conflict of interest when a doctor works for the hospital. As reported by Scott Gottlieb in Forbes, this can predictably decrease physician productivity as salaried employees and increase health care costs.

To quote Gottlieb, “The doctors will get squeezed but the real misfortunate will befall patients. We will increasingly be getting our medical care out of busy, hospital-run clinics. Our doctors will be salaried employees, more beholden to the rules that hospitals erect to manage their activities than the medical practices that they once owned.”

The interlopers can come from anywhere even from within the health care industry. They are endorsed by Congress and financed by big business. Physicians will need to engage our patients as our partners in order to fight this war. It is time for patients to demand as much from us, their trusted physician, or suffer the inevitable long lines in emergency rooms, even longer wait times and increasing costs only to fill the back pockets of the interlopers.

Californians Struggle to Afford Obamacare Premiums

covered caIn May 2013, Covered California officials faced sharp criticism over claims that premiums would actually go down for many health insurance purchasers. Forbes.com’s Avik Roy wrote that the agency implementing the Golden State’s version of Obamacare needed to look at its own data, which suggested health premiums would surge at least 64 percent after the regulations in the Affordable Care Act took effect. Bloomberg analysts offered similar criticisms.

Two years later, the Kaiser Family Foundation has issued a report that suggests these warnings were more accurate than the upbeat predictions of Covered California Executive Director Peter Lee. A key finding:

“Among adults who say that they pay a monthly premium for their health coverage, nearly half of newly insured adults (47 percent) say it is somewhat or very difficult to afford this cost, compared to just 27 percent of adults who were insured before 2014. When looking specifically by type of coverage, 44 percent of Covered California enrollees (not all of whom are newly insured) report difficulty paying their monthly premium, versus a quarter of adults with other types of private coverage. Medi-Cal enrollees do not pay monthly premiums for their coverage.”

Cost, not glitches, slowing CA sign-ups

The Kaiser report, which was based on interviews with 4,555 Californians, says the cost factor is the biggest barrier to higher enrollments, not online technical snafus:

“Cost continues to prevent many uninsured adults from seeking coverage. While many people focused on website glitches and administrative barriers during 2014, uninsured adults say that the reason they still lack coverage is because it’s too expensive, with most not even trying to get ACA coverage, and many who did still saying they are ineligible or believe the coverage is too costly.”

The cost of premiums is also prompting Californians to quit Covered California, KCRA TV in Sacramento reported, citing documents showing that 150,000 people dropped their state coverage in 2014.

These developments come in a pivotal year for Covered California — the last year in which federal subsidies will help cover the subsidies provided by the state agency. By law, beginning in 2016, the agency cannot seek state subsidies and must rely only on revenue it generates from premiums. Its goal was to have 1.7 million residents enrolled by Feb. 15, but it fell far short, with 1.4 million signups.

More criticism from national media

Meanwhile, Covered California is again provoking comment from outside of California. A May 31 Columbia Journalism Review essay by Trudy Lieberman criticized coverage of the agency as misleading:

It’s not easy to figure out how to monitor the progress of Covered California, the country’s largest state-run health insurance exchange.

Is it the total number of people who have signed up for an insurance plan on the exchange during open enrollment? The rate at which people renew? The number of new sign-ups in a given year? The number of Latino sign-ups? The number of “covered lives”? The number of Californians who have had coverage through the exchange at any point? Or, simply, the overall rate of uninsured adults across the state?

“In recent months, Covered California has cited each of these measures to tout its success. And though outside analysts have raised some notes of caution, press coverage has largely followed the lead set by the exchange. The result is coverage that has too often been reactive, short on enterprise, and with missed opportunities to ask some necessary questions. Covered California may ultimately have a success story to tell — but it will need to face some sharper skepticism before we can be sure.”

Lieberman wrote that California journalists should spend more time talking to affected state residents about their experiences with the agency and be less inclined to accept Covered California’s characterizations of its record.

Originally published by CalWatchdog.com

CARTOON: Medi-Cal Mess

Medi-Cal Cartoon

California could offer state-subsidized health care to 170,000 undocumented children

As reported by the Associated Press:

SANTA ANA >> In a move that adds momentum to efforts to integrate immigrants, California is on the cusp of becoming the largest state in the nation to extend state-subsidized health care coverage to children from low-income families who are in the country illegally.

Democrats, immigration groups and health care advocates celebrated the announcement as both a cost-saving move and social progress for the state’s estimated 2.5 million immigrants who are in the country illegally. Critics, however, worry that the overburdened state-funded health program can’t handle another 170,000 children.

Gov. Jerry Brown and legislative leaders announced a $115.4 billion budget agreement that for the first time includes state funding to cover low-income children under 19 regardless of their legal status in Medi-Cal, the state’s health care program for the poor.

Click here to read the full article

Nearly One-Third of Californians Dependent on Medi-Cal

Healthcare costsWith Medicaid eligibility expanded nationwide under the Affordable Care Act, Medi-Cal enrollees have discovered that care in California is not keeping up with increased demand.

“Today, more than 12 million Californians, nearly one-third of the state’s total population, are enrolled in the government’s health insurance plan for low-income, disabled and disadvantaged residents,” U-T San Diego reported.

Wrangling reimbursements

The sharply increased burden has driven stark divides into statewide politics. The dispute has centered around reimbursement rates, which have fallen low enough to discourage many doctors from accepting Medi-Cal.

Even for those who do, low caps on Medi-Cal patients have become the norm. “According to the California Medical Association, Medi-Cal pays an average of $41.48 for an office visit, less than half the $102.45 that Medicare pays for the same service,” according to U-T San Diego.

Part of the problem traced back to 2011, when the state Legislature, deep in the red, passed Assembly Bill 97 — a bill cutting Medi-Cal reimbursements by 10 percent. As the San Jose Mercury News reported, a court injunction forestalled the cut until this fiscal year, but did not prevent it from staying in effect each year after that. In opposing the cut, Medi-Cal providers have beenjoined by the California Hospital Association and representatives in California’s rural counties, where doctors accepting Medi-Cal can be especially difficult to find without traveling long distances.

Gov. Brown’s administration has anticipated that the reimbursement cut will yield a first-year savings of over $214 million. But as state coffers have swelled with a big taxation windfall, Sacramento Democrats have pushed Brown to take a more liberal approach to budgeting.

For now, with the state deadline for budgeting looming, the governor’s office has refused to budge. Finance Department spokesman H.D. Palmer told the Mercury News that more specifics are needed on how reimbursement increases will expand access to care before the old rates are restored. Meanwhile, finance officials “have pointed out that the $91.3 billion Medi-Cal budget for 2015-16 is almost $10 billion more than the current fiscal year. More than half of the cost comes from the federal government, but the state increased its contribution from the general fund by $700 million for the next fiscal year, up to $18.2 billion.”

Competing priorities

Adding to the sense of chaos, activists have begun a new push to increase health care access for unlawful immigrants. That effort has come at an awkward time. As the Los Angeles Times observed, “reductions made in county health program funding to help finance Obamacare have made it more difficult for some local officials to add — and in some cases maintain — medical care for the poor and residents living here illegally.” California pulled about $900 million in funding for local health programs “to help pay for expanded insurance coverage for those eligible to receive Medi-Cal,” according to the Times.

Lawmakers have also targeted another way Gov. Brown has clawed back some health care outlays. In a unanimous vote, the state Senate sent legislation to the Assembly that would crack down on California’s so-called Medi-Cal recovery program. That regulatory approach that allows the state to reclaim Medi-Cal money from the estates of deceased beneficiaries, even going after the value of their homes. Under the law governing Medicaid, the federal government has been authorized to recover funds in a more narrow way.

For many Californians affected by the rules, the takings come as an shock. As Emily Bazar noted at the Sacramento Bee, beneficiaries can be targeted even if they never went to a doctor. In a particularly counter-intuitive twist, Obamacare enrollees placed into Medi-Cal based on their low income will be required to pay back their health subsidies — while higher-income Covered California enrollees will not have to repay the ones they receive.

Originally published by CalWatchdog.com

Retiree with $183,690 Annual Pension Attacks Pension Critics

“Critics of public employee retirement benefits are engaging in hyperbole and pointing to potholes as evidence that millions of elderly Californians should be stripped of their retirement savings.”
Brian Rice, president, Sacramento Area Fire Fighters, Sacramento Bee, June 2, 2015

Notwithstanding the possibility that saying pension reformers want to see “millions of elderly Californians stripped of their retirement savings” is itself “hyperbole,” Brian Rice’s recent Sacramento Bee submission requires a detailed rebuttal. Rice’s piece, entitled “Pensions aren’t being paid at expense of filling potholes,” was in response to a study written by Stephen Eide and released by the Manhattan Institute entitled “California Crowd-Out, How Rising Retirement Benefit Costs Threaten Municipal Services,” published in April 2015.

Rice leads off by attempting to link the Manhattan Institute to the supposedly infamous Koch Bros., despite offering zero evidence that the Koch Brothers contribute to that organization. And, of course, he is relying on this unsubstantiated link to discredit Eide’s work, apparently because if the Koch’s funded the work, then the author had to come up with data and conclusions that fit their agenda, instead of the facts and logic.

We’ll get to facts and logic in a moment, but first it is necessary to consider Brian Rice’s agenda. Because there is virtually no comparison between California’s urban firefighters and the “working class,” “minority, low-income and rural communities,” to whom Rice makes reference in his article, and for whom unions are more legitimately challenged to represent. Brian Rice, who retired in 2011 after 28 years of service, collected a pension in 2013 of $183,690, NOT including other benefits which probably add at least another $10,000 to his total retirement package.

Here’s pension data for Brian Rice. Notice how during retirement his pension still increases each year.

Here’s pension data for Rice and his fellow retirees from Sac Metro Fire – and Rice isn’t even in the top 10. The top spot is held by James Eastman, who collected a modest pension of $231,428 in 2013.

Rice writes: “Public employees have traded off other compensation in order to have a secure retirement.”

Really? Here’s payroll and benefits data for Sac Metro Fire’s active employees. Eleven employees made over $300,000 in 2013, 195 made over $200,000 in 2013, and 408 made over $150,000 in 2013. The Sacramento Bee recently published an analysis of average pay, not including benefits, for Sacramento firefighters. The data shows the average firefighter makes $122,677 per year, NOT including current benefits such as health insurance, and not including the employer’s pension contribution. Add those and the average goes up to $194,083. And no, that average does NOT include captains, who average $163,040 before benefits.

Quite a trade off. Modest pay in return for a secure pension. No hidden agenda there, right? No motive to engage in “hyperbole” when you encounter critics?

Back to potholes. A California Policy Center study published in February 2015, “California City Pension Burdens,” documents the average employer pension contribution for California cities in 2013 at 7% of total revenue. CalPERS is increasing their required pension contribution by 50%, meaning the average will become over 10% of total revenue. And that assumes the markets don’t correct downwards. Many cities are in far worse shape. Is it really necessary for 10% of every dollar in local tax revenue go to pay pensions that average over $100,000 per year for public safety employees who retire early and whose pensions get annual cost-of-living increases?

The “crowding out” effect is real, and it affects more than potholes. Rice is perhaps at his most hyperbolic when he writes “each year, the $13 billion that much-maligned CalPERS pays Californians in pension payments creates $30.4 billion in economic activity. The California Public Employees’ Retirement System also invests in big infrastructure projects for the state, and makes capital available to minority, low-income and rural communities.”

Bull. Bull. And Bull. To wit:

(1) The $13 billion creating $30.4 billion in economic activity is known as a “multiplier.” As Rice puts it, “They spend it on housing, food, gasoline, other necessities, gifts for the grandkids and more – which drives economic activity, creates jobs and increases tax revenues.” We hate to break it to you, Mr. Rice, but if we had been able to keep that money, instead of paying higher taxes so you can have your $183,690 per year pension, We would have also been able to “spend it on housing, food, gasoline,” etc. No net benefit there.

(2) Rice claims $13 billion is paid out annually by CalPERS to pensioners. Actually last year it was $17.7 billion (ref. CalPERS CAFR 6-30-2014, page 24). But Rice neglects to mention that 15% of those pensioners have moved out of California. And Rice ignores the other side of the equation, which is that based on their asset allocation to-date, 91% of the $12.6 billion paidinto CalPERS last year was invested out-of-state. CalPERS has $301 billion in assets, and ninety-one percent of that money is invested out-of-state. As it stands today, California’s citizens, their cities, and the overall economy would be a lot better off if CalPERS, and every other pension system in California, did not exist.

(3) When it comes to infrastructure, not only is CalPERS investing a ridiculously minute portion of their portfolio, but the primary reason there isn’t money for infrastructure is because cities, counties, and the state are too busy allocating all of their financial resources to overcompensated public employees. And if CalPERS and the other pension systems were willing to invest for reasonable rates of return, instead of speculating on global markets, they could take their roughly $700 billion in assets and finance revenue producing civil infrastructure such as dams, upgraded water treatment to allow reuse of waste water, desalination plants, aqueduct upgrades, port expansions, road and freeway upgrades, bridge repair – the list is endless.

Despite Mr. Rice’s hyperbole, most pension reformers do not want to abolish defined benefit pensions for public employees, if these pensions could be made fair and financially sustainable. That would require returning to the conservative investment guidelines in place until Prop. 21 was passed in 1984, and it would require returning to the modest and fair benefit formulas that were in place until SB 400 was passed in 1999. Taking these steps would not only save defined benefit pensions, but enable massive investment by the pension systems in revenue producing civil infrastructure.

There’s a lot of middle ground between someone collecting a pension of $183,690 per year, and being “stripped of their retirement savings,” Mr. Rice.

Originally published by UnionWatch.org

*   *   *

Ed Ring is the executive director of the California Policy Center.

The Medi-Cal Mess

Pills health careCalifornia’s health program for the poor and disabled, Medi-Cal, has presented state lawmakers with quite a perplexing paradox. More and more people fall under the protection of Medi-Cal and need a doctor but fewer and fewer doctors are accepting the low fees associated with the program. While a simple solution may appear to be increasing the size of the Medi-Cal budget, Medi-Cal is already stretching the state budget and squeezing other programs. Thus, dealing with the Medi-Cal mess has become a real problem for state lawmakers and the governor.

As former Gov. Schwarzenegger economic advisor David Crane pointed out in a Sacramento Bee op-ed, “Medi-Cal’s share of spending has grown 35 percent since Brown took office and now consumes one-sixth of the budget.”

Yet, while the Medi-Cal costs surged upward with new patients coming into the system, especially because of the Affordable Care Act, fees were cut for health care providers during the recent recession and have not been restored. Many providers have decided not to accept Medi-Cal patients because of the low reimbursement rate.

So, more patients seek doctors and other health care providers while fewer health care providers are available to see them. And raising the cost of the program jeopardizes the cautious fiscal management of the Brown Administration that is concerned about what happens when there is another economic downturn.

Recently, Brown’s Director of Finance, Michael Cohen, told the press that the administration was willing to discuss boosting Medi-Cal reimbursement rates if that would guarantee greater access to doctors. How that guarantee is made to work is not certain.

There is no question that the health care providers should be more fairly compensated for their services and that all patients should be able to see a doctor. Given the increase in state revenues it is anticipated that some relief to the Medi-Cal program is in the offing. Yet, Brown is right to be concerned about an expanding budget.

While there seems no simple solution, not just the health care providers and the budget dollars should be considered. Another focus should be on the users of the system, their participation in the program and the opportunity for them to rise up and get free of the need for Medi-Cal assistance.

That California has nearly a third of its residents in need of Medi-Cal to provide health care is a sad commentary on the opportunity for the people to improve their circumstances. Obstacles should be removed so that the private sector can increase well-paying jobs. Then many of the people and their families using Medi-Cal can move away from the state sponsored health care and get company or individual health insurance.

Reducing obstacles to good job creation would go a long way toward relieving the burden on the Medi-Cal program.

In addition, Medi-Cal’s value must be brought home to patients. Health care providers have told me that they sometimes have to double and triple book Medi-Cal patients because they don’t appear for their appointments. The reason often suggested is that many patients are not required to pay anything for the appointment and thus put little value on the service. A nominal co-pay by all patients would add value to the service and change the character of the program.

Californians should receive health care due them and health care providers should be justly compensated for their work. However, there appears to be no Alexander’s sword to cut through the Gordian knot that is Medi-Cal so the fix must be a more holistic approach.

Joel Fox is editor of Fox & Hounds and President of the Small Business Action Committee

Mandatory Vaccination Bill Quickly Advancing Through Legislature

vaccine2After a fractious debate, the California Senate passed a revised draft of the controversial bill that would largely eliminate the state’s religious and personal belief exemptions for child inoculation. With the bill on a likely track for passage in the Assembly, momentum has begun to gather for even more muscular pro-vaccine legislation.

Sweeping changes

As CalWatchdog.com previously reported, state Sens. Richard Pan, D-Sacramento, and Ben Allen, D-Santa Monica, had to rewrite key passages of the bill’s language in order to head off potential constitutional challenges to its treatment of kids without the specified vaccinations.

The bulk of the original bill remained intact, however, sweeping away California’s longstanding and generous rules permitting parents to keep their children vaccine-free. “Several Republican senators tried to stall the bill by introducing a series of amendments that would have reinserted the religious exemption and required labeling of vaccine ingredients,” according to the Sacramento Bee. But Democrats moved swiftly to shut them down.

For some critics, barring unvaccinated children from public school remained a bone of contention. “It’s clear that a large portion of concerned parents will likely withhold their children from public schools because of their concerns or lack of comfort from the vaccination process,” said GOP state Sen. John Moorlach, according to the Christian Science Monitor.

But some carveouts were set to remain. “The legislation only addresses families that will soon enroll their children in school,” as Newsweek observed. “Under the proposed law, children who aren’t currently immunized are not required to get vaccinated until seventh grade. The law still allows families to opt out due to medical reasons, such as a history of allergies to vaccines and inherited or acquired immune disorders or deficiencies.”

The so-called grandfather clause represented a major concession to parents’ groups, which had succeeded in stalling Pan and Allen’s legislation once before. Now, as the San Jose Mercury News reported, “more than 13,000 children who have had no vaccinations by first grade won’t have to get their shots until they enter seventh grade. And nearly 10,000 seventh-graders who today aren’t fully vaccinated may be able to avoid future shots because the state does not always require them after that grade.”

Regulatory momentum

Despite the lenience built into the advancing legislation, the pro-vaccine logic that propelled it has already increased momentum for an even more assertive approach to enforcing inoculation.

As KQED News has noted, “two other vaccine-related bills are making their way through the Legislature a bit more quietly. One would require preschool and child care workers to have certain vaccinations; another seeks to improve vaccination rates for 2-year-olds.”

“If SB792 becomes law, California will be the first state in the country to require that all preschool and child care workers be immunized against measles, pertussis and the flu.”

Supporters of the ratcheted-up regulation sought to head off more controversy by downplaying the invasiveness and inconvenience of their approach. “We certainly aren’t out to arrest people who aren’t vaccinated,” said Kat DeBurgh, executive director of the Health Officers Association of California, a group that sponsored SB792. “We wanted to make this just like any other violation of code that an inspector would look for. If you don’t remediate, then there is a fine to the day care center.”

At the same time, pro-vaccination analysts have speculated that the Golden State will save money the more it ensures vaccination. Referring to a recent study showing that Iowa’s health care spending would double if it added a personal belief exemption, Tara Haelle suggested that California’s “health care cost savings would be far more substantial” once its exemption was eliminated, although, she conceded, “no thorough analyses are currently available.”

Originally published by CalWatchdog.com