Press Releases

Press inquiries may be directed to:

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

CA Senate and Assembly Budgets Align on Key Health Care Priorities

Today the California State Assembly Democrats unveiled their updated 2021-2022 Budget of Opportunity, which comes on the heels of last week's announcement from California State Senate Democrats of their Build Back Bolder budget outline. Both budget blueprints aligned on a number of key health care priorities, going above and beyond Governor Newsom's January 2021 budget proposal, and would take major steps to close the remaining gaps in the uninsured, by eliminating barriers to needed coverage and care. Ultimately, the budget proposals by the Senate and Assembly will get our state closer than ever to our goal of universal health care coverage. 
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For Immediate Release: Wednesday, April 28, 2021

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

CALIFORNIA STATE SENATE AND ASSEMBLY 2021-2022 BUDGET BLUEPRINTS ALIGN ON KEY HEALTH CARE PRIORITIES;

TOP HEALTH PROPOSALS WOULD MOVE CALIFORNIA CLOSER TO UNIVERSAL COVERAGE

  • CA State Assembly Democrats today unveiled their updated Budget of Opportunity, which includes key health care proposals that match closely with last week’s Build Back Bolder budget outline from the CA State Senate Democrats. 
  • With the CA State Senate and Assembly aligned on the issue of Medi-Cal expansions to more undocumented Californians, improving affordability in Covered California, and getting rid of the Medi-Cal assets test, all eyes now on the Governor to include these proposals in his May Revise.
  • While the Governor’s January 2021 budget proposal makes some investments in Medi-Cal, such as a $1.1 billion CalAIM proposal to improve the program, more is needed for Californians to have access to care and coverage in this pandemic and beyond.
  • Health care advocates urge the Governor to adopt proposals in his May Revise like those outlined by the Senate and Assembly Democrats.

SACRAMENTO, CA – Today the California State Assembly Democrats unveiled their updated 2021-2022 Budget of Opportunity, which comes on the heels of last week’s announcement from California State Senate Democrats of their Build Back Bolder budget outline. Both budget blueprints aligned on a number of key health care priorities, going above and beyond Governor Newsom’s January 2021 budget proposal, and would take major steps to close the remaining gaps in the uninsured, by eliminating barriers to needed coverage and care. Ultimately, the budget proposals by the Senate and Assembly will get our state closer than ever to our goal of universal health care coverage.

“These legislative budget proposals would expand access and affordability for hundreds of thousands of Californians seeking coverage and care, and get our state closer to a universal health system for all. These health proposals would provide urgent help to California families, particularly for older Californians that were disproportionately impacted by the COVID-19 crisis,” said Anthony Wright, executive director of Health Access California. “We applaud our legislative leaders of the Budget Committees for appropriately making health care a central plank of our state’s recovery from this public health and economic crisis.”

#HEALTH4ALL: Both the Assembly and the Senate highlighted Medi-Cal expansions to more income-eligible undocumented Californians as a top priority. This proposal was included in Governor Newsom’s January 2020 budget proposal, but was withdrawn due to a forecasted budget downturn that failed to materialize. Health and immigrant groups have been advocating for these expansions, starting with older Californians, as they are the most vulnerable population currently excluded from public coverage programs, and have been particularly at risk during the COVID-19 pandemic.

“With all the health issues raised by the pandemic, the time is now to remove unfair exclusions to care in Medi-Cal based simply on where you were born,” said Anthony Wright, executive director of Health Access California, which co-chairs the #Health4All campaign with the California Immigrant Policy Center. “This public health crisis has only highlighted what we’ve long known – our health care system is stronger when everyone has access to comprehensive health care, and able to get the primary and preventative care they need. We urge Governor Newsom to make this vital investment in the health of our communities, to help us get out of this pandemic and create a better and more equitable health care system moving forward.”

COVERED CALIFORNIA: Another investment prioritized by the state Senate and Assembly, but not included in the Governor’s January proposal, is the effort to improve affordability in Covered California. While President Biden’s American Rescue Plan made some historic investments to bring down premiums for those who purchase care on their own, many Californians still cannot afford care in our high-cost of living state. Many cost barriers remain including high deductibles and other out-of-pocket cost sharing. By redirecting the affordability assistance California invested for premiums two years ago, we can lower these costs and attract more Californians into coverage.

“The out-of-pocket costs to consumers in our health care system remains a huge barrier to care, particularly in an expensive state like California where many have to choose between paying housing, food, and health care bills each month,” said Wright. “If we can redirect our existing state subsidies, reduce or even eliminate deductibles, and lower other cost-sharing, more Californians will be able to afford care and will seek the care they need without fear that they can’t pay the bill. Just as Governor Newsom led by piloting additional affordability assistance in Covered California, which lead to the new federal premium help across the country, California can again lead the nation on the issue of lowering deductibles and cost-sharing.”

MEDI-CAL ASSETS TEST: Lastly, the Senate and Assembly both highlight the importance of eliminating the assets test in Medi-Cal that has for too long prevented some seniors from accessing Medi-Cal for having a small amount of savings. The proposal, also pending as SB 470 (Carillo), would expand access for seniors and people with disabilities, and allow them to have savings needed to deal with housing and other needs and emergencies.

Health care advocates praise the legislature for highlighting these health care priorities, and now look to the Governor’s May Revise to include these key investments as well, along with those the Governor has already committed to in the January budget, such as Cal-AIM reforms, improved vaccine distribution efforts, expanded Medi-Cal benefits, and creating a new Office of Health Care Affordability.

Learn More

Health Access Factsheet: Expanding Affordability Assistance in Covered California

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    CA Assembly Health Committee to Hear Key Bill to Contain Inflated Health Care Costs

    Today, the California Assembly Health Committee will consider a key bill, AB 1130 by Assemblymember Jim Wood, to implement a new statewide Office of Health Care Affordability, a new effort to address the rising cost of health care. As Californians face an affordability crisis on many fronts, the proposed Office is a bold, far-reaching effort to address inflated health care costs that are taking a bigger and bigger bite out of workers’ wages and family finances, forcing many people to skip or ration their care. This Office would put in place a comprehensive strategy to contain health care costs, setting targets for affordability with accountability, and drive innovation in payment and delivery of care while still prioritizing quality and equity.
    READ MORE

    For Immediate Release: Tuesday, April 6, 2021

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

    CA ASSEMBLY HEALTH COMMITTEE TO HEAR KEY BILL TO CONTAIN INFLATED HEALTH CARE COSTS

    New “Office of Health Care Affordability” would set cost goals across California’s entire health care industry

    SACRAMENTO, CA — Today, the California Assembly Health Committee will consider a key bill, AB 1130 by Assemblymember Jim Wood, to implement a new statewide Office of Health Care Affordability, a new effort to address the rising cost of health care. As Californians face an affordability crisis on many fronts, the proposed Office is a bold, far-reaching effort to address inflated health care costs that are taking a bigger and bigger bite out of workers’ wages and family finances, forcing many people to skip or ration their care. This Office would put in place a comprehensive strategy to contain health care costs, setting targets for affordability with accountability, and drive innovation in payment and delivery of care while still prioritizing quality and equity.

    While California has made enormous progress in extending health care coverage to millions of people in our state, the spiraling cost of care is still a huge obstacle to consumers, even when they have insurance coverage. Californians rank health care affordability as a top priority, with 84% calling it “extremely” or “very” important, according to a poll by the California Health Care Foundation (CHCF). The worry Californians experience about costs has direct implications for their care. The same survey reported that more than half of adults skipped or postponed care because of the cost, and 42% felt the consequences in worse health outcomes.

    “Californians are facing an affordability crisis on many fronts, but crushing increases in health care costs are at the top of the list, particularly during a pandemic,” said Yasmin Peled, a policy advocate for Health Access California, the statewide health care consumer advocacy coalition. “As consumers, workers, and taxpayers, we are paying more and getting less—less care and less health. When we can’t afford health care, it’s not just our pocketbooks that are at stake, it’s our lives.”

    The high cost of care in America – and in California – does not correlate to better care. The price of health care in the United States is higher, for almost all services, than in other developed nations. In California, health insurance premiums for employer coverage  increased by 249% between 2002 and 2017, six times the rate of general inflation. Americans get less care than those in many other wealthy countries, including fewer doctor visits and health outcomes in terms of illnesses, health status, and life expectancy are no better in the U.S., and on some measures, are even worse than other wealthy nations.

    An Office of Health Care Affordability addresses many of the market failures that have led to this situation, including unchecked cost growth and consolidation. It will set real goals for health care cost containment across our health care system, providing strategies and flexibility to the health stakeholders to meet these targets, and accountability if they don’t. AB 1130 is complementary to a companion effort by Governor Newsom in the California state budget. Both have the support of a broad range of organizations, including consumer, labor, business, and health care stakeholders.

    “We can’t meet goals that aren’t set,” said Peled. “With an Office of Health Care Affordability in place, we can track health costs across the industry, set enforceable targets, provide accountability, and better ensure quality, access, and equity goals are met. Ultimately, we hope to have savings returned to consumers who are facing these crushing health costs.”

    AB 1130 (Wood) will be heard during today’s state Assembly Health Committee, which begins at 1:00pm PST. You can access a livestream of the hearing here.

    Resources

    Fact sheets:

    Research:

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      CA Health Advocates Praise Nomination of Rob Bonta as State Attorney General

      Today Governor Gavin Newsom nominated Assemblymember Rob Bonta to be California's next Attorney General, replacing Xavier Becerra who was just confirmed as United States secretary of Health and Human Services last week. Here is a statement on the nomination from Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition:
      READ MORE

      For Immediate Release: Wednesday, March 24, 2021

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

      CA HEALTH ADVOCATES PRAISE NOMINATION OF ROB BONTA AS STATE ATTORNEY GENERAL

      SACRAMENTO, CA – Today Governor Gavin Newsom nominated Assemblymember Rob Bonta to be California’s next Attorney General, replacing Xavier Becerra who was just confirmed as United States secretary of Health and Human Services last week. Here is a statement on the nomination from Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition:

      “We are proud to have a health care champion like Rob Bonta as our state’s next Attorney General. As an Assemblymember and former chair of the Assembly Health Committee, Bonta worked to win key consumer protections like banning surprise medical bills, as well as advocated for crucial health care expansions in Medi-Cal, regardless of immigration status. Like his predecessors at the Department of Justice, he worked to defend the Affordable Care Act against attacks, and to take bold steps to build on it, and can continue the fight for California patients’ rights as Attorney General. We look forward to continuing to partner with him to take on the health care industry and confront issues like skyrocketing health care costs, prescription drug prices and hospital consolidation, towards the goal of ensuring greater health equity, quality, and access for all Californians.”

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        New Bill Helps Californians Track Out-of-Pocket Health Care Spending

        Today, the Senate Health Committee will hear a key patient protection bill, Senate Bill 368 (Limón), that would require consumers to receive timely and accurate information about their progress over the course of a year in meeting their deductible, out-of-pocket maximum, and other spending limits. Our health care system requires many consumers to pay for a share of their health care through deductibles and other out-of-pocket spending.
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        For Immediate Release: Wednesday, March 17, 2021

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

         NEW BILL HELPS CALIFORNIANS TRACK OUT-OF-POCKET HEALTH CARE SPENDING

        SB 368 (Limón), which is being heard in Senate Health Committee today, provides health consumers with the knowledge of how close they are to meeting their deductible and other spending limits, helping them better plan for their health care and other financial needs

        SACRAMENTO, CA – Today, the Senate Health Committee will hear a key patient protection bill, Senate Bill 368 (Limón), that would require consumers to receive timely and accurate information about their progress over the course of a year in meeting their deductible, out-of-pocket maximum, and other spending limits.

        Our health care system requires many consumers to pay for a share of their health care through deductibles and other out-of-pocket spending. Thankfully, the Affordable Care Act capped the lifetime amounts that a person must be forced to spend on care throughout their lives. This was a huge relief for many Californians who face high-cost medical needs and were often forced into bankruptcy to cover medical bills. But these same Californians must still meet deductibles and other spending limits before financial help kicks in. For these individuals, it’s vital to track these accruals so they can make financial planning decisions for themselves and their family, and better manage their health conditions. Currently health plans already track this information for their records, but it is not shared with consumers unless explicitly requested. SB 368 by Senator Limón requires health plan regulated by the Department of Managed Health Care to track and communicate accruals to enrollees.

        “People already experiencing significant health needs should have access to the same up-to-date deductible information health plans have available,” said Senator Limón, author of SB 368. “SB 368 provides consumers accurate and timely information on the cost of care they need, and can better budget their health and financial needs.”

        Health care spending for some can be significant. Many deductibles are over $1,000 and Covered California silver-level plans have deductibles of $4,000 for hospital stays. Consumers in the individual market may have deductibles as high as $7,000 or even $8,000. On top of this, every Californian with private coverage has a maximum out-of-pocket limit for covered essential health benefits. Though only a small percentage of people incur costs that put them close to their out-of-pocket limit, those that do meet this limit are the ones with the most burdensome and expensive-to-treat conditions. Major health care needs that add up quickly could include those relying on MS drugs, those with HIV/AIDS and someone undergoing cancer treatment.

        Despite the significant financial impact of deductibles and maximum out-of-pocket limits, consumers are often left with little help from insurance plans in tracking their accrual towards these amounts — even while their health plans have ready access to this information. Underserved communities may particularly suffer from this lack of transparency and face additional challenges, such as language barriers and health and financial literacy, that make keeping track of their payments even more difficult.

        “SB 368 shifts the burden for tracking these accruals from people to the health plans,” said Diana Douglas, policy advocate for Health Access California, sponsor of SB 368. “With regular communication on spending towards these limits, Californians can better stay on top of their health and financial well-being.”

        SB 368 will be heard today in Senate Health Committee which begins at 1:00pm.

        Resources

        FACT SHEET: SB 368 (Limón): Helping Consumers Keep Track of Their Deductibles and Maximum Out-of-Pocket Expenses

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          CA Advocates Praise Federal Bill on ACA Affordability Assistance, Urge State Action

          California consumer and health advocates hailed the current COVID-19 relief package that passed the Senate this weekend for its historic investments in health care coverage and accessibility, and urged its final passage in the House of Representatives. The package includes significant funding for vaccine distribution, direct income support to families, and aid to state and local governments that will assist in providing health and human services. Most notably, the federal bill provides historic financial assistance to help millions of Americans afford health coverage in the midst of this pandemic, ensuring that no American will pay more than 8.5% of their income on health care coverage.
          READ MORE

          For Immediate Release: Tuesday, March 9, 2021

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

           IN FEDERAL COVID-19 RELIEF BILL, OVER A MILLION CALIFORNIANS TO GET GREATER HELP TO AFFORD HEALTH COVERAGE;

          NEW CALL FOR CALIFORNIA TO REPURPOSE EXISTING STATE SUBSIDIES FOR ADDITIONAL AFFORDABILITY ASSISTANCE

          • House set to pass historic $1.9 trillion COVID-19 relief package and send to President Biden this week, which includes key health spending on vaccine distribution, direct support for families, aid to state and local government, and more.
          • Building on California’s successful state subsidy enhancements, the federal package includes historic new affordability assistance to well over a million with health coverage through Covered California, and potentially hundreds of thousands more, committing that nobody of any income has to spend more than 8.5% of their income for coverage, effectively eliminating all “affordability cliffs” in the ACA marketplaces.
          • Health advocates urge California lawmakers to extend and repurpose existing state subsidies to fill remaining affordability gaps, especially to lower cost-sharing and deductibles.

          SACRAMENTO, CA – California consumer and health advocates hailed the current COVID-19 relief package that passed the Senate this weekend for its historic investments in health care coverage and accessibility, and urged its final passage in the House of Representatives.

          The package includes significant funding for vaccine distribution, direct income support to families, and aid to state and local governments that will assist in providing health and human services. Most notably, the federal bill provides historic financial assistance to help millions of Americans afford health coverage in the midst of this pandemic, ensuring that no American will pay more than 8.5% of their income on health care coverage.

          This premium relief builds on the work already done in California, where the state has been investing in subsides for more people in Covered California since last year, above and beyond what the Affordable Care Act (ACA) provided.. As these state investments get supplanted with the federal assistance, advocates urge quick action for California policymakers to extend and repurpose the state subsidies to meet the additional affordability needs in our high cost-of-living state, including a reduction in cost-sharing and deductibles.

          Here is comment from Health Access California:

          ON THE OVERALL PACKAGE: “This federal package brings much-needed relief to Californians continuing to struggle with the current public health and economic crises. The major health investments will help our state get through the pandemic, with direct assistance to families to get and stay covered, necessary funds for an efficient and equitable vaccine distribution, and state and local aid to our health system that has been stretched to the brink,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition. “The additional help to afford coverage, whether through COBRA or Covered California and other ACA marketplaces, is a literal lifesaver in this public health emergency. Keeping Californians covered in this crisis is crucial not just to provide care to patients with COVID-19 but for all the co-morbid conditions that make this virus so deadly.”

          ON THE NEW AFFORDABILITY ASSISTANCE: “This new assistance, augmenting the help in the ACA insurance marketplaces like Covered California, is a long-sought victory in the work to strengthen the ACA and cover millions more Americans, and make care more affordable for millions more,” said Wright. “Retroactive to the beginning of the year and through 2022, the bill stipulates that no one will spend more than 8.5% of their income on coverage. Virtually everyone who gets a health plan through Covered California—around one and a half million Californians, up and down the income scale, and potentially hundreds of thousands more—will get new financial help, with new assistance totaling hundreds or even thousands of dollars. For low-income Californians, a new sliding scale will mean even lower costs, down to zero premiums for those at 150% of the poverty level or below. This new investment will eliminate all affordability cliffs in the individual health care market.”

          “For so many workers that lost not just wages and jobs but their employer-based health benefits during this pandemic, this help is an urgently needed lifeline, and protection against the sticker shock that many experience when looking buy a health plan as an individual,” concluded Wright.

          ON THE NEED FOR STATE ACTION ON SUBSIDIES: “California’s investment in state-level subsides was the vanguard for this federal financing. Implemented in 2020 by Governor Newsom and the Californian Legislature, after years of advocacy by health and consumer groups, the state subsides helped many Californians afford care during the pandemic. This federal bill takes the next step to cap those premiums and make care even more affordable. These new federal resources will supplant the state’s existing efforts, but California is an expensive state and Californian’s will continue to struggle to pay for care – particularly out of pocket expenses.  California policymakers should reinvest this money to fill ongoing affordability gaps, such as lowering cost-sharing and ever-increasing deductibles,” said Diana Douglas, policy advocate with Health Access California.

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          Resources

          KFF: Impact of Key Provisions of the House COVID-19 Relief Proposal on Marketplace Premiums

            New CA Bill Helps Connect Unemployed Californians to Health Coverage

            The COVID-19 pandemic has led to unprecedented job loss and drops in income, and with that a loss in job-based health care coverage. Since the implementation of the Affordable Care Act (ACA), most Californians without employer coverage can enroll in health insurance through Medi-Cal or Covered California, both which provide help in paying for coverage depending on income. Despite significant job loss as a result of the pandemic, both Medi-Cal and Covered California have experienced lower-than-expected enrollment, particularly among communities of color. Keeping Californians covered requires proactive efforts to ensure that they are aware of their options.
            READ MORE

            For Immediate Release: Friday February 19, 2021

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

            SB 644 (LEYVA) INTRODUCED TO HELP CONNECT UNEMPLOYED TO HEALTH COVERAGE

            Losing your job should not mean losing health care insurance

            SACRAMENTO, CA – The COVID-19 pandemic has led to unprecedented job loss and drops in income, and with that a loss in job-based health care coverage. Since the implementation of the Affordable Care Act (ACA), most Californians without employer coverage can enroll in health insurance through Medi-Cal or Covered California, both which provide help in paying for coverage depending on income. Despite significant job loss as a result of the pandemic, both Medi-Cal and Covered California have experienced lower-than-expected enrollment, particularly among communities of color. Keeping Californians covered requires proactive efforts to ensure that they are aware of their options.

            SB 644 introduced today by Senator Connie M. Leyva (D – Chino) and co-authored by Assemblymember David Chiu (D – San Francisco), will allow the Employment Development Department (EDD) to share information with Covered California for the purpose of connecting Californians facing job or income loss to their health care options. The bill is sponsored by the California Pan-Ethnic Health Network, Health Access California, and Western Center on Law & Poverty.

            “I introduced SB 644 to improve the ability of Californians—regardless of their employment status—to have access to affordable health care,” said Senator Leyva, author of SB 644. “The COVID-19 pandemic has further highlighted the need to close the gap in care so that all Californians are able to receive the health care that they or their family need.”

            EDD reports that amid the pandemic, 1.3 million more Californians filed unemployment insurance, with women, people of color, younger, and less educated workers experiencing disproportionate rates of job loss. Loss of job-based health coverage can exacerbate health disparities and lead to poorer health outcomes from COVID-19 related illness or delayed care.

            “Historically, people of color, women, and immigrants face the worst job losses during economic upheaval and that continues to be the case with COVID-19. These are the same communities who are most likely to be uninsured due to systemic racism and cultural and linguistic barriers to accessing care. We are proud to co-sponsor this bill as it will help to reverse health inequities by ensuring these vulnerable and underserved communities know their options and can avoid gaps in health care coverage at a time when it is most needed,” said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network.

            Providing Covered California with contact information for unemployment applicants would allow them to conduct proactive, targeted outreach to those who are likely to benefit from learning about coverage options and how to sign up for Covered California or Medi-Cal. This would include not only those who qualify for unemployment, but also those who apply and are ineligible, such as gig workers, those with insufficient hours, or those in the underground economy.

            “Californians should not face any barriers to accessing quality, affordable health care, during a pandemic and beyond,” said Diana Douglas, Policy and Legislative Advocate for Health Access California. “Keeping Californians covered helps consumers avoid costly and dangerous gaps in their care, and ensures patients will seek care when needed, which is essential to getting us all out of this pandemic sooner.”

            Covered California already does extensive marketing and outreach in multiple languages. Their robust enrollment program includes community-based navigators who offer culturally and linguistically appropriate assistance.

            “California’s unemployment rate has gone up, but Covered California and Medi-Cal enrollment has not increased proportionately. That’s especially dangerous for communities hard hit by COVID and unemployment,” said Jen Flory, policy advocate for Western Center on Law & Poverty. “People need health care no matter what, and dealing with unemployment is hard enough, we’re just asking the state to take one more step that could get thousands of Californians insured.”

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            Resources:

            SB 644 (Leyva) Sponsor Fact Sheet

              CA Bill Strengthens Surprise Medical Bill Protections After Win at the Federal Level

              A new California bill introduced today, AB 510 by Assemblymember Wood, will strengthen California's already historic protections against surprise medical bills. While California's AB 72 (2016) already protected most Californians from receiving costly medical bills for out-of-network care unknowingly received at an in-network facility, Congress recently passed the No Surprises Act which fills in most of the gaps which remained. The No Surprises Act, which will go into effect January 1, 2022, will cover the over 6 million Californians with coverage regulated at the federal level who were not protected under AB 72. While the state law is stronger in many areas, the new federal law includes some reforms that are even more consumer friendly than state law. AB 510 will conform state law with federal law, particularly regarding a patients' ability to consent to go out-of-network.
              READ MORE

              For Immediate Release: Wednesday February 10, 2021

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

              CA BILL STRENGTHENS SURPRISE MEDICAL BILL PROTECTIONS AFTER WIN AT THE FEDERAL LEVEL

              • Congress passed the No Surprises Act at the end of the last year benefiting millions of Californians who will now have protections against receiving surprise out-of-network bills when receiving in-network care, no matter who their insurer is. 
              • The new federal law keeps in place California’s four year-old landmark law against surprise medical bills from out-of-network physicians, AB 72, but there are areas with the new federal law has even stronger protections than state law.
              • A new CA bill, AB 510 (Wood) conforms state law with federal law, particularly regarding a patients’ ability to consent to go out-of-network. 

              SACRAMENTO, CA – A new California bill introduced today, AB 510 by Assemblymember Wood, will strengthen California’s already historic protections against surprise medical bills. While California’s AB 72 (2016) already protected most Californians from receiving costly medical bills for out-of-network care unknowingly received at an in-network facility, Congress recently passed the No Surprises Act which fills in most of the gaps which remained. The No Surprises Act, which will go into effect January 1, 2022, will cover the over 6 million Californians with coverage regulated at the federal level who were not protected under AB 72. While the state law is stronger in many areas, the new federal law includes some reforms that are even more consumer friendly than state law. AB 510 will conform state law with federal law, particularly regarding a patients’ ability to consent to go out-of-network.

              “Closing the loopholes which still allowed consumers to receive huge out-of-network surprise bills has only grown more urgent during this pandemic when many are finding themselves in the hospital or seeking emergency care. Aligning state and federal law will codify powerful consumer protections and keep Californians from falling into traps that might lead to a costly bill,” said Yasmin Peled, policy and legislative advocate for Health Access California, a sponsor of AB 510.

              Under the federal No Surprises Act, a patient can consent 72 hours in advance to receive care from certain types of providers who are out-of-network. However, this provision does not apply to emergency care or certain providers, including: anesthesiologists, radiologists, pathologists, neonatologists or if there is no in-network doctor at in-network hospital. Current California law allows consent only 24 hours in advance if given in writing and does not include any exemptions. AB 510 will adopt these stronger provisions that will reduce the number of potential out-of-network providers and give patients more time to consider their options when deciding whether or not to consent to out-of-network care.

              California will retain one of the most important provisions of AB 72, its payment standard for out-of-network physicians, which is better for consumers than the payment structure established in the federal No Surprises Act. In California, the payment between physicians and insurers remains the greater of 125 percent of Medicare, or the “average contracted rate” for that service for that health plan in that region. Providers or insurers can appeal through an Independent Dispute Resolution Process. This payment standard prevents inflated rates that may end up occurring in the structure established under the new federal law while ensuring that providers are paid fairly.

              “The federal act does not include a benchmark payment standard like California’s but instead relies on voluntary negotiations between insurers and providers, backed up by arbitration if negotiations fail,” said Assemblymember Wood, author of AB 510. “We have absolutely no interest in changing California’s current payment structure because it provides the most effective patient protections and also serves us well in controlling health care costs,” said Wood. “We put California’s benchmark payment structure into statute to protect patients, not to make payments more lucrative for providers.”

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                CA Governor 2021-22 Budget Proposal Provides Urgently Needed Short – Term Help, But Long – Term Investments Needed for Care, and California’s Recovery

                Governor Gavin Newsom today unveiled the January proposal for the 2021-22 state budget, which provides much needed short-term investments to help Californians in crisis, but more ongoing and long-term support will be necessary to move California down the road towards health and economic recovery.
                READ MORE

                For Immediate Release: Friday, January 8, 2020

                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)

                CA GOVERNOR 2021-22 BUDGET PROPOSAL PROVIDES URGENTLY NEEDED SHORT-TERM HELP,

                BUT LONG-TERM INVESTMENTS NEEDED FOR CARE, COVERAGE, AND CALIFORNIA’S RECOVERY

                • 2021-22 CA budget proposed today by Governor Gavin Newsom provides urgently needed financial help to confront the COVID-19 crisis, including $372 million for vaccine distribution. 
                • Budget proposal makes some investments in Medi-Cal, including $1.1 billion CalAIM proposal to improve Medi-Cal, and pushes back scheduled $1.2 billion cut to Medi-Cal provider payments, and, delaying that and other benefits suspensions for one year.
                • Budget restarts or continues key health cost, quality, and equity efforts, including a new Office of Health Care Affordability to address health consolidation and set cost targets, using the state’s purchasing power to get better prescription drug prices through Medi-Cal Rx, and more accountability to health plans to reduce disparities.
                • More is needed for Californians to have access to care and coverage in this pandemic and beyond including helping laid off workers who lost health coverage, increasing affordability assistance in Covered California, and expanding Medi-Cal regardless of immigration status to the goal of #Health4All.
                • California’s recovery needs a bigger and broader investments for public health and more such as increasing taxes on the wealthy to sustain services and prevent cuts in the future.

                SACRAMENTO, CA – Governor Gavin Newsom today unveiled the January proposal for the 2021-22 state budget, which provides much needed short-term investments to help Californians in crisis, but more ongoing and long-term support will be necessary to move California down the road towards health and economic recovery.

                “This budget’s immediate investments to confront the COVID-19 crisis and it ongoing improvements to Medi-Cal and our health system are appreciated and urgently needed, but we also urge the Legislature to look at what more can be done for Californians to get care and coverage that is desperately needed in this pandemic and its aftermath,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition. “The success of our health and economic recovery depends not just on these upfront investments, but our ongoing commitments to care, coverage and public health.”

                This proposed budget includes a range of specific investments in response to the COVID-19 crisis, including $372 million to augment the over $400 million already allocated for vaccine distribution. This critical investment is a key step in controlling the COVID-19 pandemic.

                The Governor’s proposed budget makes other key health investments, including a $532 million state commitment to restarting the Cal-AIM effort to improve Medi-Cal program. Of note, the budget delays suspensions and cuts from last year, such as a scheduled $1.2 billion cut to Medi-Cal, which was taken from Prop 56 tobacco tax funds that have gone as supplemental payments to Medi-Cal providers over the past several years. That cut is delayed for one year, as are other sunsets and suspensions for Medi-Cal coverage of extended post-partum coverage, and benefits like audiology, optical services, podiatry and others. The budget would also add glucose monitoring as a Medi-Cal benefit.

                “This budget proposal provides much needed and urgent help for Californians who are still in the middle of both a health and financial crisis, including specific health investments for testing, tracing, treatment, and therapeutics. The augmentation for vaccine distribution is especially helpful, since shortening this pandemic by even a few weeks would save thousands of lives, and help restart our economic recovery sooner,” said Wright. “We are also glad for the delays of the cuts to health care made last year, including a scheduled $1.2 billion cut to Medi-Cal providers, many of whom are on the front lines of this pandemic.”

                The budget also include key initiatives on health care costs, quality, and equity. This includes initiatives like the Medi-Cal Rx effort to use the state’s purchasing power to get better prescription drug prices, and a restarted effort to create a new Office of Health Care Affordability, to confront health care consolidation and set cost-growth targets for all sectors of the industry. Other industry accountability efforts would require health plans to meet goals regarding quality and reducing disparities, through regulation by the Department of Managed Health Care and contracting by Medi-Cal and Covered California.

                While some Medi-Cal investments were made, other key expansions were not included, such as a the critical step of removing barriers to Medi-Cal based on immigration status. This is of particular need for elders in the middle of a pandemic that is disproportionately harming seniors and communities of color.

                “We appreciate that the Governor has proposed a state budget that undoes some of the steep cuts of last year and makes immediate investments to respond to the COVID-19 crisis, but we ask our state leaders to think bigger and bolder about how to increase revenues for our state, including ideas to increase taxes on the richest California’s, who have only grown their wealth during this pandemic,” said Wright. “Ultimately, we need major investments in health care and coverage to get out of this crisis, particularly for low-income and communities of color being especially hard hit by the dual health and economic consequences of COVID-19.”

                “In order to fully address this pandemic and its aftermath, California leaders must recommit to expanding coverage and affordability assistance. We need to provide more assistance for those who have lost coverage along with their jobs and income, increase affordability assistance in Covered California, and remove exclusions in Medi-Cal based on immigration status,” said Ronald Coleman, policy director for Health Access California. “The coronavirus does not discriminate based on immigration status, and our health care system shouldn’t either. We are stronger when everyone is included getting the treatment and care they need as soon as possible, especially our seniors who are at most at-risk in this current pandemic. We will continue to fight 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.”

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                  Twenty Takeaways for 2020 For CA Health Care Consumers: Confronting the Challenges of COVID-19, While Protecting and Expanding Our Progress

                  California health policy and system changes in 2020 both responded to the COVID-19 crisis, but also continued the ongoing work to improve the state's health system. Even amidst COVID-19, new and noteworthy changes were made, culminating the years-long effort to ban surprise medical bills nationally. 
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                  For Immediate Release: Tuesday, December 29, 2020

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

                   TWENTY TAKEAWAYS FOR 2020 FOR CA HEALTH CARE CONSUMERS:

                  CONFRONTING THE CHALLENGES OF COVID-19, WHILE PROTECTING AND EXPANDING OUR PROGRESS 

                  • The signing of fifth federal COVID-19 relief bill on Sunday, including long-sought patient protections to prevent surprise medical bills, typifies 2020 for health care: seeking to confront the challenges of COVID-19, while taking some new steps forward, with more work to do.
                  • 2020 began with historic expansions in Medi-Cal and Covered California, new initiatives for transparency and accountability such as a new Health Payments Database, and efforts to control costs like state manufacturing of generic drugs. The year ended with a focus on shoring up the health care system through a historic pandemic, efforts to prevent #CABudget cuts to health programs due to the economic downturn caused the by the health crisis, and a renewed commitment to address racial inequality in our health care system.
                  • Progress was still made with several new laws taking effect on January 1 include expanded access to mental health services in private health insurance.
                  • Full list of ten victories in 2020 for CA health care consumers, and ten ongoing efforts from 2020 on the Health Access website: https://health-access.org/2020/12/twenty-takeaways-from-2020/
                  • #Care4AllCA Campaign of community and consumer groups continues to expand and improve our health system, with our goals more urgent than ever.

                  SACRAMENTO, CA – California health policy and system changes in 2020 both responded to the COVID-19 crisis, but also continued the ongoing work to improve the state’s health system. Even amidst COVID-19, new and noteworthy changes were made, culminating the years-long effort to ban surprise medical bills nationally.

                  “Even in a tough year like 2020, California was able to protect our progress and pursue additional health reforms, even as the unfinished work to improve the health system is desperately needed. COVID-19 has exacerbated the existing health inequities and disparities in the distribution of care, but has also given us an opportunity to do better. While California directly respond to the health care crisis at hand, 2020 also made way for greater transparency and accountability in our health care system,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition.

                  “Through legislation taking effect on January 1, Californians will have better access mental health care services, and new efforts to control health care costs are underway, from a new health payments database to a new state initiative to directly contract to manufacture generic prescription drugs.” said Wright. “The year’s protests also served to refocus our efforts to address racial inequities in our health care system, which have led to higher infection and death rates for Black and Latino communities not just for COVID-19, but a whole host of other ailments.”

                  Major coverage efforts that began on January 1, 2020, including a range of new Medi-Cal expansions and Covered California subsidies, were threatened in the budget crisis resulting from the COVID-19 pandemic and economic fallout. Health, senior, labor, and consumer advocates were able to stave off the worse of the cuts, which would have especially hit older Californians of color who were already at greater risk during the pandemic. California also led efforts to protect our progress under the Affordable Care Act, which continued to be under attack administratively and through litigation.

                  Also on the federal front, five COVID-19 relief packages provide some needed resources, even as key elements were not included, and California sought to do what it could. As part of the end-of-year COVID-19 relief package, a bipartisan solution on medical billing will ensure that patients don’t get unexpected out-of-network bills, such as when they go to an in-network facility but are seen by an out-of-network doctor. California has had this protection against many of these “surprise bills” since 2016, but gaps remained that were filled in by the new federal law. “The long-sought federal patient protections to prevent surprise medical bills that will help seven million Californians who were not covered by our state laws and at risk of these unexpected out-of-network charges that went into the hundreds or thousands of dollars, or even more from emergency rooms or air ambulances,” said Wright.

                  “Despite the federal administrative attacks on our health system, the pandemic and the resulting budget crisis, California was able to protect our progress, and continue the work to improve our health system by expanding coverage, controlling costs, and holding the industry accountable on quality and equity–all more urgent than ever,” said Wright. “We look forward to continuing the unfinished business of health reform into 2021, where we hope we will have a better federal partner, and better tools not just to control the COVID-19 crisis, but to improve public health past the pandemic.”

                  See the full list of Twenty Takeaways for 2020.

                  Here’s an abridged version of TWENTY TAKEAWAYS FOR 2020

                  TOP TEN ACCOMPLISHMENTS IN 2020 IN CALIFORNIA HEALTH POLICY:

                  1. Implemented first-in-the-nation coverage expansions in Medi-Cal and Covered California.
                  2. Advocated for aggressive and equitable state and federal responses to the COVID-19 crisis, from federal aid to expanding Medi-Cal to provide testing and treatment for COVID-19 for the uninsured and underinsured, extending Covered California’s special enrollment period, creating the Medi-Nurse line for the uninsured, instituting new insurance guidance to encourage COVID-19 testing and treatment without co-payments, etc.
                  3. Prevented proposed state budget cuts to Medi-Cal that would have curtailed benefits and access to care for millions.
                  4. Increased transparency of health care costs, quality, and equity, with a new Health Payments Database and enhanced rate reporting in the individual market. AB 2118 (Kalra)
                  5. Passed a first-in-the-nation initiative to help lower drug prices by allowing the state to contract to manufacture generic drugs under its own label. SB 852 (Pan)
                  6. Helped win mental health parity, expanding the range of mental health and substance use disorder treatments that private health insurance plans must cover. SB 855 (Weiner)
                  7. Banned flavored tobacco products in response to an alarming rise in e-cigarette use among youth. SB 793 (Hill)
                  8. Greater equity for LGBTQ Californians, by collecting data on sexual orientation and gender identity (SOGI) for public health efforts like those related to COVID-19, and other efforts. SB 932 (Weiner)
                  9. Expanded rural care in the County Medical Services Program (CMSP) consortium, with extended efforts under new “Path To Health” and “Connect To Care” options for the uninsured.
                  10. Stopped surprise medical bills with a long-sought federal fix passed by Congress in the end-of-year COVID-19 relief package.

                  TOP TEN ONGOING EFFORTS THAT WERE STARTED IN 2020:

                  1. Electing a new U.S. President & ending the Trump Administration’s four years of attacks on our health care, with key Californians to be Vice President and HHS Secretary.
                  2. Pushing back against Trump Administration attacks, from regulations on “public charge,” MFAR, and 1557, to litigation like the Supreme Court case to strike down the ACA.
                  3. Recommitting ourselves to racial justice and health equity by responding both internally and externally to the inequities highlighted by the national protests and COVID-19.
                  4. Serving as a key consumer voice on the rollout of the COVID-19 vaccine, as part of California’s Community Vaccine Advisory Committee..
                  5. Highlighting the need for new investments and increased revenues, while launching the #CommitToEquity campaign.
                  6. Getting commitments to cover seniors in Medi-Cal regardless of immigration status, with more work to get this and other steps to #Health4All.
                  7. Initiating new efforts to improve Medi-Cal, including a new Cal-AIM set of reforms to better coordinate care, and a new re-procurement process to set higher standards in Medi-Cal.
                  8. Establishing the framework for a possible new Office of Health Care Affordability, to have coordinated oversight of the health system and to set enforceable cost-growth targets.
                  9. Continuing oversight on hospital consolidation, with the Attorney General implementing a $575 million settlement with Sutter, and imposing conditions on specific hospital mergers.
                  10. Beginning the work to plan out a path to universal health coverage through a unified financing system as part of the Healthy California for All Commission.

                  See the full list of Twenty Takeaways for 2020 on the Health Access website.

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

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

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                    Californians to Benefit from COVID-19 Relief and Solution to Surprise Medical Bills

                    Health advocates expressed support for the package of COVID-19 financial relief set for a vote in Congress today, with the vow to continue to advocate for key elements that are not included in the current package, such as state and local aid to maintain health and other vital services. In particular, health advocates are pleased with the inclusion of consumer protections to stop surprise medical bills, a long-sought solution to ensure patients don’t get unexpected out-of-network bills from health providers, which can often be in the hundreds or thousands of dollars. 
                    READ MORE

                    For Immediate Release: Monday, December 21, 2020

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

                    CALIFORNIANS TO BENEFIT FROM COVID-19 RELIEF AND SOLUTION TO SURPRISE MEDICAL BILLS

                    • While much more is needed, the Congressional COVID-19 package includes direct help to California families, and funding for vaccine distribution. 
                    • The federal proposal also protects patients and stops surprise medical bills from doctors, hospitals, emergency rooms, and air ambulances.
                    • The new national fix–years in negotiation–would keep in place California’s four year-old landmark law against surprise medical bills from out-of-network physicians, AB 72. Health Access’  2019 report  described the positive impacts of that state law, which goes further than the federal deal in preventing inflated health prices.  
                    • Federal fix fills in gap to stop surprise medical bills, especially for emergency rooms and air ambulances, and additionally for around seven million Californians currently in health plans that have been exempt from existing state patient protections.

                    SACRAMENTO, CA – Health advocates expressed support for the package of COVID-19 financial relief set for a vote in Congress today, with the vow to continue to advocate for key elements that are not included in the current package, such as state and local aid to maintain health and other vital services. In particular, health advocates are pleased with the inclusion of consumer protections to stop surprise medical bills, a long-sought solution to ensure patients don’t get unexpected out-of-network bills from health providers, which can often be in the hundreds or thousands of dollars.

                    “While the omission of key priorities like state aid will need to be revisited, this federal deal offers urgent relief crucial in this public health & economic crisis, from direct financial help for families to protection for patients against surprise medical bills. We will continue to advocate in the new year for the funds needed so state and local governments maintain health and other vital services, and affordability assistance for Californians to get and stay covered,” said Anthony Wright, executive director, Health Access California, the statewide health care consumer advocacy coalition. “In particular, money for vaccine distribution is especially important to ensure an efficient & equitable distribution that will help us get out of this COVID-19 crisis as quickly as possible. Public health professionals have been pleading for help, so we are not just jerryrigging the vaccine distribution on top of the fragmented financing of our patchwork health system. Investing in a smart and sensible coordination of vaccination will have big returns in getting our society and economy back sooner.”

                    ON SURPRISE MEDICAL BILLS: “We are relieved that the federal package finally includes a solution to surprise medical bills, protecting patients from getting stuck with a life-altering bill because their medical provider was unexpectedly out-of-network. This deal keeps 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 7 million Californians in health plans exempt from state patient protections who have been at risk of getting these bills,” said Yasmin Peled, policy advocate with Health Access California.

                    “While this federal fix to surprise medical bills was not our preferred solution, it still does the job to prevent patients from getting billed by these out-of-network doctors, ERs, and air ambulances, and including key protections against providers’ inflated charges. During this pandemic and after, patients will have the security of not getting a surprise medical bill when they do the right thing and seek needed care in-network but find out that their provider was unknowingly out-of-network.”

                    report released last year by Health Access showed the success of California’s compromise solution to stop surprise medical bills (AB 72). The report demonstrates how the three year old 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, and can often be hundreds or thousands of dollars or more. While the report highlights the success in stopping surprise medical bills, many Californians needed a federal solution. In California alone there are six million people who do not fall under the protections of AB 72 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.

                    In addition to actively working on a federal fix, Health Access California had been working in the California Legislature over the past two years to pass AB 1611 (Chiu), to fill these gaps in state patient protections, but those efforts stalled in Senate Health Committee. The federal legislation resolves these issues, and also commissions a study on ground ambulance services, a remaining source of surprise medical bills.

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