Massachusetts

This Dispatch is a roundup of what ballot initiatives will appear on state ballots across the country this November.  Whether it's workers rights, energy policy, education, transit, abortion or health care, ballot initiates give voters a chance to directly vote on an issue.

In a case with national implications for state health reform across the country, the Ninth Circuit Court of Appeals this week in Golden Gate Rest. Ass'n v. San Francisco upheld the employer responsibility provisions of the San Francisco universal health care plan.  The decision follows a preliminary decision earlier in the year that allowed the plan to be initially implemented.

According to The Boston Globe, a national shortage of primary care doctors is hitting Massachusetts especially hard.  The state's 2006 health insurance mandate has resulted in an additional 439,000 newly insured residents trying to seek care from an already over-stressed medical profession.  According to an annual survey by the Massachusetts Medical Society, wait times for new patients to see primary care doctors are running an average of 50 days, though some doctors report delays up to 100 days.

To address the misuse of health insurance premiums, legislators in California recently passed tougher standards regulating how insurance companies use premiums.  The law is designed to put teeth into the basic expectation that health insurance premiums paid by families and businesses should be used by insurance companies for actual medical care.  Sponsored by State Senator Sheila Kuehl, legislators passed SB 1440, which creates a "medical loss ratio" of 85% - or "care share" - requiring insurance companies to spend at least 85-cents of every premium-dollar on actual medical care.  Governor Schwarzenegger has yet to act on the bill, but the legislation was amended at his request to exempt new plans from the 85% threshold for the first two years they are available, signaling that his signature is likely.