A Dramatic Year – and Decade – in California Health Care

California had a landmark 2019 in health reform, expanding access and affordability to coverage, not just by countering the administrative attacks from the federal government, but also expanding access and affordability, and placing additional oversight on the health industry to control costs and improve quality and equity. These wins on behalf of consumers are due to the advocacy of health and consumer advocates, working with Governor Gavin Newsom and the California Legislature. With new investments in our health care system, over a million Californians will get help to afford care, with hundreds of thousands to be newly covered due to Medi-Cal and Covered California expansions, along with reduced premiums for many more. The year 2019 also saw benefit restorations of cuts in Medi-Cal from a decade ago, the end of the “senior penalty” in Medi-Cal, and successful efforts to reduce premiums and prescription drug costs through greater industry accountability.

With the federal administration and the courts seek to roll-back protections and take away our care, California is showing a progressive and positive path that is working to strengthen our state’s health care system and move us closer to universal coverage.

NEW POLICIES START JANUARY 1: Many of these new policies have immediate impact starting in the new year, on January 1st.

Californians purchasing health care through Covered California have new state subsidies starting January 1. Despite the ACA lawsuit decision announced last week, our exchange is open for business through January and families are encouraged to sign up for coverage and take advantage of new affordability assistance. Come January 1st, all income-eligible young adults in California, regardless of immigration status, will now be able to enroll in comprehensive health care through Medi-Cal. Our communities will be healthier and more families will be able to thrive thanks to these expansions of access and affordability in California.

Laws affecting health care consumers going into effect on January 1, 2020 include:

Expansions of Access and Affordability and Improving Quality as Steps to Care4All California

  • A better open enrollment period in Covered California that goes through January 31st, allowing Californians more time after the holiday to sign up for coverage in 2020. (AB 1309, Bauer-Kahan)
  • Additional ease and help to more seamlessly keep Californians covered as they transition between incomes and shift from Medi-Cal to Covered California and from employer coverage to Covered California. (SB 260, Hurtado)
  • Keeping seniors covered in Medi-Cal by fixing income counting rules for seniors that caused some individuals to bounce in and out of free Medi-Cal coverage. (AB 1088, Wood)
  • Require implicit bias training for perinatal providers, to lower maternal mortality rates for black women that have stayed high. (SB 464, Mitchell)

Increasing Oversight on of the Health Care Industry

  • Deterring “pay-for-delay” practices where drug companies pay off their generic competitors to put off introduction of lower-cost alternatives. (AB 824, Wood)
  • Enhanced rate review for large group plans which could save consumers tens of millions (AB 731, Kalra) & greater transparency by removing key reporting exemptions for Kaiser (SB 343, Pan).
  • More public reporting of plan-specific data on quality and equity by Covered California and its qualified health plans. (AB 929, L. Rivas)

Health Access published two review documents this week, including a 2019 Year in Review that details these and other budget, legislative, administrative, judicial, and other changes that will make a difference to health care consumers.

A DECADE OF REFORM: Marking the ten year anniversary of the U.S. Senate passage of the Affordable Care Act on December 24th, 2009, Health Access also published a Timeline of Health Reform in California, detailing a decade of our state implementing and improving the ACA. The state passed over a dozen bills and budget items, and with additional investments and initiatives to get Californians coverage and consumer protections.

In ten years, California took aggressive advantage of the ACA, which led to cutting the uninsured rate by more than half, the largest reduction of all 50 states. California was instrumental in passing the ACA, in implementing and improving the law, and in showing its promise and potential. While the ACA has survived multiple political, legal, legislative, and administrative attacks, these health reforms have thrived in California, with additional consumer protections and expansions.

LOOKING TO 2020: California’s success so far under the ACA shows that progress is possible, as we work to do more to expand coverage, control cost, and reform the health system. Consumer advocates plan to use this momentum to work to lower premiums and out-of-pockets costs for consumers, and move closer to universal coverage with continued steps toward health for all Californians. We hope the Governor fulfills his commitment to expand Medi-Cal access to all income-eligible undocumented seniors, to double down on affordability assistance, and take other concrete steps to universal coverage. We will continue our efforts to stop surprise medical bills and prevent prescription drug price increases. We look forward to working with the Governor and legislature in the new year on comprehensive efforts to hold the industry accountable, to control health care costs, and improve quality and equity.

For a summary of the highlights of the year in California health policy, see our Health Access 2019 Year in Review

For a detailing of the decade, see our Timeline of Post-ACA Health Reform in California

For more details on affordability assistance in Covered California, see this Health Access fact sheet.

For more on California’s efforts to block the federal sabotage of the ACA, see this Health Access fact sheet.