Comprehensive Care4All California Agenda Advances to Improve Universality and Affordability in our Health System

With crucial votes taken this week, a sweeping package of legislation that would move California closer to universal health care has advanced through the state legislature. The bills that passed their final “first house” hurdles this week, combined with those that passed earlier and proposals moving forward in the state budget, would close a large amount of the gap between California’s current 93% rate of health coverage and the universal, 100% goal. At the same time, these proposed reforms would make California’s health care system more accessible, affordable, and equitable.

Earlier this year, the Care4All California coalition of over 50 consumer, community, labor, progressive, and health care organizations outlined an ambitious agenda of nearly 20 bills and budget proposals to meet the goal of quality affordable health care for all Californians now, without the need for federal approval. The agenda aimed to tackle the largest hurdles to universal healthcare, including unfair exclusions, unaffordable premiums, co-pays and deductibles, and gaps in quality. Virtually all of the package has advanced in the state legislature. The only exception being the ambitious Health Care Price Relief Act, AB 3087 (Kalra), which was held at the request of the author and sponsors last week to provide more time to negotiate with members of the health care industry.

As opposed to the federal efforts to take us backward, California is advancing an ambitious agenda to strengthen and expand health care in California and move us forward to a more universal, affordable, and accountable health system. Especially in our high cost-of-living state, Californians cannot wait any longer for relief in affording and accessing needed care. The bills passed this week are major steps to providing direct help to many Californians, but also helping improve the health system for everyone.

The bills that were voted on this week include:

#HEALTH4ALL: Ending the unfair exclusion of some low-income undocumented Californians in Medi-Cal. SB 974 (Lara) for seniors (age 65 and over) and AB 2965 (Arambula) for young adults (age 19 – 25). Funding for these proposals is currently being discussed in budget conference committee.

AFFORDABILITY: Require Covered CA to provide financial assistance for coverage, prioritizing people who currently spend more than 8% of income on premiums (SB 1255, Hernandez). Increase subsidies in Covered California for people up to 400% FPL (AB 2565, Chiu) and provide a tax credit to those 400% – 600% FPL so they only spend up to 8% of their income on premiums (AB 2459, Friedman). Funding for these proposals is currently being discussed in budget conference committee.

ENDING MEDI-CAL’S SENIOR PENALTY: AB 2430 (Arambula) ends Medi-Cal’s senior penalty by aligning income limits for seniors with younger adults. Funding for this proposal is currently being discussed in budget conference committee.

NEW OPTIONS IN COVERED CALIFORNIA: AB 2427 & AB 2472 (Wood) encourages public plans and other options for every region of the state, so that no region is left with only one or zero plans.

MEDI-CAL QUALITY ACCOUNTABILITY: AB 2275 (Arambula) ensures the managed care plans that cover nearly one-third of Californians are accountable for improving health care quality and reducing disparities.

MEDICAL LOSS RATIO: AB 2499 (Arambula) ensures health plans spend at least 80% on health care, limiting administrative costs and profits.

EXPRESS LANE ENROLLMENT: AB 2579 (Burke) institutes express lane enrollment in Medi-Cal for those in the WIC program.

PRESCRIPTION DRUGS: SB 1021 (Wiener) maintains a $250 cap on prescription drug co-pays so people who need expensive medications are still able to afford them.

These bills join other #Care4AllCA priority bills that moved forward last week to prevent the Trump Administration’s sabotage of California’s health care system:

JUNK INSURANCE: SB 910 & SB 1375 (Hernandez) prevents substandard “junk” insurance promoted by the Trump Administration from being sold in California.

MEDICAID ELIGIBILITY RESTRICTIONS: SB 1108 (Hernandez) prohibits the state from pursuing waivers that make it harder for low-income people to enroll in Medi-Cal.

All fifteen of these bills now move to the next house to be heard in policy committees. Also moving forward will be a number of “2-year bills” that were put on hold last year, but will soon be debated. This includes bills to increase oversight on health industry consolidation (AB 595, Wood and SB 538, Monning) as well as bills to help prevent prescription drug price spikes (AB 315, Wood and AB 587, Chiu).

The #Care4AllCA coalition also identified increasing affordability in the individual health care market and expanding access to undocumented adults as priorities in the state budget. The state budget conference committee began meeting today to discuss those efforts, with key negotiations between the Assembly Speaker, Senate Pro Tempore, and Governor Brown to begin as soon as next week. Track the health care budget items on Health Access’ Budget Scorecard.

 

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