This package of legislation builds on the progress California has made implementing and improving on the Affordable Care Act over the last decade, having led the nation with the biggest drop of the uninsured rate of any state. Our coalition of over 70 organizations seek additional and bold action to achieve a high quality health care system that is universal, affordable, and equitable to all Californians. These are steps California can take now, without the need for constitutional amendments, federal approvals or Acts of Congress–urgent actions that are complementary with longer-term goals and reforms.
COVERING ALL CALIFORNIANS AND IMPROVING AFFORDABILITY TOWARD UNIVERSAL COVERAGE
Everybody benefits when everyone is covered, getting primary and preventive care to stay healthy. These state budget and policy steps can remove exclusions in our public programs and increase affordability to further reduce our uninsured rate.
- AB 4 (Arambula): Remove Barriers to Covered California Based on Immigration Status, Toward #Health4All. This bill authorizes Covered California to apply for a federal 1332 waiver seeking to waive the specific section within the Affordable Care Act that explicitly bars undocumented individuals from purchasing coverage in Covered California. [Sponsored by California Immigrant Policy Center and Health Access California]
- AB 1208 (Schiavo): Cost-Sharing Affordability in Covered California. Affordability remains a significant barrier preventing Californians from accessing care when they need it. This bill requires Covered California to provide state-funded cost-sharing assistance to Silver-plan enrollees to reduce deductibles and co-pays for low- and middle-income enrollees, for as long as the Federal premium subsidies continue. [Sponsored by Health Access California]
IMPROVING HEALTH CARE EQUITY AND ADDRESSING DISPARITIES
Once enrolled in coverage, all Californians should be able to access quality care, and our health system should be held accountable for improved health outcomes and reduced racial disparities and other inequities. State efforts should focus on population health rather than profits.
- AB 1157 (Ortega): Access to Durable Medical Equipment. Private health plans regularly exclude or severely limit coverage for durable medical equipment, such as wheelchairs, hearing aids or ventilators, causing people to go without medically necessary devices or obtaining inferior ones that put their health and safety at risk. This bill will clarify that durable medical equipment is a covered essential benefit in California-regulated health plans when prescribed by a doctor. [Sponsored by National Health Law Program and Western Center on Law & Poverty]
- AB 608 (Schiavo): Comprehensive Perinatal Services in Medi-Cal. Medi-Cal’s Comprehensive Perinatal Services Program (CPSP) helps connect pregnant and postpartum people to services to address social determinants of health (SDOH) and mental health conditions. This bill will ensure that CPSP services will be available to provide assessments, care plans, and warm handoffs for SDOH assistance throughout the extended 12-month post pregnancy eligibility period that launched April 1, 2022. [Sponsored by Maternal and Child Health Access]
- AB 665 (Carrillo): Minor Consent to Mental Health Services. This bill will align the standards of mental health care consent for all young people in the state, allowing all youth, including those on Medi-Cal, to get the help they need before things escalate to a crisis situation. This bill will ensure young people ages 12 and up could utilize their Medi-Cal benefits when consenting to their own outpatient mental health treatment, while still allowing providers, after consulting with the youth, to involve the youth’s parent(s) or guardians when appropriate. [Sponsored by The Children’s Partnership and National Health Law Program]
- SB 238 (Wiener): Automatic Review of Health Plan Denials of Child & Youth Mental Health Services. Too many California families must fight health plans to get lifesaving mental health care for their children. To ensure children (0-26) are able to receive this needed treatment, health plans will be required to submit any denial of care claims to the Independent Medical Review process. [Sponsored by Children Now]
PROTECTING CONSUMERS AND CONTAINING HEALTH CARE COSTS
California needs proper oversight and measures in place to protect health care consumers. We cannot rely on the goodwill of health care corporations to prioritize the wellbeing of patients over their own interests. These policy steps can ensure industry accountability, preserve access to care, and contain rising costs.
- AB 716 (Boerner Horvath): Ending Surprise Ground Ambulance Billing. When you or a loved one have an emergency, you should not hesitate to call 911 for an ambulance because you are afraid of the ambulance bill. This bill will prevent consumers from being charged an out-of-network surprise bill for ground ambulance services and protects uninsured Californians from being charged inflated ambulance rates. [Sponsored by Health Access California]
- AB 1091 (Wood): Oversight of Health Care Mergers and Monopoly Prevention. Health care mergers lead to higher costs for consumers and employers, and can lead to cuts to critical services in communities, longer distances to access care, and worse health outcomes. This bill extends and strengthens the Attorney General’s existing oversight to ensure consumers are protected when health care entities merge, and prohibits anti-competitive contracting provisions that drive up health costs. [Author-sponsored]
- AB 1092 (Wood): DMHC Health Plan Merger Oversight. Mergers in the health insurance industry often mean fewer choices for consumers and less competition, with little to no benefit to consumers or purchasers. AB 1092 will expand State oversight over health plan mergers by requiring that health plans notify and seek approval from the Department of Managed Health Care (DMHC) when they acquire or obtain a control of another entity, such as a physician group. [Author-sponsored]
- AB 616 (Rodriguez): Medical Group Financial Transparency Act. This bill advances California’s efforts to limit health care cost growth and create greater accountability in the health care delivery system by closing a gap in publicly accessible financial data. Specifically, this bill would remove the exemption from public disclosure for medical group financial data reports already required and collected by the Department of Managed Health Care (DMHC) and Department of Health Care Access and Information (HCAI). [Sponsored by SEIU California]
Sponsors listed for each priority only include coalition members and may not be comprehensive.