California has led the nation with the biggest drop in the uninsured of any state (from 7 million to 3 million) by implementing and improving on the Affordable Care Act. Our coalition seeks the additional, bold steps needed to achieve a universal health care system that is affordable, accountable, and equitable to all Californians. Over 70 organizations have joined together to win Care4All California in the next few years, despite obstacles posed by the federal government. Below are the legislative and budget items proposed by the coalition this year that were passed and enacted, as well as the legislation that we will continue to pursue in future years.


Everybody benefits when everyone is covered, sharing in the cost of care, and getting primary and preventive services to stay healthy. Specific state budget and policy steps can remove exclusions in our public programs and increase affordability to allow more people to access care.

In the 2019-20 State Budget, California Governor Gavin Newsom and the Legislature agreed to include several significant investments in health care, including some first-in-the-nation steps that provide a down payment to get to near universal coverage, which were aligned with many proposed legislative bills:

  • Expanded Medi-Cal to all young adults regardless of immigration status, toward the goal of #Health4All: SIGNED. Pending legislation would take additional steps to open up Medi-Cal to income-eligible seniors and other undocumented Californians: SB 29 (Durazo), AB 4 (Arambula, Bonta, Chiu, Santiago, Gonzalez) (two-year bills) [Co-Sponsored by California Immigrant Policy Center and Health Access California]
  • Increased affordability assistance in Covered California: SIGNED. The state budget increases and extends the ACA’s affordability assistance up to 600% of poverty level which in a high cost-of-living state will help more Californians get covered and reduce their premiums and cost-sharing. [Formerly SB 65 (Pan)]. AB 174 (Wood), requires reporting on the subsidies [Sponsored by Health Access California]
  • Maintaining stability in individual market and prevent premium spikes by implementing a state individual mandatepenalty, improving affordability in Covered California and encouraging enrollment. SIGNED. AB 414 (Bonta) requires reporting on the implementation of the mandate.
  • Ending the “senior penalty” in Medi-Cal, by aligning income-eligibility for the Medi-Cal Aged and Disabled Program with income eligibility for those under age 65. SIGNED. [Formerly AB 715 (Wood)] [co-sponsored by Western Center on Law and Poverty, Disability Rights California, and Justice in Aging]
  • Investments in outreach and enrollment funding, to ensure that consumers have accurate information about Medi-Cal eligibility and access to care by funding counties to contract with community-based organizations to provide Medi-Cal enrollment and health navigation assistance. SIGNED. [Sponsored by California Pan Ethnic Health Network]

In the California Legislature, Assemblymembers and Senators proposed, and Governor Newsom signed, additional legislation on expanding & improving coverage, in order to:

  • Keep Californians covered by helping consumers avoid coverage gaps when they undergo life events that cause them to lose health coverage either from Medi-Cal or other private health coverage. SIGNED: SB 260 (Hurtado) [Co-Sponsored by Health Access California and Western Center on Law and Poverty]
  • Stop seniors from losing free Medi-Cal by fixing Medi-Cal income counting rules that cause some individuals to continually bounce in and out of free Medi-Cal. SIGNED: AB 1088 (Wood) [Co-Sponsored by Disability Rights California, Justice in Aging, and Western Center on Law & Poverty]
  • Extend the open enrollment deadline in Covered California to January 31st to give consumers more time to shop, buy, and enroll in affordable coverage. SIGNED: AB 1309 (Bauer Kahan) [Sponsored by Health Access California]


The United States spends more than most industrialized countries on health care, not because we use more services or have better health outcomes, but because prices are higher. Our higher prices are driven by consolidation, lack of oversight, and industry profit motives leading to less coverage and higher premiums, deductibles, and co-pays—and lower paychecks. To increase accountability on the health industry for lower prices, bills enacted this year seek to:

  • Expand and improve rate review for health insurance to the large group market, which could save consumers hundreds of millions of dollars, and standardize & improve information insurers must report. SIGNED: AB 731 (Kalra) [Co-Sponsored by Health Access California, California Labor Fed, SEIU California, UNITE HERE, and Teamsters]
  • Ensure uniform and transparent data by removing Kaiser Permanente’s reporting exclusions in state law, setting a standard for health plan data and hospital financial reporting. SIGNED: SB 343 (Pan) [Sponsored by SEIU California]
  • Prevent the practice of “pay for delay” for prescription drugs, by curbing these collusive agreements where drug manufacturers pay generic companies to delay the introduction of lower-price medication to the market which keep drug prices artificially high. SIGNED: AB 824 (Wood) [Sponsored by Attorney General Xavier Becerra]


Our health system should ensure that all Californians can equally access quality care, and be accountable for improved health outcomes and reduced health disparities. Beyond appointing a new California Surgeon General, the state can take other actions to shift our focus to prevention rather than profits. This year legislation was passed to:

  • Require implicit bias training for perinatal providers and improve data collection to lower maternal mortality rates for black women.SIGNED: SB 464 (Mitchell) [Co-Sponsored by Western Center on Law and Poverty, Black Women for Wellness, ACT for Women and Girls, and NARAL Pro-Choice CA]
  • Require plan-specific reporting on cost, quality and disparities for plans that participate in Covered California so we can better target where needs remain. SIGNED: AB 929 (Luz Rivas) [Co-Sponsored by California Pan Ethnic Health Network and Health Access California]

#Care4AllCA bills that did NOT pass in 2019, but the coalition remains committed to advancing:

  • Banning surprise ER billing, by preventing surprise bills for out-of-network hospital ER visits so consumers are only billed for their co-pay or deductible, and setting a fair provider payment standard. AB 1611 (Chiu) (two-year bill) [Co-Sponsored by California Labor Federation and Health Access California]
  • Improve translation and readability by ensuring that the Medi-Cal documents consumers rely on the most are understandable and appropriately translated, removing barriers to care. AB 318 (Chu) (Vetoed.) [Co-Sponsored by California Pan Ethnic Health Network and Western Center on Law and Poverty]
  • Ensure quality in Medi-Cal managed care plans that must be accountable for improving health care quality and reducing disparities. AB 537 (Arambula) (two-year bill) [Co-Sponsored by California Pan Ethnic Health Network and Western Center on Law and Poverty]
  • Level up benefit standards & prescription drug protections so all consumers, regardless of who regulates their coverage, get the same benefits and consumer protections. AB 1246 (Limon) (held in committee) [Sponsored by Health Access California]
  • Prevent Trump sabotage of the ACA by prohibiting any “1332 waiver” that does not ensure access to the same affordable and comprehensive coverage available under the Affordable Care Act. AB 1063 (Petrie Norris) (two-year bill) [Co-sponsored by Western Center on Law and Poverty and Health Access California]
  • Streamline and encourage insurance enrollment by instituting express lane enrollment into Medi-Cal for those in the WIC program. AB 526 (Petrie Norris) (held in committee) [Co-Sponsored by The Children’s Partnership, Children Now, Children’s Defense Fund – California, and California Coverage and Health Initiatives]
  • Raise the assets limit for seniors in Medi-Cal so they don’t lose access to Medi-Cal for having small amounts of savings. AB 683 (Carrillo) (two-year bill) [Co-sponsored by Western Center on Law and Poverty and Justice in Aging]