5 Things California: LA Event recap, CNA contract agreement, Dynamex case

Thanks to Marjie High on our team for taking the reins of 5 Things for the last few issues.  We had a great event in LA yesterday, and wanted to get you this issue which has been informed by some of the hallway conversations and panel discussions from yesterday.  As always, thanks for reading our stuff!

DJ 5 Things Signature


1.  What you missed yesterday in LA

If you were with us yesterday in Burbank for the 2018 Los Angeles State of Reform Health Policy Conference, you know the conversations were lively and well informed.  If you missed the conference, don’t worry.  We’ve got you covered.

You can check out this highlight video from yesterday’s convening, which captures the energy, the sounds, and the faces of the event.  You can also see some of the presentations that were shared with folks here.  We’ll have the keynote sessions available to watch in a few days, which you can find at stateofreform.com.


2. Dynamex decision and the impact on health care

A quiet but consequential decision from the California Supreme Court known as the Dynamex case was getting a lot of buzz yesterday. The decision changes the test of what an independent contractor is. Now, if you are an independent contractor, you must be doing work “outside the usual course of the hiring entity’s business” in order to retain that status. Otherwise, you’ll be considered an employee.

So, if you’re an ER physician contracted to provide emergency services at a hospital, you may now be considered an employee.  If you hire locum tenens, then you’re probably going to have to count them as employees. If you bring on physicians as potential partners of your group, but start them as contractors, that’s now illegal.

push was made during the legislative session to overturn this decision, but it faltered.


3. California uninsured rate falls

New data from the U.S. Census Bureau shows California’s uninsured rate continues to drop. According to the report, California’s uninsured rate fell to 7.2 percent in 2017, representing a 10 percentage point decline from the 17.2 percent uninsured rate in 2013. California’s 10-point decrease is the largest decrease of any state during that time period.

“The Census figures are the gold standard and what the numbers show is that California continues to make history in reducing the rate of the uninsured,” said Covered California Executive Director Peter V. Lee.

However, the Census numbers also estimate there are still 2.8 million Californians who remain without insurance. Covered California estimates that approximately 59 percent of those that remain uninsured are ineligible due to their immigration status.


4.  California Nurses Association reaches tentative agreement with UC system

After 20 months of negotiations, the California Nurses Association (CNA) has reached a tentative contract with the University of California system. Back in May, the CNA, which represents over 14,000 registered nurses working within UC’s medical centers and health clinics, joined with roughly 43,000 other UC workers to strike against the system. The CNA contract disputes centered around wage increases and work place protections.

If the new agreement is approved, nurse wages will increase by 15 percent over the next five years through October 2022. The new contract also includes ensured meal and rest breaks, added incentive wages to address economic disparity in certain locations, strengthened communicable disease protections, and protected pension benefits. The full membership of the association is expected to vote on the agreement over the coming week.

5. Covered California announces 2019 small business rates

Covered California for Small Business (CCSB) announced a rate increase of 4.6 percent for 2019 this week. The rate increase is the lowest of the last five years, perhaps due in part to the fact that the exchange has had large gains in enrollment which help diversify the participant pool.

The exchange will offer five plans in next year, including two preferred provider organization (PPO) plans, and two health maintenance organization (HMO) plans. In addition, CCSB will include plans from Chinese Community Health Plan in San Francisco and Sharp Health Plan in San Diego. CCSB plans cover 5,700 small businesses, which employ around 47,000 workers, although most small businesses purchase plans from brokers or other small business exchanges.