Care4All California Agenda Advances in the Final Days of 2018 Legislative Session

Yesterday, Monday August 27th, the California Legislature passed a number of important health care bills part of the Care4All California campaign that seeks to move California towards a more accessible, equitable, and universal health care system. AB 595 by Assemblymember Wood, instituting stronger state oversight over health plan mergers, was passed on a preliminary 42-17 vote. 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, now heading to the Governor’s desk, protects Californians from changes to the health plan market that may lead to negative outcomes for consumers.

With concerns about rising premiums, fewer choices, and competition in health insurance, the state legislature rightly voted to protect consumers with stronger oversight of health plan mega-mergers. State policymakers need the authority to investigate, put conditions on, or even reject health plan mergers so they are in the public interest, not just private equity and executives.

The California Legislature also passed AB 2472 (Wood) today on a bipartisan 51-10 vote, to conduct a study on the feasibility of creating a new “public option” in Covered California and the individual health insurance marketplace. Whether for rural Californians looking for alternatives to the few health plans available in their area, or others just looking for a better deal, it is promising that the Legislature has taken a first step to explore setting up a public health insurance option. Patient advocates have long supported a public option in federal health reforms and look forward to seeing what may make sense here in California.

Finally, the California Assembly also passed several other bills that now head to the Senate for a final concurrence vote, including efforts to prevent federal further administrative attacks to undermine our health insurance system. This includes SB 1108 (Hernandez) which institutes guidelines for Medicaid waivers to prevent eligibility restrictions like work requirements, SB 1375 (Hernandez) which limits the sale of “junk insurance” through Association Health Plans, and SB 1021 (Wiener) that would extend prescription drug co-pay caps.

The Legislature and the Governor now have the chance to advance legislation not only to shield consumers from the sabotage of our health system by the Trump Administration and Congress, but also to take steps towards a more affordable and accountable system for all Californians. While we push back against federal efforts to roll back and repeal health coverage, we urge our state elected leaders to stand up for our state and advance these key protections to make progress in California this year.

The priority Care4All California health bills facing final votes this week or on the Governor’s desk are listed below:


  • SB 910 (Hernandez): Bans the sale of junk, short-term insurance plans in California (on Governor’s desk)
  • SB 1108 (Hernandez): Prohibits the state from agreeing to Medicaid waivers that make it harder for low-income people to enroll in Medi-Cal (on Senate concurrence)
  • SB 1375 (Hernandez): Regulates who can be sold association health plans and requires AHPs to comply with ACA consumer protections (on Senate concurrence)
  • 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 (on Governor’s desk)


  • SB 1021 (Wiener): Maintains a $250 cap on prescription drug co-pays so people who need expensive medications are still able to afford them (on Senate concurrence)
  • AB 315 (Wood): Requires pharmacy benefit managers (PBMs) to register with DMHC to help consumers & purchasers benefit from the savings PBMs negotiate (on Senate floor)


  • AB 595 (Wood): Institutes stronger state oversight over health plan mergers (on Governor’s desk)
  • 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 (on Assembly concurrence)
  • AB 2472 (Wood): 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 (on Governor’s desk)