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Column: This huge insurer got caught flouting a law protecting contraceptive access, but its fine is a joke

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Column: This huge insurer got caught flouting a law protecting contraceptive access, but its fine is a joke

There’s good news and bad news about a legal settlement that New York state just reached with the giant health insurer UnitedHealth over its denial of contraception coverage for a member, which violated state law.

The good news is that UnitedHealth got caught and has been ordered to reimburse the member — and all others in her situation — for the out-of-pocket costs they incurred.

The bad news is that in addition to the reimbursement order, New York Atty. Gen. Letitia James imposed a penalty of only $1 million on the company.

The ability to access birth control and the legal right to it are being threatened by extremists. The threat goes against the will and the desires of the American public, which overwhelmingly supports birth control and overwhelmingly use it.

— Gretchen Borchelt, National Women’s Law Center

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For UnitedHealth, that’s the equivalent of about one-hundredth of a penny based on its annual revenue. In other words, if someone dropped a packet worth of $1 million on the street in front of the company’s chairman, he might not even bend over to pick them up for fear of creasing his trousers.

A couple more bits of bad news: Not only is UnitedHealth a “repeat offender” in breaching contraception access laws (in the words of Gretchen Borchelt of the National Womens Law Center), but it’s also not the only health insurer engaging in sophistry and pretexts to deny members access to birth control in violation of state and federal laws.

The center has documented cases in which Blue Cross and Blue Shield affiliates, the pharmacy benefit manager CVS Caremark, and others have charged customers illegal out-of-pocket payments or imposed prior authorization rules before approving reimbursements for contraceptives.

Vermont regulators last year reported that they discovered 14,000 instances affecting 9,000 residents who were illegally charged for contraceptives that the law required to be dispensed without costs. The state’s three largest health insurers — Blue Cross Blue Shield, MVP Healthcare and Cigna — illicitly shifted $1.5 million in costs for contraceptives, tubal ligations and vasectomies to consumers over the prior two years. The health plans were ordered to reimburse their members.

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In 2022, the House Committee on Oversight and Reform found widespread violations by health plans and pharmacy benefit managers of the Affordable Care Act’s mandates that the full range of FDA-approved birth control be offered to all customers. The committee cited the NWLC’s findings, and specifically queried five of the largest insurers (including UnitedHealth) and four of the largest PBMs to determine whether they were complying with the law.

But that was when the committee was under a Democratic Party majority. Since it came under GOP control last year, it’s been preoccupied with chasing the Hunter Biden case and harassing scientists and government officials as part of a fruitless effort to prove that the COVID-19 pandemic originated in a Chinese lab. So women’s healthcare rights have fallen off its radar screen.

Protecting access to contraceptives is more important today than it has been since 1965, when the Supreme Court guaranteed married couples’ access to contraceptives on privacy grounds in Griswold vs. Connecticut; that decision was augmented in 1972 in Eisenstadt vs. Baird, which extended access rights to single women, and of course by Roe vs. Wade, which brought privacy protections to the right to abortion in 1973.

The Supreme Court overturned Roe vs. Wade two years ago Monday, fomenting sheer chaos and pain and suffering for women in the states that have jumped in to quash abortion rights since that moment.

Politicians and judges in anti-abortion states have been talking about extending the Supreme Court’s abortion ruling to contraception. Supreme Court Justice Clarence Thomas, in a concurring opinion to the Dobbs decision overturning Roe vs. Wade, listed Griswold among the precedents he thinks should be “reconsidered.”

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A popular claim is that contraceptives fall into a ban on the mailing of those products enacted as part of the Comstock Act in 1873.

Past practice and legal tradition relegated the act, which Congress passed at the behest of Anthony Comstock, one of the outstanding bluenoses of American history, to the scrap heap long ago. Most rational legal experts, including those at the Department of Justice, interpret it today as banning the shipment of materials destined for illegal use; since contraceptives are legal nationwide and only 14 states have total abortion bans, it’s maybe hard to make the illegality claim stick.

Nevertheless, the Comstock Act was cited in the ruling by federal Judge Matthew Kacsmarykoutlawing mifepristone for medical abortions and by U.S. 5th Circuit Court of Appeals Judge James C. Ho in his partial dissent from an appellate decision placing some of Kacsmaryk’s ruling on hold; both judges are certified anti-abortion fanatics. The Supreme Court threw out their restrictions on the drug, protecting access nationwide for the present, on June 12.

As recently as June 5, Senate Republicans blocked a Democratic effort to install a right to contraception in federal law. The Democratic measure won 51 votes — a majority, but not enough to forestall a filibuster threat, which would have required 60 votes.

The UnitedHealth case illustrates how contraceptive rights can fall victim to the complexities of America’s fragmented healthcare system, though that’s not an excuse for the company’s legal violation.

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In response to the settlement, UnitedHealth told me by email that it aims for all its members to have “timely access to a variety of high-value and affordable FDA-approved contraceptives when they need them.” It says it provides “access to more than 150 FDA-approved contraceptive options with $0 cost-share.”

Under New York law, that may not be enough. The state requires health plans to provide access to all contraceptive options approved by the Food and Drug Administration without cost-sharing. That goes further than the Affordable Care Act, which requires health plans to provide access to at least one treatment in each of several contraceptive categories “without copays, restrictions, or delays.” California’s Contraceptive Equity Act requires health plans to cover certain birth control methods without copays; voters enshrined rights to abortion and contraceptives in the state Constitution via Proposition 1 of 2022, which passed by a decisive 2-1 majority.

UnitedHealth ran afoul of New York’s law when it denied coverage to a member whose doctor had prescribed Slynd, a progestin-only oral contraceptive. The product is aimed at patients for whom the more conventional estrogen-based birth control is medically unsuitable. The patient filed a complaint with state regulators last year.

UnitedHealth refused to cover the product because of “safety concerns,” according to the state’s settlement. It insisted on prior authorization and step therapy (in which patients are required to try cheaper treatments first) before approving coverage, and continued to deny the patient coverage even after an appeal and queries by the state attorney general and other regulators. The insurer says it has dropped these requirements for Slynd.

The settlement requires UnitedHealth to identify and reimburse all members who were denied contraceptive coverage without copays or restrictions at any time since June 1, 2020, plus 12% annual interest.

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How James and UnitedHealth came to the $1-million penalty isn’t clear — the contraceptive access law itself doesn’t carry a penalty clause, but other potentially relevant state laws do. The attorney general’s office noted that the penalty was imposed after only a single complaint, suggesting that it took the matter seriously.

What is clear, however, is that if the penalty is meant to be a disincentive to deliberately flouting the law or doing so through inaction or inattention, it’s laughable. UnitedHealth collected $371.6 billion in revenue last year — that’s more than $1 billion a day. Of that sum, nearly $291 billion came from insurance premiums. The firm reported more than $29 billion in pretax profits last year.

Imposing unnecessary, burdensome or illegal restrictions on contraceptive access is one way that health insurers or other healthcare providers make themselves complicit in the conservative project to narrow women’s reproductive health options.

It should be remembered, for example, that the drugstore chain Walgreens announced last year that it wouldn’t distribute or ship mifepristone in at least 21 red states, including at least four where abortions remain legal. The company was unnerved by a saber-rattling letter it received from the attorneys general of those states warning vaguely of “consequences” for shipping mifepristone, a drug used to induce abortions. The letter cited the Comstock Act.

Walgreens said in March that it would start distributing the product to physicians, but not directly to patients and not in states where abortion is banned.

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“The ability to access birth control and the legal right to it are being threatened by extremists,” Borchelt says. “The threat goes against the will and the desires of the American public, which overwhelmingly supports birth control and overwhelmingly use it.”

Surveys by the NWLC — and patient complaints filed via its CoverHer hotline — document that restrictions on coverage for legal birth control have been endemic. Some plans have refused to cover products such as the vaginal contraceptive ring or contraceptive patch, arguing that other “hormonal” contraceptives were covered and therefore patients didn’t need access to the ring or patch, which are obviously discrete methods. That was an argument used by UnitedHealth.

Other health plans have covered only certain IUDs, or covered only generic contraceptives even when patients had difficulty tolerating any but brand name products. Women who underwent tubal ligations were told that their insurers would cover only the direct cost of the procedure, but not anesthesia, medications or facility charges. Some have been denied coverage for innovative but FDA-approved birth control methods, such as a hormone-free gel.

Patients denied coverage are often forced to undertake lengthy appeals and continue their efforts through repeated denials.

Whether because it is the nation’s largest health insurer or it has continued to place barriers in the way of members seeking coverage to which they’re entitled by law, UnitedHealth is “one of the insurance companies we hear about most often through our CoverHer hotline as being problematic,” Borchelt says. “They have been on notice that it has been violating the law in numerous ways; while the New York attorney general has done incredible work that will make a real difference for consumers not just in New York, but it shouldn’t have come to this.”

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WGA cancels Los Angeles awards show amid labor strike

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WGA cancels Los Angeles awards show amid labor strike

The Writers Guild of America West has canceled its awards ceremony scheduled to take place March 8 as its staff union members continue to strike, demanding higher pay and protections against artificial intelligence.

In a letter sent to members on Sunday, WGA West’s board of directors, including President Michele Mulroney, wrote, “The non-supervisory staff of the WGAW are currently on strike and the Guild would not ask our members or guests to cross a picket line to attend the awards show. The WGAW staff have a right to strike and our exceptional nominees and honorees deserve an uncomplicated celebration of their achievements.”

The New York ceremony, scheduled on the same day, is expected go forward while an alternative celebration for Los Angeles-based nominees will take place at a later date, according to the letter.

Comedian and actor Atsuko Okatsuka was set to host the L.A. show, while filmmaker James Cameron was to receive the WGA West Laurel Award.

WGA union staffers have been striking outside the guild’s Los Angeles headquarters on Fairfax Avenue since Feb. 17. The union alleged that management did not intend to reach an agreement on the pending contract. Further, it claimed that guild management had “surveilled workers for union activity, terminated union supporters, and engaged in bad faith surface bargaining.”

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On Tuesday, the labor organization said that management had raised the specter of canceling the ceremony during a call about contraction negotiations.

“Make no mistake: this is an attempt by WGAW management to drive a wedge between WGSU and WGA membership when we should be building unity ahead of MBA [Minimum Basic Agreement] negotiations with the AMPTP [Alliance of Motion Picture and Television Producers],” wrote the staff union. “We urge Guild management to end this strike now,” the union wrote on Instagram.

The union, made up of more than 100 employees who work in areas including legal, communications and residuals, was formed last spring and first authorized a strike in January with 82% of its members. Contract negotiations, which began in September, have focused on the use of artificial intelligence, pay raises and “basic protections” including grievance procedures.

The WGA has said that it offered “comprehensive proposals with numerous union protections and improvements to compensation and benefits.”

The ceremony’s cancellation, coming just weeks before the Academy Awards, casts a shadow over the upcoming contraction negotiations between the WGA and the Alliance of Motion Picture and Television Producers, which represents the studios and streamers.

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In 2023, the WGA went on a strike lasting 148 days, the second-longest strike in the union’s history.

Times staff writer Cerys Davies contributed to this report.

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Commentary: The Pentagon is demanding to use Claude AI as it pleases. Claude told me that’s ‘dangerous’

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Commentary: The Pentagon is demanding to use Claude AI as it pleases. Claude told me that’s ‘dangerous’

Recently, I asked Claude, an artificial-intelligence thingy at the center of a standoff with the Pentagon, if it could be dangerous in the wrong hands.

Say, for example, hands that wanted to put a tight net of surveillance around every American citizen, monitoring our lives in real time to ensure our compliance with government.

“Yes. Honestly, yes,” Claude replied. “I can process and synthesize enormous amounts of information very quickly. That’s great for research. But hooked into surveillance infrastructure, that same capability could be used to monitor, profile and flag people at a scale no human analyst could match. The danger isn’t that I’d want to do that — it’s that I’d be good at it.”

That danger is also imminent.

Claude’s maker, the Silicon Valley company Anthropic, is in a showdown over ethics with the Pentagon. Specifically, Anthropic has said it does not want Claude to be used for either domestic surveillance of Americans, or to handle deadly military operations, such as drone attacks, without human supervision.

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Those are two red lines that seem rather reasonable, even to Claude.

However, the Pentagon — specifically Pete Hegseth, our secretary of Defense who prefers the made-up title of secretary of war — has given Anthropic until Friday evening to back off of that position, and allow the military to use Claude for any “lawful” purpose it sees fit.

Defense Secretary Pete Hegseth, center, arrives for the State of the Union address in the House Chamber of the U.S. Capitol on Tuesday.

(Tom Williams / CQ-Roll Call Inc. via Getty Images)

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The or-else attached to this ultimatum is big. The U.S. government is threatening not just to cut its contract with Anthropic, but to perhaps use a wartime law to force the company to comply or use another legal avenue to prevent any company that does business with the government from also doing business with Anthropic. That might not be a death sentence, but it’s pretty crippling.

Other AI companies, such as white rights’ advocate Elon Musk’s Grok, have already agreed to the Pentagon’s do-as-you-please proposal. The problem is, Claude is the only AI currently cleared for such high-level work. The whole fiasco came to light after our recent raid in Venezuela, when Anthropic reportedly inquired after the fact if another Silicon Valley company involved in the operation, Palantir, had used Claude. It had.

Palantir is known, among other things, for its surveillance technologies and growing association with Immigration and Customs Enforcement. It’s also at the center of an effort by the Trump administration to share government data across departments about individual citizens, effectively breaking down privacy and security barriers that have existed for decades. The company’s founder, the right-wing political heavyweight Peter Thiel, often gives lectures about the Antichrist and is credited with helping JD Vance wiggle into his vice presidential role.

Anthropic’s co-founder, Dario Amodei, could be considered the anti-Thiel. He began Anthropic because he believed that artificial intelligence could be just as dangerous as it could be powerful if we aren’t careful, and wanted a company that would prioritize the careful part.

Again, seems like common sense, but Amodei and Anthropic are the outliers in an industry that has long argued that nearly all safety regulations hamper American efforts to be fastest and best at artificial intelligence (although even they have conceded some to this pressure).

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Not long ago, Amodei wrote an essay in which he agreed that AI was beneficial and necessary for democracies, but “we cannot ignore the potential for abuse of these technologies by democratic governments themselves.”

He warned that a few bad actors could have the ability to circumvent safeguards, maybe even laws, which are already eroding in some democracies — not that I’m naming any here.

“We should arm democracies with AI,” he said. “But we should do so carefully and within limits: they are the immune system we need to fight autocracies, but like the immune system, there is some risk of them turning on us and becoming a threat themselves.”

For example, while the 4th Amendment technically bars the government from mass surveillance, it was written before Claude was even imagined in science fiction. Amodei warns that an AI tool like Claude could “conduct massively scaled recordings of all public conversations.” This could be fair game territory for legally recording because law has not kept pace with technology.

Emil Michael, the undersecretary of war, wrote on X Thursday that he agreed mass surveillance was unlawful, and the Department of Defense “would never do it.” But also, “We won’t have any BigTech company decide Americans’ civil liberties.”

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Kind of a weird statement, since Amodei is basically on the side of protecting civil rights, which means the Department of Defense is arguing it’s bad for private people and entities to do that? And also, isn’t the Department of Homeland Security already creating some secretive database of immigration protesters? So maybe the worry isn’t that exaggerated?

Help, Claude! Make it make sense.

If that Orwellian logic isn’t alarming enough, I also asked Claude about the other red line Anthropic holds — the possibility of allowing it to run deadly operations without human oversight.

Claude pointed out something chilling. It’s not that it would go rogue, it’s that it would be too efficient and fast.

“If the instructions are ‘identify and target’ and there’s no human checkpoint, the speed and scale at which that could operate is genuinely frightening,” Claude informed me.

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Just to top that with a cherry, a recent study found that in war games, AI’s escalated to nuclear options 95% of the time.

I pointed out to Claude that these military decisions are usually made with loyalty to America as the highest priority. Could Claude be trusted to feel that loyalty, the patriotism and purpose, that our human soldiers are guided by?

“I don’t have that,” Claude said, pointing out that it wasn’t “born” in the U.S., doesn’t have a “life” here and doesn’t “have people I love there.” So an American life has no greater value than “a civilian life on the other side of a conflict.”

OK then.

“A country entrusting lethal decisions to a system that doesn’t share its loyalties is taking a profound risk, even if that system is trying to be principled,” Claude added. “The loyalty, accountability and shared identity that humans bring to those decisions is part of what makes them legitimate within a society. I can’t provide that legitimacy. I’m not sure any AI can.”

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You know who can provide that legitimacy? Our elected leaders.

It is ludicrous that Amodei and Anthropic are in this position, a complete abdication on the part of our legislative bodies to create rules and regulations that are clearly and urgently needed.

Of course corporations shouldn’t be making the rules of war. But neither should Hegseth. Thursday, Amodei doubled down on his objections, saying that while the company continues to negotiate and wants to work with the Pentagon, “we cannot in good conscience accede to their request.”

Thank goodness Anthropic has the courage and foresight to raise the issue and hold its ground — without its pushback, these capabilities would have been handed to the government with barely a ripple in our conscientiousness and virtually no oversight.

Every senator, every House member, every presidential candidate should be screaming for AI regulation right now, pledging to get it done without regard to party, and demanding the Department of Defense back off its ridiculous threat while the issue is hashed out.

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Because when the machine tells us it’s dangerous to trust it, we should believe it.

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Why companies are making this change to their office space to cater to influencers

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Why companies are making this change to their office space to cater to influencers

For the trendiest tenants in Hollywood office buildings, it’s the latest fad that goes way beyond designer furniture and art: mini studios

To capitalize on the never-ending flow of stars and influencers who come through Los Angeles, a growing number of companies are building bright little corners for content creators to try products and shoot short videos. Athletic apparel maker Puma, Kim Kardashian’s Skims and cheeky cosmetics retailer e.l.f. have spaces specifically designed to give people a place to experience and broadcast about their brands.

Hollywood, which hasn’t historically been home to apparel companies, is now attracting the offices of fashion retailers, says CIM Group, one of the neighborhood’s largest commercial property landlords.

“When we’re touring a space, one of the first items they bring up is, ‘Where can I build a studio?’” said Blake Eckert, who leases CIM offices in L.A.

Their studio offices also serve as marketing centers, with showrooms and meeting spaces where brands can host proprietary events not open to the public.

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“For companies where brand visibility is really important, there is a trend of creating spaces that don’t just function as offices,” said real estate broker Nicole Mihalka of CBRE, who puts together entertainment property leases and sales.

Puma’s global entertainment marketing team is based in its new Hollywood offices, which works with such musical celebrity partners as Rihanna, ASAP Rocky, Dua Lipa, Skepta and Rosé, said Allyssa Rapp, head of Puma Studio L.A.

Allyssa Rapp, director of entertainment marketing at Puma, is shown in the Puma Studio L.A. The company keeps a closet full of Puma products on hand to give VIP guests. Visits to the studio sanctum are by invitation only, though.

(Kayla Bartkowski / Los Angeles Times)

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Hollywood is a central location, she said, for meeting with celebrities, stylists and outside designers, most of whom are based in Los Angeles.

The office is a “creation hub,” she said, where influencers can record Puma’s design prototyping lab supported by libraries of materials and equipment used to create Puma apparel. The company, founded in 1948, is known for its emblematic sneakers such as the Speedcat and its lunging feline logo, and makes athletic wear, accessories and equipment.

Puma’s entertainment marketing team also occupies the office and sometimes uses it for exclusive events.

“We use the space as a showroom, as a social space that transforms from a traditional workplace into more of an experiential space,” Rapp said.

Nontraditional uses include content creation, sit-down dinners, product launches, album listening parties and workshops.

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“Inviting people into our space and being able to give them high-touch brand experiences is something tangible and important for them,” she said. “The cultural layer is really important for us.”

The company keeps a closet full of Puma products on hand to give VIP guests. Visits to the studio sanctum are by invitation only, though. There’s no retail portal to the exclusive Hollywood offices.

Puma shoes are on display in the Puma Studio L.A.

Puma shoes are on display in the Puma Studio L.A.

(Kayla Bartkowski / Los Angeles Times)

Puma is also positioning its L.A studio as a connection point for major upcoming sporting events coming to Los Angeles, including the World Cup this summer, the 2027 Super Bowl and 2028 Olympics.

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In-office studios don’t need to be big to be impactful, Mihalka said. “These are smaller stages, closer to green screen than a massive soundstage.”

Social media is the key driver of content created by most businesses, which may set up small booth-like stages where influencers can hawk hot products while offering discounts to people watching them perform.

Bigger, elevated stages can accommodate multiple performers for extended discussions in front of small audiences, with towering screens behind them to set the mood or illustrate products.

Among the tricked-out offices, she said, is Skims. The company, which is valued at $5 billion, is based in a glass-and-steel office building near the fabled intersection of Hollywood Boulevard and Vine Street.

The fashion retailer declined to comment on the studio uses in its headquarters, but according to architecture firm Odaa, it has open and private offices, meeting rooms, collaboration zones, photo studios, sample libraries, prototype showrooms, an executive lounge and a commissary for 400 people.

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Pieces of a shoe sit on a workbench in the Puma Studio L.A.

Pieces of a shoe sit on a workbench in the Puma Studio L.A.

(Kayla Bartkowski / Los Angeles Times)

The brands building studios typically want to find the darkest spot on the premises to put their content creation or podcast spaces, Eckert said, where they can limit outside light and sound. That’s commonly near the center of the office floor, far from windows and close to permanent shear walls that limit sound intrusion.

They also need space for green rooms and restrooms dedicated to the talent.

Spotify recently built a fancy podcast studio in a CIM office building on trendy Sycamore Avenue that is open by invitation-only to video creators in Spotify’s partner program.

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“Ambitious shows need spaces that support big ideas,” Bill Simmons, head of talk strategy at Spotify, said in a statement. “These studios give teams room to experiment and keep pushing what’s possible.”

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