Analysis Politics

The Snake Oil Salesman: Author of Heritage Foundation Immigration Report Touted Failed Ab-Only Policies

Jodi Jacobson

Marco Rubio said the Heritage Foundation's work on immigration is "not a legitimate study." He's right. The author of the study, Robert Rector, has a long history of producing studies of questionable legitimacy.

You know something’s rotten in Denmark, or, well, far closer to home at the Heritage Foundation, when one of the leading contenders for the 2016 GOP presidential nomination calls a study by the think tank “deeply flawed.” That was the opinion expressed by Florida GOP Sen. Marco Rubio when asked about a new Heritage Foundation report asserting, among other things, that immigration reform would cost taxpayers $6.3 trillion, a finding contrary to virtually every other study on immigration showing net economic gains.

Rubio was joined in his criticism of the Heritage report by former Mississippi Gov. Hayley Barbour as well as former GOP vice presidential candidate and Congressman Paul Ryan (R-WI), who stated, “The Congressional Budget Office has found that fixing our broken immigration system could help our economy grow. A proper accounting of immigration reform should take into account these dynamic effects.”

It is highly unusual for GOP leading lights to so loudly and forcefully criticize not only the Heritage Foundation but by extension its new president, former GOP Sen. Jim Demint, who is credited at least in part with helping Rubio rise to national prominence. And it certainly doesn’t help recent GOP re-branding efforts that Jason Richwine, one of the report’s authors, espouses what can only be called racist views, claiming at one point that immigrants to the United States have lower IQs than the “white native population.”

But the GOP is in a panic of its own making. Concerted efforts across the country to disenfranchise voters in the 2012 election combined with the open animosity shown by many GOP and Tea Party politicians toward new and aspiring Americans have dimmed the GOP’s long-term electoral prospects. So now, the party that has relied on cooking data to bolster false arguments on everything from climate change to women’s health is having a fit about the most recent product coming out of the Heritage Foundation kitchen. So upset are aspiring presidential candidates such as Rubio that he asserted Heritage’s work on immigration is “not a legitimate study.” It’s an interesting use of language because Robert Rector, the study’s lead author, has a long history of producing studies of questionable legitimacy.

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Rector is a senior research fellow at the Heritage Foundation and has long been known for his advocacy of abstinence-only-until-marriage programs. Over the years, Rector conducted “analyses” of abstinence-only-until-marriage programs used by the GOP to push for federal funding of those programs, which well exceeded $1.5 billion over the course of the last ten years. He claimed abstinence-only-until-marriage programs reduce sexual activity, “out-of-wedlock” childbearing, and sexually transmitted infections (STIs) and that they promote personal responsibility and marital commitment. In one paper he wrote, “There are 10 scientific evaluations showing that real abstinence programs can be highly effective in reducing early sexual activity.”

Rector’s analyses, however, were severely criticized by numerous experts in the field. For example, in a 2002 paper by the National Campaign to Prevent Teen Pregnancy examining Rector’s claims, Douglas Kirby, a highly-regarded researcher in the field of adolescent health and behavior, wrote:

In sum, of the ten studies identified by the Heritage Foundation paper as providing proof that their respective programs reduced early sexual activity, nine of them failed to provide credible evidence … that they delayed the initiation of sex or reduced the frequency of sex.

One of the studies suggests that the program, Not Me, Not Now, may have delayed the initiation of sex among youth 15 and younger, but not among those 17 and younger.

Kirby noted that Rector’s evaluation relied on studies that did not meet the established criteria for evidence or peer review, so it was impossible to know whether one or another program could claim efficacy.

Likewise, in a 2006 review article in the Journal of Adolescent Health, Columbia University professor Dr. John Santelli (M.D., MPH) and his colleagues specifically critiqued evaluations of data performed by Rector on both abstinence-only curricula and virginity pledges. Regarding the ten “scientific evaluations” Rector cited supporting ab-only, Santelli and his colleagues wrote:

A review by Robert Rector identified 10 evaluations of AOE [abstinence-only education] programs that appeared to demonstrate behavior change as a result of program participation. However, few of these evaluations met the minimum scientific criteria listed above [in the article], and all contained flaws in methodology or interpretation of the data that could lead to significantly biased results. A review of 10 state program evaluations by Advocates for Youth found no evidence of an impact on adolescent sexual behavior.

Rector also tried to claim that those who took virginity pledges were less likely to contract sexually transmitted infections. But as Santelli et al., wrote:

Robert Rector of the Heritage Foundation has reanalyzed the Add Health data and severely criticized the Bruckner study in a recent presentation. However, the Rector study has not undergone peer review and it, in turn, has been severely criticized for manipulating statistical norms for significance. A serious flaw in this analysis was the use of self-reported STIs, instead of laboratory-reported infections as used in the Bruckner study. This is problematic given that many STIs are asymptomatic and pledgers were less likely to be tested for STIs.

A federally supported evaluation of abstinence-only-until-marriage programs funded under the 1996 federal welfare reform law provided further evidence that Rector’s and the Heritage Foundation’s claims about abstinence-only programs were highly over-blown. A press release from the Sexuality Information and Education Council of the United States (SIECUS) stated that the report, conducted by Mathematica Policy Research Inc. on behalf of the U.S. Department of Health and Human Services, “found no evidence that abstinence-only programs increased rates of sexual abstinence. Also, students in the abstinence-only programs had a similar number of sexual partners as their peers not in the programs, as well as a similar age of first sex.”

William Smith, then the vice president for public policy at SIECUS, stated:

In 1996, the federal government attached a provision to the welfare reform law establishing a federal program for abstinence-only-until-marriage programs. This program, Section 510(b) of Title V of the Social Security Act, dedicated $50 million per year to be distributed among states that choose to participate. States accepting the funds are required to match every four federal dollars with three state-raised dollars (for a total of $87.5 million annually, and $787.5 million for the eight years from fiscal year 1998 through 2006). Programs that receive the Title V funding are prohibited from discussing methods of contraception, including condoms, except in the context of failure rates.

Advocates for Youth, a leader in advocating for medically accurate sexual health education, also detailed numerous problems with ab-only programs and with Rector’s analyses of these programs.

So Rector’s work at the Heritage Foundation was used to support throwing taxpayer money at programs with no proven efficacy, programs which denied (and in many states continue to deny) teens access to medically accurate information on sex, sexual health, and prevention. Ironic then that one of Rector’s greatest concerns about immigration is his claim regarding how much taxpayer money will be needed to provide benefits to individuals entering the country.

Robert Rector clearly does not have a stellar record on research and analysis. But his work on immigration is being widely criticized by the GOP now simply because of the political costs to the party of appearing to be anti-immigrant. With ab-only, it well-suited the far right to dump millions of dollars into disproven programs because those funds were going to religious groups that used the money to proselytize, and to political allies in the anti-choice movement only too happy to run programs that promoted “traditional values,” such as telling rape victims they were “asking for it.”

According to SIECUS, when the Mathematica study came out disproving Rector’s work, the response by both Heritage and Rector was to “spin, spin, spin.” SIECUS noted that on a call organized by the Abstinence Clearinghouse, “abstinence-only proponents were clearly rocked by the potentially ruinous news in the report.”

High profile abstinence-only advocate, Robert Rector, led the preemptive damage-control planning. He outlined several strategies the abstinence-only movement could use to rationalize the findings in the report saying, “The other spin I think is very important is not [program] effectiveness, but rather the values that are being taught,” Rector said.

Heritage is now undertaking the same strategy of damage control on the immigration report. In what Politico called a “significant move,” the think tank is considering hiring an outside communications firm to handle the blow back.

But no amount of spin can change the fact that the Heritage Foundation and Robert Rector were selling snake oil then, and are selling snake oil now.

Culture & Conversation Media

‘Winning Lies Not in a Single Victory,’ Writes Author of Buoyant New Book on Activism

Eleanor J. Bader

An inspiring—if perhaps overly optimistic—book, When We Fight We Win!: Twenty-First-Century Social Movements and the Activists That Are Transforming Our World, showcases six areas in which progressive shifts have already happened or are possible thanks to long-range activism and political vision.

On any given day, all it takes is a quick look at the headlines to see the sorry state of world politics: Hunger, poverty, war, environmental degradation, campus shootings and stabbings, child abuse and neglect, and police brutality are just some of the atrocities that make the future seem bleak, if not hopeless.

But not everyone is filled with despair.

For one, Schott Foundation for Public Education Board Co-Chair Greg Jobin-Leeds, himself a seasoned Cambridge, Massachusetts-based community organizer, sees numerous possibilities in today’s political morass. Indeed, his inspiring—if perhaps overly optimistic—new book, When We Fight We Win!: Twenty-First-Century Social Movements and the Activists That Are Transforming Our World, showcases six areas in which he believes progressive shifts have already happened or are possible thanks to long-range activism and political vision. These include campaigns for LGBTQ equality; efforts to preserve and defend public education; challenges to mass incarceration and prison privatization; immigrant rights; and the promotion of economic and environmental justice. Each section includes interviews and case studies, as well as illustrations by members of AgitArte, an activist art collective with chapters in Puerto Rico and Massachusetts, underscoring the role of visual culture in popularizing activism.

“I asked leaders of … thriving social movements, ‘What are the lessons you’ve learned that you would like to pass on to new activists?'” Jobin-Leeds writes in an introduction to the text. Eager to parse organizing strategies and better understand the incremental steps that lead to bigger, bolder victories, Jobin-Leeds interrogates what successful campaigners have done to increase the likelihood of victory, and questions how they remain upbeat despite working in a less-than-progressive political milieu. He was not looking for conformity, he writes: Instead, he was eager to capture a range of organizing experiences.

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In the book’s foreword, for example, Rinku Sen, publisher of Colorlines and president and executive director of Race Forward: The Center for Racial Justice Innovation, takes a measured approach when compared with Jobin-Leeds’ buoyant point of view. She notes the enormity of challenging the status quo, writing, “Whether or not we win will be based on many things other than our own strategy and strength. Even strong, huge movements sometimes fail.” She continues, “There is, however, no path to victory without trying.”

Tapping into the desire to push back rather than fold in the face of obstacles is at the heart of When We Fight We Win! and Jobin-Leeds spent years interviewing activists to try and determine why they feel compelled to do this work. He also wanted to better understand how movements can create real and enduring change; tease out strategies that are consistently successful; and find effective tools to deflect apathy. These in-depth interviews supplement Jobin-Leeds’ more general points and give a hands-on immediacy to the stories and research he presents.

His introduction sets the stage and posits the benefits gleaned from organizing:

When we fight—building an organization, joining a community of activists—we win not only communal victories but also our own personal transformation, enabling us to discover common root causes to problems that had seemed unconnected before. Understanding root causes can ally us with others—across issues, cultures, identities. This aggregates individual fights into broad movement struggles, and by working in solidarity together we can realize far-reaching, systemic change. Winning lies not in a single victory, but in many victories and the lifelong struggle to change injustice and create a future based on a bold, transformative vision.

This philosophy, of course, requires us to celebrate incremental wins, no matter how small. It also requires us to acknowledge the enormous rush that comes from disrupting business-as-usual and its powerful enforcers. After all, if fighting back is joyless, why do it?

Case in point: the movement for LGBTQ equality.

Jobin-Leeds reminds us that five decades ago, sodomy was a crime in every U.S. state and the idea of marriage equality was a pipe dream writ large. So what happened? In a word, he says, AIDS: an unanticipated health crisis and mass tragedy that gave the LGBTQ community new prominence in the public eye. Rea Carey, executive director of the National LGBTQ Task Force, tells Jobin-Leeds that when people started becoming ill, “There were a lot of men—including men in urban areas who had some level of class or race privilege—who were being denied access to their partners as they were dying in hospitals because they weren’t ‘family.’” Their stories of emotional trauma were heartbreaking and led, years later, to a demand that their relationships be recognized and validated.

Evan Wolfson, founder and president of Freedom to Marry, agrees with Carey, adding, “AIDS broke the silence about gay people’s lives and really prompted non-gay people to think about gay people in a different way. It prompted gay people to embrace this language of inclusion, most preeminently marriage. That, in turn, accelerated our inclusion in society and the change in attitudes.”

AIDS’ public accounting of love and loss presaged a dramatic shift in assumptions and ideas about what it meant to be queer. It also went hand-in-hand with thrillingly defiant public actions in streets, pharmaceutical company boardrooms, and government offices throughout the country.

Of course, homophobia has not been eradicated; nor has AIDS stigma. But as a result of ACT UP and other queer-led organizations, access to life-changing drugs increased. In addition, as family and friends pushed their way into hospital rooms, the broadening of the definition of “kin” took root: Jobin-Leeds and his activist contacts theorize that this is part of what eventually led to marriage equality. All of this is surely worth celebrating; at the same time, progressives understand that the right to wed is but one demand on a long roster of LGBTQ needs.

As Carey explains, “We can’t ask someone to be an undocumented immigrant one day, a lesbian the next, and a mom on the third day … Our vision is about … transforming society so that she can be all of those things every single day and that there would be a connectedness among social justice workers and among the organizations and agendas, if you will, to make her life whole.”

These linkages, Carey said, have led the Task Force to work on a range of issues, including criminal justice reform, liberalized immigration, public education, and economic justice—issues that, she says, the largely white male activists who founded the Task Force initially considered tangential to LGBTQ rights.

Still, both Carey and others stress that not every campaign will result in victory. Paulina Helm-Hernández of Southerners on New Ground (SONG) tells Jobin-Leeds about a 2012 campaign against a same-sex marriage ban in North Carolina, a battle she says the activists anticipated losing. Nonetheless, SONG committed itself to reaching one million people to discuss “the future of our state, and about the divisive tactics of the Right, and about the reality of how integrated LGBT communities in North Carolina actually are to immigrant communities, to other communities of color—it really just became a huge opportunity for us, and I would say a success in terms of helping not just amplify the grassroots organizing that makes moments like that possible, but to say it does matter.” In essence, despite losing the war, they won what they hope will be lasting personal connections with local residents.

What’s more, Helm-Hernández emphasizes another secondary gain: When other folks saw that it was possible for individuals and organizations to stand up and speak out, it empowered them to do likewise.

Among today’s most motivated activists, Jobin-Leeds writes, are the DREAMers, young immigrant women and men whose efforts have led many people to think differently about immigration policy. Although Jobin-Leeds concedes that the United States has still not enacted meaningful reform, he reports that hundreds of immigrant youth have bravely declared themselves not only undocumented, but unafraid. They’ve told their stories, and those of their parents and grandparents, to audiences throughout the country—as well as before Congress—and their efforts have begun to pay off. The New York Times, for one, has stopped using the term “illegal” to describe undocumented people, and several states now allow undocumented residents to pay in-state tuition rates, a change that has allowed many to enroll in two- and four-year degree programs.

“DREAMers from across the country have profoundly changed the national discourse and influenced organizing tactics around immigration—catapulting an issue forward,” Jobin-Leeds reports. “Storytelling combined with direct action transforms people into activists.”

And although obtaining citizenship for the approximately 11 million undocumented U.S residents is proving difficult in today’s political climate, Jobin-Leeds writes that it remains a long-term goal.

Like the DREAMers, activists working on other issues also sometimes set their sights on local gains—targeting a recalcitrant landlord or a bank that is threatening foreclosure, for example—rather than attempting to change national policy, and Jobin-Leeds chronicles the successful efforts of the Boston-based City Life/Vida Urbana to create eviction-free zones in low-income areas. Similarly, the Restaurant Opportunities Centers United have driven companies like the Fireman Hospitality Group to settle claims for back wages and tips, and develop policies to curtail sexual harassment and discrimination. Equally significant, environmental groups such as 350.org have pushed colleges and philanthropies to divest from the fossil fuel industry.

Drops in the bucket? Maybe. But as the organizers in When We Fight We Win! repeatedly remind readers, small changes often lead to bigger ones. Furthermore, organizing requires us to take a long view of history to forestall becoming demoralized. After all, given today’s Republican assault on reproductive justice; the overt expressions of racism and xenophobia by political office holders, presidential candidates, and everyday individuals; the non-stop push to privatize once-public services; and our seemingly endless involvement in numerous wars, it’s easy to feel overwhelmed, angry, and powerless.

When We Fight We Win! admits this, albeit indirectly, and recognizes that there are no guaranteed victories. Nonetheless, the book enthusiastically celebrates activism as personally and politically invigorating. Indeed, when all is said and done, we have two choices: We can either accept the current state of affairs or try to foment change. If we opt for the latter, we may not win everything we dream of, but at least we’ll know we tried. Isn’t that better than languishing in grief and anger?

Analysis Health Systems

How Workers’ Comp Policies Leave Women to Fend for Themselves

Jean Stevens

"It's ironic and stunning that, on the one hand, we’ve seen incredible progress for women, yet on the other hand, they’re inundated with little bits of discrimination and people don’t really realize it," said Jenny Schwartz, partner at Outten & Golden, a national employment law firm.

Shortly after receiving a diagnosis of Stage 1 breast cancer in 2012, Janice Page of San Diego was surprised when her boss told her that she should file a claim for workers’ compensation—payments from an employer to compensate a worker who suffers a job-related injury. Page, a county sheriff and first responder to chemical fires, explosions, gas spills, and other emergencies, didn’t know much about it. Still, she took her employer’s advice, and when her state-appointed doctor determined that her cancer would not qualify her to receive any workers’ compensation, something felt off.

Page contacted an attorney, and learned that if she’d been a man diagnosed with prostate cancer, she’d automatically be entitled to substantial benefits.

“I don’t think it’s fair at all, and it’s not right,” said Page, who recently testified to California Assembly members about her experience when the assembly was considering new legislation to ban gendered assessments in workers’ compensation claims. She’d undergone multiple surgeries, a mastectomy, and reconstruction as a result of treating her cancer. “I don’t want another woman to have to deal with what I’m dealing with.”

Despite Page’s story, and evidence that more than 9,000 claimants annually would be affected by this change in the law, California Gov. Jerry Brown vetoed the legislation—called AB 305—on October 6, cowing to pressure from corporate and compensation insurance industry lobbyists threatened by the possible added protection to injured workers. The bill’s veto serves not only as a strike against women, but also a convenient strike against workers in the escalating corporate war on workers’ compensation.

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AB 305 and Its Implications

Introduced by Assemblywoman Lorena Gonzalez (D-San Diego) in March, AB 305 would have amended California’s labor law as it involves state-hired doctors who evaluate workers for workplace compensation claims. Under three amendments, the bill would bar doctors from factoring gendered medical conditions of menopause and pregnancy into their evaluations of an injury when those conditions had no proven impact on their injury. Doctors could also not factor in workplace sexual harassment, menopause, or pregnancy to the case of a worker who suffered a workplace psychiatric injury if that injury arose at the same time of the harassment, menopause, or pregnancy. Finally, it would have forced doctors to rate prostate and breast cancer equally in their evaluations.

Gonzalez and the bill’s supporters, including the California Democratic Caucus, workers’ groups, and many of the state’s women’s groups, believe the administration’s denial reflects a greater war on women in the workplace. While workplace discrimination such as this hardly resembles the explicit forms faced by women workers in the past, it still manifests in various ways, including in workers’ compensation decisions, said Jenny Schwartz, partner at Outten & Golden, a national employment law firm.

“It’s ironic and stunning that, on the one hand, we’ve seen incredible progress for women, yet on the other hand, they’re inundated with little bits of discrimination and people don’t really realize it,” Schwartz said. “In order to achieve gender equity in the workforce, the whole point is to diligently attack each and every occurrence which is perceived to be a smaller type of discrimination. It’s a bit like whack-a-mole.”

AB 305 inspired a heated “boobs and prostate debate” among lawmakers and pundits, as the bill would require workers’ compensation doctors to rate the diagnosis of breast cancer and prostate cancer equally. Under current California law, which is based on a system of guidelines by the American Medical Association (AMA), workers with prostate cancer resulting from their work conditions receive a 16 to 20 percent disability rating. Workers diagnosed with breast cancer “of childbearing age” only receive a 5 percent rating and those of “non-childbearing age,” like Page, have a 0 percent rating, said Christel Schoenfelder, workers’ compensation attorney at Rose, Klein & Marias LLP and president-elect of the California Applicants’ Attorneys Association.

“Imagine a 60-year-old female firefighter who’s been fighting fires and been in the front lines,” Schoenfelder said. “She’s diagnosed with breast cancer and it’s related to toxic exposure. When the doctor goes to calculate her percentage of permanent disability, she’d get nothing, because she’s not a woman of childbearing age. Now, in the same situation, but a man [with prostate cancer], he gets 16 percent to 20 percent. If he’s incontinent, he gets another percent increase. If sexual dysfunction, another.”

To AB 305 supporters, this gendered distinction indicates that AMA guidelines only value breasts in the context of child-rearing; they have no other purpose, and in turn, their loss has little effect. It ignores the side effects of breast cancer and mastectomies, Page said, including physical pain, numbness, reduced range of motion, psychological anguish, post-traumatic stress disorder, and loss of sense of self and identity.

“If a man had his balls removed and had plastic ones put there, how would he feel?” Page said. “If they had been removed, I’m sure it would be psychologically [damaging] to them, too.”

AB 305’s second proposed change to the California labor code sparked far less excitement, but the need behind it feels equally infuriating to supporters. Under current state workers’ compensation law, a person who cannot work at all because of the job injury is considered permanently disabled. State-appointed doctors examining a woman worker who has been injured are entitled to credit—or apportion—some of their injury to menopause and pregnancy, even if that person never felt any side effects or health problems from these conditions before their on-the-job injury, Schoenfelder said. In turn, these women receive less compensation from their employer. In other words, male workers facing certain injuries would receive full benefits, but injured women workers would automatically have their benefits reduced if it is possible their injury results from menopause or pregnancy, even if there is no indication of these conditions. AB 305 would forbid doctors from apportioning injuries to these conditions. It would also prevent them from factoring in psychiatric disabilities caused by these conditions, and sexual harassment resulting from these conditions.

“It’s when something is asymptomatic, and maybe the person doesn’t even know she has it, and it hasn’t even hampered your job,” Schoenfelder said. “These are not actual causes [of an injury], but risk factors. That’s what makes it discriminatory.”

Schoenfelder, rifling through files in her office during one recent phone call, read aloud from one report from 2014 where a doctor evaluated a worker with “common gender nonoccupational risk” and reduced her rating by 20 percent. In another 2015 report of a worker with a shoulder rotator cuff injury, she said, the doctor observed “calcium deposits in a rotator cuff,” but blamed 50 percent of it on “genetic predisposition,” as women are more likely to have such deposits. Then 50 percent of her disability was reduced. She added that other reports include doctors tying workplace injury symptoms to pregnancy and breastfeeding, even when symptoms occurred before workers became pregnant.

“I have never seen a report where a doctor has specifically said, ‘men get this more often, so I’ll apportion about 50 percent because I know statistically men get this more,'” Schoenfelder said. “When conditions cited by doctors are exclusive to women, then it becomes that being female is a preexisting condition.”

Gov. Brown rejected this thinking, however, claiming that these sorts of evaluations are valid. He wrote in his “veto message” that AB 305 “is based on a misunderstanding of the American Medical Association’s evidence-based standard, which is the foundation for permanent disability ratings, and replaces it with an ill-defined and unscientific standard.”

It’s a curious position, given that doctors in California and many other states make these evaluations based on the AMA guidelines, which is an inherently man-made system. Individual body parts receive greater “worth” and compensation, with required surgeries and “hardware” earning more. (Other states, including New York and Florida, have created their own system to evaluate disability.)

“That system is not really all that scientific to begin with,” said Julius Young, partner at Boxer & Gerson, LLP in Oakland, explaining that the guidelines are built around a conception of ‘whole person impairment” and ability to perform daily life activities with a certain injury, and this is given an arbitrary percentage. “[Brown’s] saying that it’s undefined and unscientific is a little ironic. People who were putting these things together maybe didn’t believe in certain conditions. They probably didn’t think about women losing their breasts. [It’s] changed over time with different editions.”

Young, who followed AB 305 since its introduction at his blog WorkersCompZone.com, believes the veto makes sense in the current California political climate around workers’ compensation. After a spike in workers’ comp claims in 2003, he explained, the state passed some reforms that were quite popular with insurance providers. Under those reforms, a doctor was required to express an opinion of all the possible causes for injury. This led to doctors “splitting up a pie,” as Young explained, for example, attributing one-third of the injury as a direct result to what happened while on the job, one-third to a prior injury, and one-third to aging process and osteoporosis. Subsequent rising costs, however, led to greater reforms in 2012, but no one remains satisfied.

“It’s really an issue that keeps coming back,” Young said. “[And I think] Jerry Brown doesn’t want to see this [workers’ compensation bill] become a front-page issue.”

The veto, then, represents another strike by businesses in their campaign against workers’ compensation.

“Employers are doing everything they can to reduce costs of workers’ comp,” said Paula Brantner, executive director of Workplace Fairness, a nonprofit public education and advocacy organization that provides workers’ rights information. “If they can screw their workers, keep wages flat, keep benefits flat, cut health care, they will,” she said. To fight it, advocates and workers must step forward and bring the most egregious examples to light.

Left to Fend for Themselves

States nationwide have slashed workers’ compensation benefits within the past ten years, according to a recent ProPublica and NPR investigation of insurance industry data, state laws, and court and medical records. Employers pay less in compensation today than any time in the past 25 years, and California and Oklahoma tied for the most cuts since 2014, the study found. Federal workers’ compensation mandates put in place in 1972 are mostly dissolved: Gone are the years where injured workers could pick their own doctors, receive compensation for all the years of their disability, or, if they died due to their injury, ensure that their spouses would receive death benefits until remarriage and their children would receive tuition benefits through college graduation.

According to the ProPublica study, legislators from California, West Virginia, North Dakota, and Oklahoma have imposed two-year time limits on claims made by temporarily disabled workers, even if they still cannot work after those two years. In another ProPublica investigation that NPR released in October, Oklahoma and Texas—and possibly soon Tennessee and South Carolina—have passed laws allowing employers to “opt out” of workers’ compensation completely. Employers then create their own workplace injury plans, which, according to the investigation, “generally cover fewer injuries, cut off benefits payments sooner, control access to doctors and even impose mandatory settlements.” Employers in those states, including Costco, Taco Bell, and Sears, have “opted out” of workers’ compensation to create their own plans when workers become injured. Under their opt-out plans, employers may refuse to cover the cost of basic injuries, like work-related infections, and deny benefits if injuries are not reported within the same shift when the injury occurs, preventing workers from making a claim if they only realize later on the full scope of their injury. They also require that company representatives accompany injured workers to doctor’s appointments so as to monitor or interpret what doctors say. Even worse, these plans do not provide an option to appeal to a third party or court, unlike in the current system, which has due process protections built in. Opponents consider it a return to the Industrial Revolution “when workers and their families had to sue their employers or bear the costs of on-the-job injuries themselves.”

Workers receiving less are now turning to welfare and other government programs, including disability benefits through Social Security, which opponents to these plans argue puts a greater burden on the government, and in turn, taxpayers. Today, families and their own private health insurance pay for about 63 percent of their lost wages and medical costs of work injuries, while workers’ compensation payments covers only about 21 percent of lost wages and medical costs of work injuries and illnesses, according to a 2015 study by the U.S. Department of Labor’s Office of Safety and Health Administration. Taxpayers cover the rest. In addition, 97 percent of workers with occupational illnesses receive no compensation, mostly because doctors do not diagnose them as work-related.

Left to fend for themselves in court based on the current law, many injured women workers could not effectively challenge workers’ compensation decisions for their injuries when doctors unfairly factored in menopause, pregnancy, or sexual harassment, or minimized their breast cancer. They typically must hire an attorney. But not all workers can afford legal help, leaving these individuals to face discrimination at a disproportionate disadvantage.

“Any employee in California can be subjected to the workers’ comp system at any moment,” Schwartz said. “If you’re poorly educated or from a lower socioeconomic group, or struggling with economic issues, and you’re not represented by counsel, you’ll have to accept what happens through the system.”

CORRECTION: A previous version of this article misspelled the Workplace Fairness executive director’s name. It’s Paula Brantner, not Branter. We regret the error.