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4 days ago
- General
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Oregon bill would reduce administrative burden for patients seeking physician assisted suicide
A doctor holds a hospital patient's hand. (Getty Images) Terminally ill people who want their doctors' help in dying could do so twice as quickly under an Oregon bill that would cut the waiting period between asking for a lethal dose of medication from 15 days to seven. Oregon is one of 11 states and Washington, D.C., that allow terminally ill individuals to choose to end their lives by asking a physician for a lethal dose of medication. Only adults who are given six months to live and who can effectively communicate for themselves can elect for physician-assisted suicide. In 2023, the state removed a residency requirement, enabling people from other states to travel to Oregon to die. Patients must make two oral requests to their physician for the medication, each separated by at least 15 days. But Senate Bill 1003, as amended, would change the law and reduce that time frame from 15 days to seven days. The bill would allow electronic transmission of prescriptions and filings, and it would require hospices and health care facilities disclose their physician-assisted suicide policy before a patient is admitted and publish the policy on their websites. The bill would also broaden who can prescribe lethal drugs by replacing 'attending physician' and 'consulting physician' in the law with 'attending practitioner' and 'consulting practitioner' while retaining the requirement that they are licensed physicians in Oregon. The bill is sponsored by the Senate Judiciary Committee. The bill received a public hearing Monday afternoon in the Senate Committee on Rules, with dozens of individuals testifying and submitting letters mostly in opposition. It has yet to receive a vote by either chamber. The state's policy, called the 'Death by Dignity Act,' was created through a 1994 citizens initiative that passed with 51% of the vote. A lawsuit paused the act from taking effect for three years, but in 1997 that injunction was lifted and an attempt to repeal the act in a citizens initiative failed the same year. In 2024, 607 people received prescriptions for lethal doses of medications, according to the Oregon Health Authority. Most patients receiving medications were 65 or older and white. The most common diagnosis was cancer, followed by neurological disease and heart disease. Most individuals, including mental health providers and Christian medical groups, testified in opposition to the bill, saying it would undermine the time needed for patients to process their diagnosis, disregard alternative health solutions and ignore mental health concerns. The committee received 429 letters in opposition to the bill and only 12 letters in support. Rep. E. Werner Reschke, R-Malin, said it 'creates a culture of death over that of life.' But a few proponents, such as Portland resident Thomas Ngo, said it would make the process smoother and less of an administrative burden for patients enduring terminal illness and pain. Ngo said his mother used the Death with Dignity Act to die after she was diagnosed with terminal cancer. 'Her passing was peaceful and on her teams,' Ngo told the committee. Ngo's father's partner died of the same disease but could not opt for physician-assisted suicide because they were at a religiously-affiliated health care provider. Oregon health care providers are not obligated to participate in the Death by Dignity Act, and many religiously affiliated hospitals do not participate. The bill will be scheduled for a work session for a later date where the committee can decide to hold the bill — killing it for the remainder of the session — or advance the bill to the Senate floor for a vote. SUPPORT: YOU MAKE OUR WORK POSSIBLE
Associated Press
11-03-2025
- Business
- Associated Press
California lawmakers propose fixes for ‘insurance industry in shambles'
The fires that reduced Altadena, Pacific Palisades and other Los Angeles-area neighborhoods to rubble have also shined a harsh light on California's raging insurance crisis. Lawmakers have proposed a variety of bills to address the issues illuminated by the disaster, plus others that predate it. Some of the legislation would be the first of its kind in the nation. The fire-insurance provider of last resort One measure would put the state's top two lawmakers on the governing committee of the FAIR Plan, the association of insurance companies that's required by law to provide fire insurance to property owners who can't find it anywhere else. The FAIR Plan said last month that it was at risk of running out of money due to claims from the LA fires and asked for a $1 billion lifeline. Its member insurance companies were on the hook for that amount, and could try to pass along up to half of the cost to their customers. The plan has become more important over the past several years as insurance companies have stopped renewing or writing new policies in California, so state officials have a keen interest in its solvency and ability to serve a growing number of customers. But the plan is not run by the state, it is run by a management team that's accountable to the pool of insurers. Lawmakers hope that adding state officials to the group of people overseeing the FAIR Plan will help it run better and improve the lives of its customers. 'The association has grown to such an extent that its financial capacity to pay claims after a catastrophic fire is unlikely,' says Assembly Bill 234, a bill by Assemblymember Lisa Calderon, a Democrat from the Los Angeles area. 'Increased transparency is imperative.' Calderon's bill calls for the speaker of the Assembly and the chairperson of the Senate Committee on Rules to immediately become non-voting members of the FAIR Plan's governing committee. Insurance Commissioner Ricardo Lara, who has limited authority over the plan, backs the bill. The FAIR Plan has not taken a position on the legislation, according to plan spokesperson Hilary McLean. If the bill passes, California could be the first state to put lawmakers on a FAIR Plan board, although several states have insurance department representatives on boards for their own FAIR Plan equivalents, said Stephen Jablonski, president of Property Insurance Plans Service Office, a nonprofit that tracks state residual property insurance plans. California's FAIR Plan would not disclose the members of its governing board. Concerns about the FAIR Plan go beyond its financial stability. As the fire insurance provider of last resort, issues surrounding the way it serves its customers have come up again and again. Placing state officials on the plan's board could help address some of those issues. In early February, Betty Ryder and her husband received a renewal notice for one policy on their Los Angeles-area home but not for their FAIR Plan policy, which is when they discovered that they did not have fire insurance on the property all of last year despite paying for it. That meant the couple was uninsured at a time when their home was particularly vulnerable: Ryder and her husband live in Tujunga, a neighborhood that Ryder said was 'right between the three fires' that burned in Los Angeles County earlier this year. Ryder got on the phone with her broker, her mortgage company and a representative from the FAIR Plan to figure out what happened. The agent for the FAIR Plan told her the plan had incorrectly applied someone else's payment to her account and that it canceled her policy after that realization. So she started writing letters: to the president of the FAIR Plan, to Lara, to her mortgage company, to her broker. 'I was in tears,' she said. 'We're old, we're in our 70s,' she added, referring to herself and her husband, William. A week later, a representative from the FAIR Plan told her they found the correct check issued by her mortgage company last year, and that the amount has been applied to her reinstated policy. A relief, but there's a remaining problem: The Ryders have already paid into their mortgage company's escrow account for this year's policy. They have not received a refund for the $5,300 check her mortgage company issued to the FAIR Plan last year, so as of now they have paid double for this year's policy. Ryder has not heard back from the FAIR Plan about a possible refund, nor has she received a response from Lara's insurance department. The department said it has assigned someone to her case. McLean said she would not discuss individual cases with CalMatters. 'In the limited instances where the California FAIR Plan is regretfully in error, it works to correct the mistake in its customer's favor,' McLean wrote in an email. 'If the FAIR Plan receives a duplicate payment, the FAIR Plan will refund the duplicate payment with interest.' But Lili Thompson, an account manager for an insurance agency in Chico, told CalMatters that the FAIR Plan often makes errors, and that she has customers who have had experiences similar to Ryder's. When they do, it's hard to get those issues resolved because it's tough to get the plan to address problems in a timely manner, Thompson said. 'We don't have access to billing information, which is constantly incorrect,' Thompson said. 'Payments aren't applied. Or there's a balance of 3 cents, or $4 or $10, and they cancel (policies).' In fact, Thompson submitted a complaint about the FAIR Plan to the Insurance Department in January. It read in part: 'Our agency is having significant problems with the FAIR Plan as a whole. Issues with billing, renewals, cancellations have been reoccurring at an alarming rate.' In an emailed response seen by CalMatters, an insurance department compliance officer urged Thompson to tell her clients to file complaints with the department 'so we can address their specific situation.' CalMatters wrote about similar complaints against the FAIR Plan — delays in payments, slow response times, poor customer service — about a year ago. At the time, McLean said the plan was dealing with increased volume and had hired more staff to deal with it all. She also mentioned that the FAIR Plan had transitioned to a new software system and insurance agents and brokers were still learning it. Asked what the FAIR Plan has changed in the past year, and why the same types of complaints persist, McLean again pointed to the plan's 'historic growth over the past several years,' and mentioned that it has hired even more staff to deal with claims from the January Palisades and Eaton fires. Another bill that addresses the FAIR Plan's financial stability is Assembly Bill 226, aimed at allowing it to spread out claims payments over time. It would do that by allowing the FAIR Plan to obtain bond financing through the California Infrastructure and Economic Development Bank. Assemblymember David Alvarez, co-author of the bill with Calderon and Democrat from Chula Vista, told CalMatters: 'We wanted to make sure if there was an event of (the LA fires') magnitude, insurance companies wouldn't use that as a reason to not cover California.' He added that this legislation is just another 'tool' to 'maintain insurers in California, and get claims paid in a way that doesn't cost consumers.' Alvarez also noted that the bill, which was first introduced last year, had no opposition. The FAIR Plan supports it. Paying claims without full inventories Senate Bill 495, by Sen. Ben Allen, a Democrat from El Segundo, would make California the only state in the nation to require insurers to pay claims in full without first seeing itemized inventories from policyholders. It also gives consumers at least 180 days, up from 60 days, to provide proof of loss to their insurance companies after a declared state of emergency. 'A lot of insurance companies have already been doing this,' the senator said in an interview with CalMatters. 'It's a hassle for them to go through all the (inventory) lists, too.' Allen said he has been going to town halls in his LA-area community and hearing from 'people who have lost everything.' Getting rid of the inventory requirement 'really cuts out an important barrier for a lot of people especially during a very difficult moment,' he said. Lara backs the bill, and last week his department released a list of insurance companies that have agreed to pay at least 75% of contents coverage without a detailed inventory. A majority of companies operating in the state have — with some agreeing to provide 100%. Insurance industry representatives opposed a similar bill in the 2004-05 legislative session and plan to do so again. Rex Frazier, president of the Personal Insurance Federation of California, said the bill could raise costs for insurance companies, which would pass the higher costs on to consumers. 'Why require overpayment and require insurers to increase rates when people are already worried about the affordability of property insurance?' he said. Insurance premium tax write-offs Assembly Bill 1354, by Assemblymembers Heath Flora and Greg Wallis, would allow California taxpayers to write off the rising costs of their fire insurance premiums for the next five years. Flora, of Ripon, and Wallis, of Rancho Mirage, are Republicans. The tax credits would reduce the amount of personal income taxes people would pay to the state. They would be based on the difference between their current premiums and their premiums from 2023, plus any current assessments or charges. If passed, the tax credit would apply to individuals with annual adjusted gross incomes not exceeding $150,000, with the limit being $300,000 for joint taxpayers. Owners of individual homes and properties with four dwelling units or less, and individual condos and mobile homes, would qualify as long as their property values do not exceed $3.3 million. Flora told CalMatters he expects premiums to rise in the short term as the insurance department's new regulations are implemented, but that he hopes it all means insurers will start writing policies in the state again. 'Our insurance industry is in shambles right now,' he said. 'For the next few years it's not going to be great. If we can allow our constituents to write off some of that increase, maybe they can get some sort of relief.' But he doesn't yet know what it would cost the state — and its taxpayers. Flora said he plans to ask the Legislative Analyst's Office to look into it. 'There will be a hit to the general fund,' Flora acknowledged, adding that 'in California, we spend a lot of money on a lot of different things. But fundamentally, people cannot buy homes without insurance.' Amy Bach, executive director of the consumer advocacy group United Policyholders, does not support the bill and said 'if we're going to have insurance companies benefit from taxpayer funds paid toward premiums,' the state should extract some concessions from insurance companies, including getting them to write more policies. Bach said what she is in favor of is tax credits for mitigation expenses. For example, one bill would establish state grants for fire-rated roofs and other expenses, while another would allow for tax-free savings accounts for the purposes of mitigation or deductibles in case of a disaster. Douglas Heller, director of insurance at Consumer Federation of America, agreed, saying taxpayer dollars would be better used preventing catastrophe and loss in the state. Fossil-fuel company liability Senate Bill 222, by Sen. Scott Wiener and several co-authors, would allow insurance companies and individuals to sue fossil-fuel companies over damages from climate-related disasters — part of a wave of efforts to hold the industry responsible for climate change. Hawaii is also considering a similar bill. 'Disasters that are so much more frequent and so much bigger in scale than five to 10 years ago (are) not random,' said Wiener, a Democrat from San Francisco, during a press conference. 'That's because of climate change being fueled by companies.' The idea is that allowing individuals, insurers and the FAIR Plan to try to recoup some costs from disasters would provide an alternative to insurance companies simply raising their rates. A business group that represents insurance companies warned against the legislation, saying it could lead to increased costs for consumers. Though California Business Roundtable does not publicly disclose all its members, it does include executives from the insurance and fossil-fuel industries, said Brooke Armour, president of the California Center for Jobs & the Economy, the group's information arm. Center for Climate Integrity, a co-sponsor of Wiener's bill, has been trying for almost a decade to hold the fossil fuel industry accountable for climate change. Iyla Shornstein, political director at the group, said if nobody holds the oil industry responsible for disaster costs, insurance rates will only continue to 'skyrocket and overburden victims.'
