California Legislature Passes Key Patient Protections Bills

Facing final deadlines of the 2017-2018 California legislative session, the State Legislature this week has voted on final passage of nine important health care bills to improve the state’s health care system. These bills, championed by the Care4All California campaign, will help to create a more accessible, affordable, and accountable heath care system, while also protecting the state from harm caused by the Trump Administration and Congress sabotage of our care.

These bills seek to keep California’s gains under the Affordable Care Act intact, despite the efforts to undermine our health system by the Trump Administration and Congress, while also taking pro-active steps forward to make our health system work better for everyone. Governor Brown should sign these bills to shield consumers from the impacts of the federal government’s administrative attacks on our health system.

Governor Brown has an opportunity to improve quality, equity, and affordability in our health system, through increased accountability of insurers and our health system. The Governor can and should sign bills to address prescription drug costs, put oversight on the consolidation of our health care system, and ensure that insurers are providing value for our health care.

In the last two days, the Legislature voted to approve an additional five bills, which makes nine total #Care4AllCA priority bills now on the Governor’s desk. These include:

SHIELDING CALIFORNIA CONSUMERS FROM THE FEDERAL SABOTAGE OF OUR HEALTH SYSTEM:

  • In July, the Trump Administration announced that it would allow so-called “short-insurance” health care coverage — insurance that does not have to abide by Affordable Care Act (ACA) consumer protections & can deny those with pre-existing conditions — to last a year, with the option to renew for up to 3 years. SB 910 (Hernandez) bans the sale of these junk plans in California.
  • As the Trump Administration pushes increased implementation of restrictive work requirements in Medicaid that have been proven to be counterproductive, SB 1108 (Hernandez) institutes guidelines for Medicaid waivers to prevent eligibility restrictions like work requirements.
  • SB 1375 (Hernandez) regulates who can be sold association health plans (AHPs) — which can also skirt ACA protections — and requires AHPs to comply with ACA consumer protections
  • AB 2499 (Arambula) ensures health plans spend at least 80% of premium dollars on health care, limiting administrative costs and profits. The Trump Administration has proposed to loosen these “medical loss ratios” allowing insurers to collect more in profits

ADDRESSING PRESCRIPTION DRUG COSTS:

  • Those with expensive health conditions such as cancer or HIV are also often the people who can least afford treatment. SB 1021 (Wiener) keeps prescription drugs affordable by maintaining a $250 co-pay cap so people who need costly medications are still able to afford them.
  • Pharmacy benefit managers (PBMs) have been identified as a piece of the prescription drug price chain that need additional regulation. AB 315 (Wood) requires PBMs to register with DMHC to help consumers & purchasers benefit from the savings PBMs negotiate.

INCREASING INSURER ACCOUNTABILITY: In addition to SB 910, SB 1375, SB 1021, and AB 2499 which also keep insurers accountable:

  • In California, the top five insurers control over 90% of the health care market. With health insurance already highly consolidated, additional mergers are likely to result in fewer choices and higher prices for the millions of California consumers enrolled in private coverage. AB 595 (Wood) institutes stronger state oversight over health plan mergers, protecting Californians from changes to the health plan market that may lead to negative outcomes for consumers.
  • Medi-Cal covers nearly one-third of Californians, the majority of whom are in managed care plans. AB 2275 (Arambula) ensures that these managed care plans are accountable for improving health care quality and reducing disparities
  • Last year, the CA State Assembly held a number of hearings on how to move towards a more universal health care system in California. One idea, a public option, would be studied in AB 2472 (Wood) which directs a new California Council on Health Care Delivery Systems to do a feasibility study of a public option in Covered California and the state health insurance market.

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