Press Releases

Press inquiries may be directed to:

Rachel Linn Gish, Director of Communications
rlinngish@health-access.org: 916-497-0923 ex. 809

Governor’s May Revision Take Steps on Health Affordability–But Legislature Should Do More

Governor Gavin Newsom released his May Revision of a $300 billion state budget, which continues to propose major steps to expand health care coverage, and included some new investments, including to ensure Californians keep the coverage as the public health emergency unwinds. Building on these proposals and given the urgent needs, health and community advocates urged the Legislature to take quicker and additional steps to address health affordability.
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For Immediate Release: Friday, May 13, 2022

CONTACT: Anthony Wright, executive director, Health Access California, awright@health-access.org, 916-870-4782 (cell)

CALIFORNIA GOVERNOR NEWSOM’S REVISED 2022-23 BUDGET PROPOSAL WOULD IMPROVE HEALTH CARE AFFORDABILITY,

BUT LEGISLATURE NEEDS TO TAKE ADDITIONAL STEPS

  • 2022-23 “May Revise” budget by Governor Gavin Newsom continues January investments to improve health care access and affordability, including restarting state subsidies in Covered California, expanding Medi-Cal for ALL income-eligible Californians regardless of immigration status, eliminating premiums in Medi-Cal, and creating an Office of Health Care Affordability to set cost targets across the health care system.
  • The May Revise includes new investments in keeping Californians covered as the public health emergency unwinds, in reproductive health, and $100 million in funding to contract to manufacture insulin to lower costs.
  • Given the real concerns on costs, and health costs specifically, health and community advocates are urging the Legislature to provide more relief sooner, including a quicker expansion of Medi-Cal, additional affordability assistance in Covered California including for cost-sharing and deductibles, lower “share of cost” in Medi-Cal, and more.

SACRAMENTO, CA – Governor Gavin Newsom released his May Revision of a $300 billion state budget, which continues to propose major steps to expand health care coverage, and included some new investments, including to ensure Californians keep the coverage as the public health emergency unwinds. Building on these proposals and given the urgent needs, health and community advocates urged the Legislature to take quicker and additional steps to address health affordability.

“We appreciate Governor Newsom’s continued commitments to significantly improve health care access and affordability, and we urge the Legislature to seek more relief sooner to help California families stressed by health care costs. The focus on health care affordability is welcome and urgent, and under this budget, California has the opportunity to provide long and short term solutions, to reduce costs and limit price increases in both public and private coverage,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition. “Millions of Californians would benefit from a new Office of Health Care Affordability taking a comprehensive approach in preventing inflated health costs, to specific solutions on prescription drug prices on insulin, and relief in reducing Medi-Cal and Covered California premiums and cost-sharing. We appreciate the investments to keep Californians covered, especially in Medi-Cal as the public health emergency unwinds, complementing the work we need to do to expand coverage in Medi-Cal and affordability assistance in Covered California.”

“Given the big concern on costs, the Legislature should take this proposal and seek bigger and bolder action to improve health affordability for California families.” said Wright. “We need to prevent premium spikes in Covered California, and while the $304 million investment in state subsidies is welcome, it would be a fraction of the $1.7 billion in federal help that may expire at the end of the year, and we also need to address cost-sharing and deductibles which will rise as well without additional action. We are excited by ending the cruel exclusion of coverage in Medi-Cal based on immigration, which should not be delayed under 2024, especially for the tens of thousands of Californians who will needlessly age out of coverage otherwise. The Governor’s proposal continues to eliminate Medi-Cal premiums for children and people with disabilities just over the poverty level, and the Legislature should similarly reduce share of costs for such seniors and people with disabilities. These budgeted and proposed actions, together, are big steps to a more affordable, equitable, and universal health system.”

For more background, here’s our one sheet on the Governor’s January budget, which have largely continued in the May Revise, and then more comment about what advocates and legislators will be seeking: https://health-access.org/wp-content/uploads/2022/03/HA-Budget-FactSheet-final-3.2.22.pdf

HEALTH4ALL: The Governor’s budget proposal continues to seek an expansion of Medi-Cal to all income-eligible Californians, regardless of immigration status, starting January 1, 2024 for over 700,000 Californians aged 26-49 years old. “Expanding Medi-Cal coverage will benefit not just hundreds of thousands of essential workers we rely on, but the health and economic security of their families, and our common public health. We will work hard to make sure this expansion happens as soon as possible to cover the Californians explicitly excluded from coverage because of where they were born. These Californians can’t wait for coverage, especially the 40,000 young adults that will age out of coverage without more urgent action,” said Jose Torres Casillas, policy and legislative advocate for Health Access California.

COVERED CALIFORNIA: In the January budget, the Governor made a commitment to improve affordability assistance, including on cost-sharing, building on federal funds. The May proposal would reinstitute the state subsidy program, which would help if Congress does not extend federal American Rescue Plan dollars, but would be a fraction of the $1.7 billion/year that Californians would lose in affordability assistance. “We will continue to seek more help to prevent premiums in Covered California from spiking by over $1000/person, and especially if federal funds are continued, to also to help with cost sharing, especially with deductibles that will rise to $4750 next year for Silver plans.” said Wright.

OFFICE OF HEALTH CARE AFFORDABILITY: The budget continues to propose this new Office of Health Care Affordability, a comprehensive approach to set enforceable cost targets for the health industry. “In addition to the immediate relief in the budget release, this Office of Health Care Affordability is most far-reaching health affordability proposal, with the potential to prevent inflated health costs for nearly all Californians, in public and commercial coverage.” said Wright. “After three years of active negotiation, it’s time for the Office of Health Care Affordability to start its crucial work of preventing

MEDI-CAL AFFORDABILITY: The Governor proposes to suspend premiums in Medi-Cal for hundreds of thousands of children, people with disabilities and others just over the poverty level, while advocates hope to eliminate them permanently. Advocates are also seeking reduction of “share of cost” Medi-Cal for seniors and people with disabilities just over the poverty level.

PRESCRIPTION DRUGS PRICES/INSULIN: The Governor hinted in January about California moving forward to contract to manufacture insulin, as a way to address market failures that have left this century old medicine with an inflated price. This May Revision includes more details, including seeking a $100 million investment to start that process. “This budget would make an important investment to correct the market failures that have left insulin prices inflate for decades. California can and should use its purchasing power to provide relief to California patients and taxpayers struggling with the price of prescription drugs like insulin.” said Wright.

KEEPING CALIFORNIANS COVERED: The budget includes investments related to the ongoing COVID-19 crisis, and also help to ensure people stay on coverage, through investments like $30 million general fund in Medi-Cal navigators, and another $12.5 million in a media campaign so people know their coverage options and opportunities. “We strongly support the new investments to provide public education and outreach, to keep Californians covered, especially as the public health emergency unwinds. Californians need care and coverage even after the worse of the pandemic and public health measures are lifted, and we all benefit when we all are included in the health system,” said Wright.

FURTHER STEPS TO UNIVERSAL COVERAGE: In addition to these major investments in coverage and affordability, other important investments are in reproductive health, in Medi-Cal benefits, and in a health information exchange. “These budget investments include big and bold steps to expand coverage and affordability, and we also appreciate the staffing to further explore federal waivers and other steps outlined by the Healthy California For All Commission to take additional steps to a universal health system with unified financing.” said Wright.

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    Major CA Bills to Increase Accountability in Our Health Care System Up In Committee This Week

    California legislative committees are set to hear two health care bills this week that would increase accountability for health care consumers while preserving their access to care and preventing inflated health prices. SB 858 by Senator Scott Wiener, which will be heard today (Tuesday) in Senate Judiciary Committee, updates penalty amounts that the state can levy on health plans that don't meet consumer protection standards. AB 2080 by Assemblymember Wood, which will be heard today (Tuesday) in Assembly Health Committee and on Thursday in Assembly Judiciary Committee, would provide needed oversight on for-profit hospital mergers to ensure they are in the best interest of the California public.  
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    MAJOR CA BILLS TO INCREASE ACCOUNTABILITY IN OUR HEALTH CARE SYSTEM UP IN COMMITTEE THIS WEEK

    • AB 2080 (Wood) improves oversight by the CA Attorney General over for-profit health care mergers, to preserve access and prevent inflated costs due to consolidation
    • SB 858 (Wiener) increases fines on health plans that don’t meet requirements for timely access to care and other consumer protections, updating fines not changed since the 1970s
    • Both bills to be heard this week in Health and Judiciary Committees, before a crucial end-of-week deadline

    SACRAMENTO, CA – California legislative committees are set to hear two health care bills this week that would increase accountability for health care consumers while preserving their access to care and preventing inflated health prices. SB 858 by Senator Scott Wiener, which will be heard today (Tuesday) in Senate Judiciary Committee, updates penalty amounts that the state can levy on health plans that don’t meet consumer protection standards. AB 2080 by Assemblymember Wood, which will be heard today (Tuesday) in Assembly Health Committee and on Thursday in Assembly Judiciary Committee, would provide needed oversight on for-profit hospital mergers to ensure they are in the best interest of the California public.

    “The California Legislature can and should take action this year to ensure access to care and contain rising health care costs,” said Anthony Wright, executive director of Health Access California, the lead supporter of SB 858 and AB 2080. “These bills will increase state oversight on health plans and the health industry, whether through the Attorney General or the Department of Managed Health Care, to ensure consumers’ best interests are taken into account when reviewing hospital mergers or when setting fine amounts for health plans. As families struggle to find and pay for health care, these bills will make sure that for-profit hospitals and health plans are responding to the needs of California consumers first and foremost.”

    UPDATING HEALTH PLAN FINES: Despite strong consumer protections for 27 million Californians in health plans regulated at the Department of Managed Health Care (DMHC), many are still denied or delayed in getting medically necessary services.

    “DMHC’s financial penalties have not been updated for decades, and plans may find it cheaper to pay the penalties instead of improving care. Some fine amounts have not been updated since 1975 when gas was 59 cents a gallon. Fine amounts for violations related to grievance handling and other specific consumer protections have not been updated since 1999 or 2000—and in the last 20 years, health insurance premiums have not just doubled, premiums today are four times as high as they were in 1999,” said Diana Douglas, Health Access California’s manager of policy and legislative advocacy.

    SB 858 (Wiener) would increase the minimum civil fines imposed by DMHC from a maximum of $2,500 per violation to a minimum of $25,000. SB 858 would increase fixed fine amounts by four, based on the rate of increase in health insurance premiums since 1999. SB 858 also increases future fine amounts along with healthcare premiums and out-of-pocket costs.

    INCREASING OVERSIGHT ON HEALTH CONSOLIDATION: For decades, the California’s Attorney General has reviewed, held public hearings, imposed conditions, and approved nonprofit hospital mergers so that consumer impact could be measured and considered. AB 2080 (Wood) extends that existing authority and process to for-profit hospitals, medical groups, and the other major health industry transactions.

    “As mergers reshape the health system we all rely on right under our feet, these for-profit deals should get proper public scrutiny and input on their impact on cost, quality, equity and access. The oversight is important since mergers can decrease competition for consumers or result in the cutting of services, the lowering the quality and accessibility of care, and increasing prices. Health care consolidation is one of the major drivers of increasing health care costs – which have been rising much faster than inflation for many years. Health prices in California have less to do with the cost of providing the care, the quality of care, or the health outcomes, than with the relative size and market power of health providers to be able to charge whatever they can. AB 2080 is needed so that consumers best interest – and the health of the health care market – is taken into consideration before the AG approves a for-profit merger,” said Wright.

    Senate committee hearings can be viewed here, and Assembly committee hearings can be viewed here.

    Both of these bills are part of the larger #Care4AllCA campaign of over 70 organizations advocating for bold state action now towards a universal health care system that is affordable, high quality, and accountable to consumers.

    Background

    SB 858 (Wiener): Health Access Factsheet

    AB 2080 (Wood): Health Access Factsheet

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      #CARE4ALLCA: Major Health Reform Package Puts a Universal Health System in CA Within Reach

      Sixteen 2022 Proposals Would Expand Coverage to Hundreds of Thousands & More Affordability to Millions of Californians, Creating a More Equitable Health System, Putting Universal Coverage in CA Within Reach
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      For Immediate Release: Monday, March 21, 2022

      CONTACT: Rachel Linn Gish, Director of Communications, Health Access California, rlinngish@health-access.org, 916-532-2128 (cell)

      2022 CARE4ALL CALIFORNIA AGENDA FOR HEALTH REFORM ANNOUNCED

      Sixteen 2022 Proposals Would Expand Coverage to Hundreds of Thousands & More Affordability to Millions of Californians, Creating a More Equitable Health System, Putting Universal Coverage in CA Within Reach

      • Proposals expand Medi-Cal coverage to over 700,000 regardless of immigration status and lower costs for another 500,000 in the program, and would also:
      • Lower cost-sharing and deductibles for over 1.5 million in Covered California
      • Tackle the rising cost of health care, preventing inflated health prices
      • Make it easier to get on and stay on coverage, whether in public or private coverage, including for folks paying taxes, applying for unemployment, or going on strike
      • Increase equity, and improve outreach and access to key mental health services, and coverage in general

      SACRAMENTO, CA – As the U.S. celebrates the 12th anniversary of the Affordable Care Act this week, California legislators and the Care4All California coalition today announced a 2022 legislative package of sixteen proposals aimed to improve on the ACA and get our state to a universal, high-quality health care system. Over 70 Care4All California coalition members joined a half dozen health legislative champions to highlight the key health reform bills and budget asks to expand access and coverage, reduce health care costs, improve quality, and increase equity in our health system. Together, the proposals would slash California’s uninsured rate, make it easier to get on and stay on coverage, provide key state oversight over major drivers of high health costs, and bring our state closer than ever before to a universal health system. Here is the full list of this year’s bills and budget items.

      If passed, these proposals would make meaningful impact on almost every part of the health care system. More people would be enrolled in coverage, either directly through the expansion of Medi-Cal to over 700,000 undocumented adults age 26-49, or through increasing financial help for those who can’t afford coverage on their own and reducing the barriers to accessing coverage. Bills would lower cost-sharing and deductibles for over 1.5 million enrolled in Covered California, making care in the program more affordable than ever for those who have found the price of coverage out of reach.

      Other major efforts in the package would take bold steps to address the drivers of sky-rocketing health care prices, which harms those who have coverage but still can’t afford to pay their medical bills, by establishing an Office of Health Care Affordability and putting more oversight on industry consolidation. Taking into account the urgent needs of many of California’s underserved communities struggling during the pandemic and with access to care, the package includes a number of bills that would improve access to mental health for communities of color, gender affirming care, and Medi-Cal services, as well as improving data collection to meet health equity goals.

      “These proposals now pending in the California Legislature would represent the biggest expansion of coverage since the ACA, and would be the most far-reaching in terms of providing cost relief to millions of Californians,” said Anthony Wright, Executive Director of Health Access California, the group that convenes the coalition. “The package would make it easier to get on and stay on coverage, for public and private coverage, including for folks filing their taxes, or for unemployment, or when going on strike. The package ensures equitable outreach and access, for mental health services, gender-affirming care, and coverage in general. We thank our legislative champions for their support over the years, and for being willing to take these bold steps to get us to a better, more equitable, and universal health system to benefit all Californians.”

      “California has an incredible opportunity to positively impact the health of people who live here. One third of the state’s population relies on Medi-Cal for health care, which means the quality of Medi-Cal has a significant influence on the overall health of countless California communities,” said Crystal D. Crawford, Executive Director of Western Center on Law & Poverty. “As we expand access to health care while ensuring medical debt and other health care costs don’t keep people locked into poverty, we must also make sure the care people receive is high quality. Together, this year’s Care4All California package brings us closer to that goal.”

      “As California experiences another budget surplus, it is beyond time the State dedicates its vast resources to those who are hardest hit by the pandemic. Californians of color, people who are undocumented, people with limited English proficiencies, and people who are low income continue to fare the worst as the wealthy recover,” said Andrea Rivera, senior legislative advocate with the California Pan-Ethnic Health Network. “Care4All California has a package of policies aimed at improving quality and expanding equity in overall health, data collection, and mental health that we look forward to passing this year with the legislature and Governor.”

      Over the last dozen years of the ACA, California has led the nation with the biggest drop of the uninsured rate of any state, and invested state dollars to make our care even more affordable. For the past four years, the #Care4AllCA coalition of over 70 organizations has been advocating for additional and bold action now, without the need for federal approvals or Acts of Congress, and has seen great success in passing major health reforms.

      The event was also livestreamed on Health Access’ Facebook page.

      Here is a recap of the bills announced as part of the #Care4AllCA 2022 campaign:

      • Covering all Californians and improving affordability toward universal coverage:
        • Expanding Medi-Cal to ALL regardless of immigration status, toward the goal of #Health4All (Assemblymember Arambula & Senator Durazo)
        • SB 944 (Pan) & AB 1878 (Wood): Greater affordability in Covered California
        • AB 1995 (Arambula): Eliminating Medi-Cal premiums
        • AB 1900 (Arambula): Lowering costs through Medi-Cal share of cost reform
        • AB 2402 (Rubio): Providing Medi-Cal continuous coverage for young children
        • SB 644 (Leyva): Connecting the unemployed to coverage
        • SB 967 (Hertzberg): Connecting taxpayers to coverage information
        • AB 2530 (Wood): Keeping striking workers covered
      • Improving health care equity:
        • SB 1033 (Pan): Advancing health equity with data
        • SB 923 (Wiener): Ensuring access to gender affirming care
        • SB 1019 (Gonzalez): Strengthening access to Medi-Cal mental health for diverse communities.
        • Mobile mental health crisis response budget proposal
        • AB 1930 (Arambula): Providing comprehensive perinatal services in Medi-Cal
      • Reducing health care costs and ensuring industry accountability:
        • AB 1130 (Wood): Creating an Office of Health Care Affordability
        • AB 2080 (Wood): Improving oversight over health industry consolidation
        • SB 858 (Wiener): Strengthening health plan accountability

      Legislative and budget hearings for these proposals kick-off this week, with AB 1900 (Arambula) and AB 1995 (Arambula) being heard Tuesday in Assembly Health Committee, and SB 944 (Pan) being heard on Wednesday in Senate Health Committee.

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        Consumer Advocate Reaction to $55M Fine on LA Care Health Plan

        Today, the California Department of Managed Health Care (DMHC)  and the Department of Health Care Services (DHCS) fined the L.A. Care health plan $55 million dollars for tens of thousands of violations that resulted in delayed or denied care. Going back several years, L.A. Care systematically failed to handle grievances timely, by not giving consumers authorization for timely care, and by failing to ensure that LA County Department of Health Services provided timely access to care, especially specialty care.
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        For Immediate Release: Friday, March 4, 2022

        CONTACT: Rachel Linn Gish, director of communications, Health Access California, rlinngish@health-access.org, 916-532-2128 (cell)

        CONSUMER ADVOCATE REACTION TO $55M FINE ON LA CARE HEALTH PLAN

        • Largest fine ever imposed on a health plan, yet not enough given the tens of thousands of violations, including care delayed and denied, leading to patient harm and deaths.
        • SB 858 (Weiner) introduced this year would increase the level of fines for health plans to update outdated standards.

        SACRAMENTO & LOS ANGELES: Today, the California Department of Managed Health Care (DMHC)  and the Department of Health Care Services (DHCS) fined the L.A. Care health plan $55 million dollars for tens of thousands of violations that resulted in delayed or denied care. Going back several years, L.A. Care systematically failed to handle grievances timely, by not giving consumers authorization for timely care, and by failing to ensure that LA County Department of Health Services provided timely access to care, especially specialty care.

        “L.A. Care failed its patients in handling grievances, authorizing treatments, and ensuring timely access to care. Californians died as a result. Others suffered from unjustified delays that resulted in avoidable harm. These fines are not just merited but modest given the systemic issues and scale of the harm for tens of thousands of consumers suffered over a number of years,” said Diana Douglas, policy and legislative advocacy manager for Health Access California. “While these may be the largest fines ever, that does not mean that they are sufficient to deter future bad behavior. LA Care has 2.5 million enrollees who depend on it to get the care they need when they need it.”

        For context, LA Care had revenues exceeding $8.3 billion in 2020 with administrative costs of $452 million. (Annual Report 2019-2020: Financial Overview | L.A. Care Health Plan (lacare.org))

        SB 858 by Senator Scott Wiener, sponsored by Health Access, would increase the minimum fines imposed by DMHC from a maximum of $2,500 per violation to a minimum of $25,000. This fine amount has not been updated since 1975 when gas was 59 cents a gallon. Fine amounts for violations related to grievance handling and other specific consumer protections have not been updated since 1999 or 2000—and in the last 20 years, health insurance premiums have not just doubled, premiums today are four times as high as they were in 1999. SB 858 would increase fine amounts by four, based on the rate of increase in health insurance premiums since 1999. SB 858 also increases future fine amounts by the same percentage that premiums increase.

        “We appreciate the Departments for following up and taking these actions, even if these problems should not have been allowed to get to this point. We urge not just greater fines on the health plan, but for LA Care to immediate agree to a corrective action plan to fix these systemic problems as soon as possible,” said Douglas. “Californians who rely on Medi-Cal managed care deserve the same timely access to care and the same consumer protections as every other Californian, including those who go to Cedars Sinai or Stanford. We are alarmed by not just the lack of proper oversight by LA Care, but also about the cavalier disregard of the LA County Department of Health Services for its contractual obligation to provide timely access to care and other basic consumer protections.”

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          California Health Committee Chairs Introduce Bills to Increase Affordability in CoveredCA

          New state legislation introduced today would fill key affordability gaps in Covered California, potentially lowering cost-sharing and eliminating deductibles for over a million Californians getting coverage through the state marketplace. AB 1878 by Assemblymember Dr. Jim Wood, and SB 944 by Senator Dr. Richard Pan, both sponsored by Health Access California, the statewide health care consumer advocacy coalition, would remove financial barriers to care for hundreds of thousands of patients, and encourage even more Californians to sign up for coverage.
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          For Immediate Release: Wednesday, February 9, 2022

          CONTACT: Rachel Linn Gish, director of communications, Health Access California, rlinngish@health-access.org, 916-532-2128 (cell)

          CA HEALTH COMMITTEE CHAIRS INTRODUCE BILLS TO INCREASE AFFORDABILITY ASSISTANCE IN COVERED CALIFORNIA

          • Senate Health Committee Chair Dr. Pan and Assembly Health Committee Chair Dr. Wood introduce bills to reduce costs-sharing to over 1.8 million in Covered California.
          • With the new federal assistance in the American Rescue Plan in 2021, premiums are at an all-time low, but many patients continue to face barriers to care with other out-of-pocket costs such as deductibles and co-pays. 
          • If Congress extends current federal premium assistance into the future, AB 1878 (Wood) and SB 944 (Pan) would provide additional state subsidies to eliminate deductibles and lower co-pays.

          SACRAMENTO, CA – New state legislation introduced today would fill key affordability gaps in Covered California, potentially lowering cost-sharing and eliminating deductibles for over a million Californians getting coverage through the state marketplace.

          AB 1878 by Assemblymember Dr. Jim Wood, and SB 944 by Senator Dr. Richard Pan, both sponsored by Health Access California, the statewide health care consumer advocacy coalition, would remove financial barriers to care for hundreds of thousands of patients, and encourage even more Californians to sign up for coverage.

          Without such help, low- and middle-income Californians face counterproductive out-of-pocket costs that are financially unfeasible. High cost-sharing, especially deductibles, lead people who have coverage to avoid needed care, or face debt for seeking care, and keeps some people from purchasing care at all. Those who earn just over $2,000 per month have hospital deductibles approaching $4,000 per year, and pay over $30 for a single primary care visit for a Silver-level plan. In a Bronze plan, deductibles are over $6,000 per year, which is how much a consumer must pay out-of-pocket before getting any coverage, with the exception of preventive care and three doctor visits.

          “I am proud of the investments my colleagues and I have led in California to expand health care coverage since the initial passage of the Affordable Care Act. Health insurance is only beneficial if people are able to use it to access primary, preventive, specialty, and acute care, when needed. That is why I am introducing this critical legislation, which will create state subsidies to offset copayments and eliminate deductibles so that Californians can get the care that they need without the worry of prohibitive cost sharing that creates barriers and delays to accessing quality health care,” said Senator Richard Pan (D-Sacramento), chair of the Senate Health Committee.

          “Covered California has helped to provide health care coverage for 1.8 million Californians, and any opportunity to improve affordability and lower out-of-pocket costs by eliminating co-pays and deductibles will remove one more barrier for people who need coverage. Co-pays and deductibles can often prevent people from affording coverage and if we can help them, we will,” said Assemblymember Jim Wood (D-Santa Rosa), chair of the Assembly Health Committee.

          In the last few weeks, Covered California released a report “Bringing Health Care Coverage Within Reach” which modeled the potential reductions in cost-sharing, depending on the state and federal resources available. The two bills introduced today would invest in zeroing out deductibles and reducing co-pays.

          This proposal builds on the Biden-Harris American Rescue Plan, passed early in 2021, which included historic affordability help to almost all Covered California enrollees ensuring that nobody had to spend more than 8.5% of their income for coverage, effectively eliminating all “affordability cliffs” in the ACA marketplaces. This federal package cut premiums on average of $1000/year for Covered California enrollees. This has led to record enrollment – more than 1.8 million Californians now receive coverage through Covered California. Congress is actively considering whether to extend this additional affordability assistance into future years.

          AB 1878 (Wood) and SB 944 (Pan) would add to this federal help, by using state subsidies to help Californians cope with cost-sharing—much like California piloted premium assistance a few years ago. However, supporters acknowledge this but may not be possible if the federal financial assistance is not extended, since such state dollars would need to attempt to partially backfill the lost federal funds.

          “Record enrollment in Covered California shows how Californians are directly benefiting from the premium affordability assistance from the American Rescue Plan. Now California can take the next step to improve affordability for not just coverage, but for cost-sharing to get care,” said Diana Douglas, Policy Manager at Health Access California. “If Congress doesn’t take action, premiums will raise by an average of $1,000 per person. If California legislators don’t act, we could see deductibles for Silver plans rise to $5,000. We need our policymakers at the state and federal level to protect patients from these rising health costs.”

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            JOINT STATEMENT: Consumer Advocates Respond to Kaiser Medi-Cal Contract Announcement

            Two leading health and consumer advocate organizations have released the following statement in response to the recently announced Medi-Cal contract between the Department of Health Care Services (DHCS) and Kaiser Permanente.  “Health and consumer advocates have been strong supporters of the state’s proposal to recontract with all the managed care plans in our Medi-Cal program. It’s been decades since this re-contracting process has been done, and we have urged the state to hold all plans to higher standards for quality and equity for the over 14 million Californians who depend on Medi-Cal for their care.  These standards should include Kaiser, which has avoided a statewide contract to date, and push them to do more in Medi-Cal.”
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            For Immediate Release: Friday, February 4, 2022

            CONTACT: Rachel Linn Gish, Director of Communications, Health Access California, rlinngish@health-access.org, 916-532-2128 (cell)

             CONSUMER ADVOCATE STATEMENT ON MEDI-CAL RECONTRACTING 

            Sacramento, CA – Two leading health and consumer advocate organizations have released the following statement in response to the recently announced Medi-Cal contract between the Department of Health Care Services (DHCS) and Kaiser Permanente.

             “Health and consumer advocates have been strong supporters of the state’s proposal to recontract with all the managed care plans in our Medi-Cal program. It’s been decades since this re-contracting process has been done, and we have urged the state to hold all plans to higher standards for quality and equity for the over 14 million Californians who depend on Medi-Cal for their care.  These standards should include Kaiser, which has avoided a statewide contract to date, and push them to do more in Medi-Cal.”

            “The goals of this specific proposal is to provide patients from around the state continuity of care when moving from Kaiser plans to Medi-Cal, and for Kaiser to finally step up to provide more care in Medi-Cal, especially for vulnerable populations like foster children and “dual-eligible” seniors and people with disabilities. It’s a step in the right direction for the state to have greater and more direct oversight of Kaiser to ensure quality and equity on behalf of its 900,000 Medi-Cal patients, particularly in the 12 counties in which Kaiser is a subcontractor. While this proposal can help improve the capacity, quality, and accountability in the Medi-Cal program, we will be vigilant on Kaiser’s commitment to provide community supports and integrate with local safety-net services with input at the county level. As much as Kaiser does well on many quality metrics, it can and should do better. The arrangement between DHCS and Kaiser should include requirements to maintain or improve Kaiser’s record on quality and equity as they take on more of this vulnerable population, especially given their spotty record on behavioral health. This entire Medi-Cal recontracting process is an important effort to hold all health plans more accountable, Kaiser included.” says Anthony Wright, Executive Director of Health Access.

             “Changes in health coverage due to life transitions can be incredibly destabilizing for consumers. We support the department’s efforts to ensure continuity of care for Kaiser members, allowing consumers to keep their doctor when joining Medi-Cal. At the same time, we urge the department to require Kaiser to do more in Medi-Cal, including further diversifying future enrollment. A direct contract has the potential to increase state oversight of Kaiser’s care of Medi-Cal members, an important step toward a more equitable program. In this arrangement, DHCS must rigorously enforce quality and equity standards and improvements for Kaiser, and must ensure that Kaiser is accountable both in their care of vulnerable Californians and in their partnerships with county safety-net services, including those that are instrumental to the success of CalAIM,” says Kiran Savage-Sangwan, Executive Director of the California Pan-Ethnic Health Network.

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              Key Health Investments to be Heard in CA Budget Committees Starting This Week

              Big health reforms, from major expansions of access and affordability to efforts to control costs and improve quality and equity, will be heard in the California Legislature starting tomorrow, as hearings begin on the Governor Gavin Newsom 's $286.4 billion state budget for 2022-23. The hearings will discuss historic steps to close coverage gaps and bring California to near-universal health coverage. These hearings will debate what is in the current budget proposal, but also areas where the state can improve, or take additional steps to strengthen our health care system. 
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              For Immediate Release: Wednesday, February 2, 2022

              CONTACT: Rachel Linn Gish, director of communications, Health Access California, rlinngish@health-access.org, 916-532-2128 (cell)

              KEY HEALTH REFORM INVESTMENTS TO BE HEARD IN BUDGET COMMITTEES STARTING TOMORROW

              SACRAMENTO, CA – Big health reforms, from major expansions of access and affordability to efforts to control costs and improve quality and equity, will be heard in the California Legislature starting tomorrow, as hearings begin on the Governor Gavin Newsom ‘s $286.4 billion state budget for 2022-23. The hearings will discuss historic steps to close coverage gaps and bring California to near-universal health coverage. These hearings will debate what is in the current budget proposal, but also areas where the state can improve, or take additional steps to strengthen our health care system.

              Tomorrow’s Senate Subcommittee on Health & Human Services will kick off the schedule of hearings with an agenda that includes the major efforts to create an Office of Health Care Affordability to tackle the skyrocketing cost of care, and the Governor’s commitment in the budget to invest in making Covered California more affordable by lowering deductibles and co-pays. These same issues will also be heard on Monday (February 7th) in the Assembly Budget Subcommittee on Health & Human Services, along with other key affordability issues such as eliminating premiums in Medi-Cal, and lowering the cost of insulin. Other key investments, such as eliminating barriers in Medi-Cal based on immigration status, will be heard later this month.

              “Californians desperately need these budget investments and reforms to make our health care more affordable and accessible.” said Anthony Wright, executive director at Health Access California, the statewide health care consumer advocacy coalition. “Voters are clamoring for help with their health care bills, and these are big and bold steps that legislators can take this year. Together, these investments will help get California to near-universal health coverage in the next year or two, and lay a foundation for finally controlling costs in our health care system.”

              These hearings will discuss major investments in health care affordability that could potentially impact all Californians including:

              • A commitment to improve affordability for most of the 1.5 million in Covered California, beyond what is available from federal funds, to lower deductibles, co-pays, and other out-of-pocket costs that make accessing care still out-of-reach for many
              • The creation of an Office of Health Care Affordability to address health care costs for all Californians, by setting enforceable cost targets for all sectors of the industry.
              • An elimination of Medi-Cal premiums for tens of thousands of eligible children, working people with disabilities, and others who were just above the poverty line.
              • The Cal Rx effort will use the state’s purchasing power to get better prescription drug prices with a renewed focus on insulin.
              • An expansion of Medi-Cal to all income-eligible Californians, regardless of immigration status, starting January 1, 2024 for over 700,000 Californians (which will be discussed in hearings later this month).

              “This budget not only closes key coverage gaps, but also tackles the rising cost of health care with proposals to increase affordability in Covered California, making insulin more accessible, and prevent inflated prices over the entire health care system through an Office of Health Care Affordability,” said Diana Douglas, policy manager for Health Access California. “These proposals will build on years of work by advocates to make our health care system more affordable and accessible, while providing accountability on the health care industry to improve quality and equity in our care.”

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                California Governor Newsom’s 2022-23 Budget Proposal Makes Historic Investments Towards #Health4All

                Governor Gavin Newsom today unveiled the January proposal for the 2022-23 $286.4 billion state budget, which takes historic steps to close coverage gaps and bring California to near-universal health coverage. 
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                For Immediate Release: Monday, January 10, 2022

                CONTACT:
                Rachel Linn Gish, director of communications, Health Access California, rlinngish@health-access.org, 916-532-2128 (cell)
                Anthony Wright, executive director, Health Access California, awright@health-access.org, 916-870-4782 (cell)

                 

                CALIFORNIA GOVERNOR NEWSOM’S 2022-23 BUDGET PROPOSAL MAKES HISTORIC INVESTMENTS TO EXPAND ACCESS AND AFFORDABILITY TO HEALTH CARE

                • 2022-23 CA budget proposed today by Governor Gavin Newsom includes major investments towards a more universal, affordable, and equitable health care system, including the historic end to barriers in Medi-Cal for ALL income-eligible Californians, regardless of immigration status.
                • Budget continues key health cost, quality, and equity efforts, including the continued work to create an Office of Health Care Affordability to set cost targets across the health care system, make Covered California more affordable, new efforts to reduce or eliminate premiums in Medi-Cal, and a specific initiative to contract for lower insulin costs.

                SACRAMENTO, CA – Governor Gavin Newsom today unveiled the January proposal for the 2022-23 $286.4 billion state budget, which takes historic steps to close coverage gaps and bring California to near-universal health coverage.

                “We thank Governor Newsom for these historic investments to acknowledge the lessons of the pandemic, that our health is dependent on the health of each other. Our goal of universal coverage is more urgent that ever, and removing barriers to Medi-Cal coverage will close a cruel coverage gap, directly benefiting millions of Californians and their families while strengthening the health care system we all rely on,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition. “If this budget is approved, California will make history in being the first state to ensure access to coverage for all Californians, no matter their income, age, disability, or immigration status.”

                The California budget includes major investments in health care affordability that could potentially impact all Californians including:

                • An expansion of Medi-Cal to all income-eligible Californians, regardless of immigration status, starting January 1, 2024 for over 700,000 Californians.
                • A commitment to improve affordability for most of the 1.5 million in Covered California, beyond what is available from federal funds.
                • An elimination of Medi-Cal premiums for tens of thousands of eligible children, working people with disabilities, and others who were just above the poverty line.
                • The Cal Rx effort will use the state’s purchasing power to get better prescription drug prices with a renewed focus on insulin.
                • The creation of an Office of Health Care Affordability to address health care costs for all Californians, by setting enforceable cost targets for all sectors of the industry.

                “This budget not only closes key coverage gaps, but also tackles the rising cost of health care with proposals to increase affordability in Covered California, making insulin more accessible, and prevent inflated prices over the entire health care system through an Office of Health Care Affordability,” said Diana Douglas, policy manager for Health Access California. “These proposals build on years of work by advocates to make our health care system more affordable and accessible, while providing accountability on the health care industry to improve quality and equity in our care.”

                “COVID-19 doesn’t discriminate based on immigration status, and our health care system shouldn’t either,” said Jose Torres Casillas, policy and legislative advocate for Health Access California. “Expanding Medi-Cal coverage will benefit not just hundreds of thousands of essential workers we rely on, but the health and economic security of their families, and our common public health. We will work hard to make sure this budget passes to cover the Californians explicitly excluded from coverage because of where they were born, toward the goal of a more universal, accessible health system for all.”

                This proposed budget also includes a range of specific investments in response to the COVID-19 crisis. The Governor’s proposed budget makes other key health investments, including the continuation of the Cal-AIM effort to improve Medi-Cal program. Of note, the budget also removes scheduled provider cuts to Medi-Cal, and augments Prop 56 tobacco tax funds that have gone as supplemental payments to Medi-Cal providers over the past several years.

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                  HEALTH ACCESS: Updated Health Access Report Points to Success for New National Law Against Surprise Medical Bills Now in Effect

                  On the week that new federal rules go into effect to prevent patients from getting surprise medical bills, consumer advocacy group Health Access California releases an updated report on the California experience of a similar state law. The report shows the laws success in protecting patients from unexpected out-of-network bills as well as inflated premiums from provider overcharging with no indication of negative impacts on network size or patient access to care.
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                  For Immediate Release: Tuesday, January 5, 2022

                  CONTACT: Rachel Linn Gish, director of communications, rlinngish@health-access.org, (916) 532-2128 (cell)

                  NEW NATIONAL PATIENT PROTECTIONS AGAINST SURPRISE MEDICAL BILLS NOW BENEFITTING MILLIONS MORE IN CA AND ACCROSS THE COUNTRY

                  Updated Health Access Report Released Today Details California’s Experience, Undercuts Opposition Arguments

                  • Despite opposition from some health providers, new rules from US HHS Secretary Becerra are now in effect to prevent patients from getting unexpected out-of-network medical bills, often costing consumers thousands of dollars, if not much more.
                  • While California has had in place its own landmark law against surprise medical bills from out-of-network physicians, AB 72, since 2017, the federal law now extends these patient protections to over six million Californians in federally-regulated plans, and millions more across the country, as well as filling in gaps in state law on emergency rooms and air ambulances. See our fact sheet on the California impact. 
                  • California’s experience undercuts the arguments and scare tactics by law’s health industry opponents. A new Health Access report released today (updated from the original 2019 report) describes the positive impacts of that state law, which actually goes further than the federal deal in preventing inflated health prices. More recent studies show patients protected, providers paid, and networks increased.
                  • While consumers should now be taken out of the middle of these billing disputes, they should remain vigilant about what their plan covers, if a provider is out-of-network, cost sharing, and more.

                  SACRAMENTO, CA – On the week that new federal rules go into effect to prevent patients from getting surprise medical bills, consumer advocacy group Health Access California releases an updated report on the California experience of a similar state law. The report shows the laws success in protecting patients from unexpected out-of-network bills as well as inflated premiums from provider overcharging with no indication of negative impacts on network size or patient access to care.

                  “Finally, we have federal rules in place providing comprehensive consumer protections to prevent surprise medical bills, which can often be in the hundreds or thousands of dollars, if not much more. This solution to stop surprise medical bills protects patients, both from getting stuck with a life-altering bill because their medical provider was unexpectedly out-of-network, and from inflated premiums as well,” said Anthony Wright, executive director, Health Access California, the statewide health care consumer advocacy coalition.  “While the federal rules fill in the gaps in our state protections, California’s experience is useful to show the success of these protections, ensuring patients are protected and providers paid, with no evidence of a negative impact on access to care or network size.”

                  The updated report demonstrates how the state law, AB 72, which served as a model for the national law, has been successful in protecting patients from surprise bills which occur when patients go to an in-network hospital or facility but then get a bill from an out-of-network doctor. These bills come as a surprise to the consumer who did the right thing by going to an in-network facility or who sought emergency treatment that can often be hundreds or thousands of dollars or more.

                  California’s experience shows that providers are accepting the payments based on a benchmark similar to the “qualifying payment amount” in the federal regulations, with very few appeals in the four years since the state put in place its protections.  This and even more recent reports have shown no negative impact on patient access to care, with provider networks actually expanding.

                  CALIFORNIA’S EXPERIENCE SHOWS FEDERAL FIX WILL WORK: “California’s experience shows that this federal fix will work, preventing patients from getting billed by these out-of-network doctors, ERs, and air ambulances, while also preventing providers’ inflated charges from raising our premiums. California’s reality undercuts the scare tactics of some health providers that oppose the law and these important patient protection rules. In California, millions of patients have been protected, yet providers were paid fairly and timely, with few provider complaints or appeals, and networks actually increased, improving patient access to care,” said Wright.

                  MILLIONS OF CALIFORNIANS TO BENEFIT:  “These new federal rules thankfully keep California’s strong state solutions regarding physician surprise bills in place, while filling in key gaps, especially around emergency room bills and air ambulances, and for the over six million Californians in federally-regulated health plans exempt from state patient protections, and millions more across the country,” said Yasmin Peled, senior policy advocate with Health Access California, and the author of this fact sheet on the California impacts of this federal law. In California alone there are six million people who do not fall under California’s AB 72 protections because they are in federally regulated health care plans. Another million Californians are in plans regulated at the state Department of Insurance (CDI) and while they have protections against physician balance billing, they did not have the same protections against emergency room bills.

                  DIRECT CONSUMER ADVICE: “With these new rules in place, consumers should be taken out of the middle of these billing disputes between health plans and providers. Frankly, they shouldn’t have gotten these surprise bills in the first place, and hopefully they won’t now without any action by the patient,” said Wright.  “That said, patients should still be vigilant about what their plan covers and doesn’t, what is the cost-sharing in their plan, and whether their providers are out-of-network or not.”

                  “Patients can sign a consent form to knowingly go out-of-network for a certain provider and be charged accordingly, but that should be done well before the service—no patient should be coerced to have to accept such a deal,” said Wright. “Finally, patients need follow-up legislative action, to address the biggest gap in these federal and state protections, which are surprise medical bills by ground ambulances.”

                  In supporting the new federal regulations, Health Access submitted comments with numerous citations of studies showing California’s experience, and signed another letter with leading California consumer, labor, business, and insurer organizations in support.

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                    HEALTH ACCESS: CA DMHC Approves Centene-Magellan Merger With Conditions

                    For immediate release: Thursday, December 30, 2021 For more information, contact:Anthony Wright, executive director, Health Access California, 916-870-4782 (cell) MERGER WATCH: CALIFORNIA DMHC APPROVES CENTENE-MAGELLAN MERGER WITH CONDITIONS AND CONSUMER PROTECTIONS California’s Department of Managed Health Care today approved a “diagonal” merger between the health plan Centene and Magellan, with several conditions on protecting patients from premium hikes as a results of the merger, improving access to care, especially regarding behavioral health, and making investments in the state’s health system. Health and consumer advocates raised concerns about the merger at a public hearing earlier this year, arguing for many of the conditions imposed.  This was the first merger reviewed under a new law, AB 595 (Wood) of 2018, to gives Department of Managed Health Care (DMHC) increased authority over health plan mergers, resulting in a public hearing and an independent health system impact analysis. SACRAMENTO, CA–Today, California’s Department of [...] Read More
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                    For immediate release: Thursday, December 30, 2021

                    For more information, contact:Anthony Wright, executive director, Health Access California, 916-870-4782 (cell)

                    MERGER WATCH: CALIFORNIA DMHC APPROVES CENTENE-MAGELLAN MERGER WITH CONDITIONS AND CONSUMER PROTECTIONS

                    California’s Department of Managed Health Care today approved a “diagonal” merger between the health plan Centene and Magellan, with several conditions on protecting patients from premium hikes as a results of the merger, improving access to care, especially regarding behavioral health, and making investments in the state’s health system.

                    • Health and consumer advocates raised concerns about the merger at a public hearing earlier this year, arguing for many of the conditions imposed. 
                    • This was the first merger reviewed under a new law, AB 595 (Wood) of 2018, to gives Department of Managed Health Care (DMHC) increased authority over health plan mergers, resulting in a public hearing and an independent health system impact analysis.

                    SACRAMENTO, CA–Today, California’s Department of Managed Health Care (DMHC) approved the merger of Centene and Magellan, with several conditions, including those advocated by consumer advocates.

                    “While not everything we advocated for, we appreciate the significant conditions placed on the Centene-Magellan merger to ensure patients are protected, from premium hikes as a result of this merger, to the other negative impacts of consolidation.” said Anthony Wright, executive director, Health Access California, the statewide consumer advocacy coalition. “We urge the Department of Managed Health Care to continue to be vigilant to ensure that the newly merged company complies with these conditions and California’s consumer protections, and ensures timely access to needed care, including behavioral health. ”

                    This was the first merger reviewed by the Department of Managed Health Care under AB 595 (Wood) of 2018. Health Access provided comment at a public hearing held on October 27, 2018, after the release of an independent health system impact analysis required by the new law.

                    “As the first merger under a new law regulating health plan mergers, this deal had to go through a public process and an independent health system impact analysis. These deals that reshape our health system are too important to be rubber stamped without public analysis and input, and we are glad that resulted in stronger conditions and consumer protections. Mergers like this have major impacts on the health care system we all rely on, including what choices consumers have and what we pay. While we appreciate the conditions placed on this merger, we continue to have watchful about the impact this deal will have on our health system, and concerned about the broader trend towards greater consolidation and higher health costs,” said Wright. “Ample academic evidence indicates that health care mergers, including those in California, often drive up health care costs but rarely improve health care quality.”

                    The California Legislature and Governor Brown enacted AB 595 by Assemblymember Wood in 2018 to institute stronger state oversight over health plan mergers and protects Californians from changes to the health market that may lead to higher health costs.

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