Press Releases

Press inquiries may be directed to:

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

Health and Consumer Advocates Gain New Momentum For Statewide Solution To Surprise ER Bills

Zuckerberg San Francisco General Hospital announced a proposal to be considered by the San Francisco Health Commission today to end the practice of "balance billing," where insured patients get billed the remaining balance after insurer payment of an emergency room bill. 
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For Immediate Release: Tuesday, April 16th, 2019

For more information, 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)

As Zuckerberg San Francisco General Hospital announces new policy ending  the practice of “balance billing”

HEALTH AND CONSUMER ADVOCATES GAIN NEW MOMENTUM FOR STATEWIDE SOLUTION TO SURPRISE ER BILLS

  • New proposed ZSFGH policy to be heard today at the San Francisco Health Commission would ban ER “balance billing”, limiting patient bills to in-network cost-sharing and new out-of-pocket maximums, based on a sliding scale. Proposal also includes increased “charity care” for uninsured. 
  • Statewide solution to cover all California patients and hospitals, AB 1611 (Chiu), is scheduled to be heard next Tuesday, April 23rd, in California Assembly Health Committee.
  • AB1611, sponsored by Health Access California and the California Labor Federation, would stop surprise ER bills across the state, preventing bills to patients beyond in-network cost-sharing, and help prevent inflated premiums by setting a standard for reimbursement to the hospital at 150% of Medicare or average contracted rate.

SAN FRANCISCO, CA — Zuckerberg San Francisco General Hospital announced a proposal to be considered by the San Francisco Health Commission today to end the practice of “balance billing,” where insured patients get billed the remaining balance after insurer payment of an emergency room bill.  This practice can leave patients with bills in the tens of thousands of dollars. The California Legislature this year introduced AB 1611 (Chiu) to end this practice and it is set for it’s first hearing in the Assembly Health Committee on Tuesday, April 23rd. The bill builds on 2016’s AB 72, which prevented this practice in other health facilities.  Here is a statement from Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition, and a co-sponsor of both AB 72 and this year’s AB 1611:

“The issue of surprise medical bills is much bigger than one hospital or one city. While we appreciate that San Francisco leaders are taking action to stop this practice at Zuckerberg San Francisco General Hospital, we will continue to seek a statewide solution. A bill currently in the California Legislature, AB 1611 by Assemblymember David Chiu, would end surprise emergency room bills that are not just unfair, but can send a family’s finances into a free-fall. Patients are doing everything right in seeking care during an emergency. When you or a loved are on a gurney in an ambulance, you are in no position to choose what emergency room you end up at, and you certainly should not get any extra or inflated charges if the hospital happens to be out-of-network.”

“AB 1611 closes loopholes in California’s otherwise strong consumer protections against surprise medical bills, taking the patient out of the middle of billing disputes between hospitals and insurers. After experiencing the trauma of an emergency, this bill helps ensure that patients and their families don’t face the additional trauma of an outrageous and unfair hospital bill.

“We hope this San Francisco proposal gives greater momentum for a solution that help patients throughout California and we urge hospital leaders to support these patient protections at the state level. With backing from patient, consumer, community, labor, and other organizations, AB 1611 will be heard next Tuesday in the Assembly Health Committee.”

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    Health Coverage and Affordability Expansions Pass Key Policy & Budget Committees This Week

    This week, California legislators advanced down the path towards universal health care in California by approving a number of major proposals to expand health coverage and increase affordability for hundreds of thousands of Californians, and which together could cut the state's uninsured rate in half.
    READ MORE

    For immediate release: Wednesday, April 10, 2019   

    For more information, contact

    Anthony Wright, executive director, Health Access California, 916-870-4782 (cell)

    Rachel Linn Gish, director of communications, Health Access California, 916-532-2128 (cell)

    HEALTH COVERAGE AND AFFORDABILITY EXPANSIONS PASS KEY POLICY & BUDGET COMMITTEES THIS WEEK

    • This week the CA Legislature heard and approved a number of priority bills to #Care4AllCA on expanding coverage, increasing affordability, containing costs, and improving quality in our health care system.
    • The bills and budget proposals advanced this week both support and go beyond the Governor’s health care plan, helping more Californians and potentially cutting the number of uninsured in half. These efforts are supported by the #Care4AllCA campaign of over 70 consumer and community groups who seek a down payment-level investment towards the goal of universal coverage this year.

    SACRAMENTO — This week, California legislators advanced down the path towards universal health care in California by approving a number of major proposals to expand health coverage and increase affordability for hundreds of thousands of Californians, and which together could cut the state’s uninsured rate in half. The bills and budget proposals would also reduce costs in our health care system while also improving quality and equity for consumers. These actions are supported by the #Care4AllCA campaign of 70 consumer and community groups committed to reaching universal health care in California, without the need for federal approvals.

    Some measures moving forward this week would be first-in-the-nation steps to expand Medi-Cal to all income-eligible Californians, regardless of immigration status, and increasing affordability assistance in Covered California. Together these two proposals would extend coverage access to over 2 million more Californians.

    “The California Legislature made it clear this week that they are committed to making a major downpayment towards universal health care this year,” said said Anthony Wright, executive director of Health Access California and a co-convener of Care4All California. “Especially in this high cost-of-living state, Californians need more help in accessing and affording health care and coverage, and we are glad that state policymakers are responding.”

    “These bold proposals–to invest in greater affordability assistance, to continue the individual requirement to have coverage at the state level, to expand Medi-Cal to all income-eligible Californians regardless of age, disability, or immigration status–would work together to cut the uninsured rate in half,” continued Wright. “Our entire health system is stronger when more people are covered.”

    The #Care4AllCA campaign supports Governor Newsom’s health care plan, while also promoting measures this week that go beyond what he proposed, mainly by opening Medi-Cal to all adults regardless of age or immigration status and by increasing the number of people able to get assistance (under 250% FPL and up to 600% of FPL) and implementing the assistance before re-instating an individual mandate.

    Here is a re-cap of bills and budget proposals heard this week:

    • ​#HEALTH4ALL
      • The Assembly Health Committee passed AB 4 (Bonta, Chiu, Santiago) to remove unfair exclusions in Medi-Cal passed on immigration status. Many community members shared their personal stories of impact.
      • The Assembly Budget Subcommittee on Health and Human Services debated the investments needed to expand access to all adults, not just between ages 19 and 26 as the Governor has proposed. These discussions will inform the budget priorities for the State Assembly.
    • AFFORDABILITY
      • Health Committees in both the Assembly and the Senate passed bills to increase financial assistance in Covered California with SB 65 (Pan) and AB 174 (Wood)
      • The Assembly Budget Subcommittee on Health and Human Services also debated investments to increase subsides in our individual market. These discussions will inform the budget priorities for the State Assembly.
    • OTHER COVERAGE:
      • Health Committees in both the Assembly and the Senate passed bills to reinstate the individual mandate at the state-level with SB 175 (Pan) and AB 414 (Bonta)
      • The Assembly Health Committee also passed AB 526 (Petrie-Norris) to streamline Medi-Cal enrollment for WIC program participants and AB 1246 (Limon) to level the playing field for benefit standard and prescription drug protections.
      • The Assembly Budget Subcommitte on Health and Human Services also debated:
        • Ending the “senior penalty” in Medi-Cal
        • Increasing funding for navigators to help Californians enroll in health care
        • Budget investment needed to streamline WIC enrollment participants into Medi-Cal
    • LOWERING HEALTH CARE COSTS
      • AB 824 (Wood) targeting the harmful Big Pharma practice of “pay for delay” for prescription drugs gained bipartisan support in the Assembly Judicary Committee
    • IMPROVING QUALITY AND EQUITY
      • The Assembly Health Committee passed AB 537 (Wood) to ensure higher quality in Medi-Cal managed care plans.
      • The Senate Health Committee passed SB 464 (Mitchell) to provide implicit bias training to reduce maternal mortality deaths for black women.

    Background

    In March 2018, over 50 organizations came together in the #Care4AllCA campaign to advance universal coverage in the near future, without the need for federal approvals. The campaign advanced 20 bills and budget items last year, and had eight pieces of legislation signed into law, however coverage expansion elements were not included. The path to universal coverage that campaign endorsed that did not need federal approval, but was complementary with longer-term efforts like a Medicare-for-All system, included expanding Medi-Cal to remove exclusions based on age, disability, or immigration status; providing greater affordability assistance in the individual insurance market and Covered California; re-instituting a state-level individual requirement to purchase coverage; and other reforms, including expanding prescription drug purchasing collaborative. This year, the coalition unveiled a revised package of 22 bills and budget items, some returning, toward these goals.

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      Legislation to Prevent PhRMA “Pay for Delay” Practices that Keep Prescription Drug Prices High Passes Key California Judiciary Committee

      A first-of-its-kind state legislation to prevent "pay-for-delay" pharmaceutical company pricing practices passed the Assembly Judiciary Committee today with bipartisan support.
      READ MORE

      For Immediate Release: Tuesday, April 9, 2019

      CONTACT: 

      Anthony Wright, executive director, Health Access California, awright@healthaccess.org, 916-870-4782 (cell)

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

      LEGISLATION TO PREVENT PHRMA “PAY FOR DELAY” PRACTICES THAT KEEP PRESCRIPTION DRUG PRICES HIGH PASSES KEY CALIFORNIA JUDICIARY COMMITTEE

      • AB 824, authored by Assemblymember Wood and sponsored by Attorney General Xavier Becerra, discourages drug companies from paying generic manufacturers to delay the entry of competitive drugs and thus keeping the price of medications artificially high. 
      • Consumer groups testified in support of the bill which passed Assembly Judiciary Committee today with bipartisan support, despite PhRMA opposition. 
      • This initiative builds on California’s leadership on tackling rising prescription drug prices, including Governor Newsom’s push for a state prescription drug purchasing pool, and 2017’s SB 17 (Hernandez) which required advance notice of drug price hikes over 16% over two years.

      SACRAMENTO, CA — A first-of-its-kind state legislation to prevent “pay-for-delay” pharmaceutical company pricing practices passed the Assembly Judiciary Committee today with bipartisan support. The California bill seeks to prevent drug manufacturers offering patent settlements to pay generic companies to delay the introduction of lower-price medication to the market. The bill, AB 824 authored by Assemblymember Jim Wood and sponsored by Attorney General Xavier Becerra, curbs this practice that reduces competition and arbitrarily keeps life-saving medications more expensive.

      These collusive agreements harm consumers. A 2010 study by the Federal Trade Commissioner concluded that these collusive pay-for-delay agreements cost consumers $3.5 billion each year in higher costs for prescription drugs. This means Californians would save hundreds of millions of dollars a year if these practices were prevented–and the number is likely much higher today.

      Assembly Bill 824 by Assemblymember Wood would end pay-for-delay and hold drug corporations accountable for their pricing tactics.

      “When drug companies pay to prevent a lower-price medication from entering the market, we all pay more, at the pharmacy and in our premiums. What’s the point of life-saving medications if people can’t afford to use them?” said Yasmin Peled, policy advocate for Health Access California, the statewide consumer advocacy coalition and strong supporter of AB 824 (Wood). “With this bill, California can take the lead in preventing this problematic, price-gouging practice of pay-for-delay by prescription drug companies.”

      The bill had previously passed the California Assembly Health Committee, and now proceeds to the Assembly Appropriations Committee. Federal legislation on “pay for delay” practices was passed last week out of the U.S. House Energy and Commerce Committee.

      AB 824 is the major prescription drug price bill this year in the legislature in California, which has been a national leader is confronting the issue of prescription drug prices.

      * In 2017, SB 17 (Hernandez) was signed into law to require all drug price hikes over 16% over a two-year span to be subject to transparency requirements, which discourages double-digit price increases and encourages better negotiations between drug companies and purchasers. This advance notice is given to public purchasers like Medi-Cal and CalPERS and private purchasers including health plans and insurers. It also enhances public disclosure of information about drug pricing by requiring drug manufacturers to file information about the rationale for pricing increase, marketing costs, and other specifics with the Office of Statewide Health Planning and Development. The law also requires health plans and insurers to disclose information about drug pricing through existing rate review processes at the Department of Managed Health Care and Department of Insurance. Co-sponsored by Health Access California, SB 17 was strongly backed by a broad coalition of consumer, labor, business, insurer, and other health organizations, but opposed by the pharmaceutical industry.

      * Other recent legislation around prescription drug have included AB 315 (Wood) to regulate pharmacy benefit managers and SB 1021 (Wiener) to maintain co-pay caps to keep life-saving drugs affordable.

      * Earlier this year, Governor Newsom proposed a statewide prescription drug purchasing pool, to consolidate the purchasing power of various state agencies, and ultimately other payers, to negotiate the best possible deal on pharmaceutical prices for Californians.

        Major Expansions of Coverage Considered by CA Legislative Committees This Week

        This week, California legislators will continue to hear and consider major proposals to expand health coverage and increase affordability for hundreds of thousands of Californians, and which together would cut the state's uninsured rate in half.
        READ MORE
        For immediate release: Monday, April 8, 2019   
        For more information, contact
        Anthony Wright, executive director, Health Access California, 916-870-4782 (cell)
        Rachel Linn Gish, director of communications, Health Access California, 916-532-2128 (cell)

        THIS WEEK: CALIFORNIA LEGISLATURE TO HEAR KEY BILLS AND BUDGET PROPOSALS TO EXPAND HEALTH COVERAGE AND AFFORDABILITY

        • TODAY at 2:30pm, the CA Assembly Budget Subcommittee #1 on Health & Human Services will hear key budget proposals for health coverage expansion, including greater affordability assistance in Covered California, expanding Medi-Cal to all regardless of age, disability, or immigration status, and greater outreach for enrollment.
        • TOMORROW, Tuesday, April 9th the CA Assembly Health Committee will vote on a number of vital coverage and quality bills including the #Health4All bill AB 4 (Bonta, Chiu), to expand Medi-Cal to all income-eligible Californians regardless of immigration status, an individual mandate, and #Care4AllCA priority bills to increase affordability assistance, streamline enrollment, and improve Medi-Cal quality
          • Also tomorrow, Tuesday, the Assembly Judiciary Committee will hear AB 824 (Wood) to end harmful Big Pharma pay-for-delay pricing practices 
        • On WEDNESDAY, April 10th, the CA Senate Health Committee will also hear proposals on affordability, a state-level individual mandate, and increasing equity in our health care system.
        • Together, these bills and budget proposals go beyond the Governor’s health care plan, helping more Californians and potentially cutting the number of uninsured in half. These efforts are supported by the #Care4AllCA campaign of over 70 consumer and community groups who seek a down payment-level investment towards the goal of universal coverage this year.
        SACRAMENTO — This week, California legislators will continue to hear and consider major proposals to expand health coverage and increase affordability for hundreds of thousands of Californians, and which together would cut the state’s uninsured rate in half. The bills and budget proposals also seek to reduce costs in our health care system which also improving quality and equity. These actions are all supported by the #Care4AllCA campaign of 70 consumer and community groups committed to reaching universal health care in California, without the need for federal approvals. 
        One proposal to expand Medi-Cal to all income-eligible Californians regardless of immigration status will be discussed today in the Assembly Budget Subcommittee on Health and Human Services, and a bill on that topic, AB 4 (Bonta, Chiu) will be voted on tomorrow in Assembly Health Committee. AB 4, along with SB 29 (Durazo) in the Senate, would go beyond the Governor’s proposal to cover undocumented young adults up to age 26, to cover all income-eligible Californians regardless of age.
        “The need to expand access to Medi-Cal to all Californians has never been more urgent, as federal attacks continue to explicitly impact the physical and mental health of California’s immigrant communities,” said Anthony Wright, executive director of Health Access California and a co-convener of Care4All California. “Our health care system works better and benefits all Californians when everyone is covered. “
        The other key piece to expanding coverage is to increase affordability assistance to Californians buying coverage on their own. This week a number of budget and policy committees will hear proposals to increase financial assistance to those purchasing coverage in Covered California. These proposals, championed by the #Care4AllCA campaign, also go beyond the Governor’s proposals, by increasing the number of people able to get assistance (under 250% FPL and up to 600% of FPL) and implementing the assistance before re-instating an individual mandate.
        “Especially in our high cost of living state, millions of Californians still struggle to made ends meet and pay their health care premiums and cost-sharing. We must include more low- and middle-income Californians in these proposals to truly make our goal of universal coverage that is also affordable,” said Wright.
        Affordability proposals include:
        • Affordability proposal for the 2019-2020 state budget (heard today in Assembly Budget Subcommittee on Health & Human Services)
        • AB 174 (Wood) (heard tomorrow in Assembly Health Committee)
        • SB 65 (Pan) (heard Wednesday in the Senate Health Committee).

        The Assembly and Senate Health Committees will also hear proposals to reinstate the individual mandate in California. 

        Other proposals to help Californians afford and access care and coverage will also be heard this week including
        • Budget proposals to end the “senior penalty” in Medi-Cal, address the Medi-Cal assets test, increase health care navigator funding, and streamline Medi-Cal enrollment for those in the WIC program
        • AB 824 (Wood) targeting the practice of “pay for delay” for prescription drugs 
        • AB 526 (Petrie-Norris) policy proposal to streamline Medi-Cal enrollment for WIC program participants. 
        • AB 537 (Wood) to ensure higher quality in Medi-Cal managed care plans
        • AB 1246 (Limon) to level the playing field for benefit standard and prescription drug protections
        • SB 464 (Mitchell) to provide implicit bias training to reduce maternal mortality deaths
        “These bold proposals–to invest in greater affordability assistance, to continue the individual requirement to have coverage at the state level, to expand Medi-Cal to all income-eligible Californians regardless of age, disability, or immigration status–would work together to cut the uninsured rate in half,” said Wright. “Listening to the voters in a health care election, the Legislature is right to go beyond the significant steps the Governor has laid out in order to get to a real down-payment towards the goal of universal health care this year. Low- and middle-income Californians across the state need the help as soon as possible, to be able to afford care and coverage.”
        The Care4All California campaign of over 70 health, consumer, and community organizations proposed many parts of this agenda last year, and are backing over 20 bills and budget items this year, many aligned with and building on Governor Newsom’s goals. 
        Background
        In March 2018, over 50 organizations came together in the #Care4AllCA campaign to advance universal coverage in the near future, without the need for federal approvals. The campaign advanced; 20 bills and budget items last year, and had eight pieces of legislation signed into law, however coverage expansion elements were not included. The path to universal coverage that campaign endorsed that did not need federal approval, but was complementary with longer-term efforts like a Medicare-for-All system, included expanding Medi-Cal to remove exclusions based on age, disability, or immigration status; providing greater affordability assistance in the individual insurance market and Covered California; re-instituting a state-level individual requirement to purchase coverage; and other reforms, including expanding prescription drug purchasing collaborative. This year, the coalition unveiled a revised package of 22 bills and budget items, some returning, toward these goals.
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          California Moves Forward on Reducing Health Care Costs: Bills to Improve Transparency on Health Care Pricing Advance in Legislature

          Today, the Senate Health Committee approved SB 343 (Pan), the third of several bills from Care4All California that hold the health care industry accountable for soaring insurance premiums, hospital, doctor, and prescription drug costs.
          READ MORE

          For Immediate Release

          April 3, 2019

          Contact: Rachel Linn Gish 916-532-2128
          Mike Roth, 916-813-1554

          California Moves Forward on Reducing Health Care Costs: Bills to Improve Transparency on Health Care Pricing Advance in Legislature

          California’s leadership on health prices comes as health care debate intensifies on the national level

          Sacramento, CA –Today, the Senate Health Committee approved SB 343 (Pan), the third of several bills from Care4All California that hold the health care industry accountable for soaring insurance premiums, hospital, doctor, and prescription drug costs.
          SB 343 (Pan) will add greater transparency to the health care industry by bringing Kaiser Permanente up to the same reporting requirements as the rest of the industry. This continues the momentum to address the rising cost of care in the California legislature. On March 26th, the Assembly Health Committee also approved AB 731 (Kalra) to enhance the rate review of large group plans, providing this protection and cost-savings to millions more Californians, and AB 824 (Wood) that would curb the harmful pay-for-delay prescription drug pricing practice that drives up costs for consumers.

          On April 23rd, the conversation on health care costs will continue when the Assembly Health Committee will hear AB 1611 (Chiu) to prevent surprise out-of-network emergency room bills than can amount to tens of thousands of dollars.

          “Responding to urgent voter demand for price relief, California legislators are moving bills to confront soaring costs that are crushing families,” said Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition. “AB 731 and SB 343 empower Californians to demand fairer insurance prices, building on successful reforms that have already saved small businesses and individual consumers more than $226 million. These bills supported by the Care4All California campaign improve accountability on the health care industry and prevent consumers from picking up the tab of increasing health care costs. While DC debates, we need our state legislators to take action to curb the high costs for care and coverage.”

          Care4All California is a campaign of more than 70 consumer, community, labor, progressive and health care organizations. In February, the campaign unveiled a plan, made up of a package of bills and budget items that together will move California closer than ever to universal coverage by eliminating many remaining coverage gaps, improving quality and equity, and reducing prices for health care consumers. The health care price reduction legislation includes:

          • AB 731, passed from the Assembly Health Committee on March 26, would expand the Department of Managed Health Care and California Department of Insurance’s authority to conduct “rate review” in the large group insurance market. Today, California’s health insurance regulators can tell individuals and small businesses whether their insurance company’s charges are reasonable or justified, and what goes into proposed rate hikes. Since this law went into effect in 2011, it has saved individuals and small businesses $226 million. If the state applies the same transparency rules to insurance plans for large employers, it will give workers and their employers the ability to negotiate a better deal on health care and has the potential to save employers and their workers billions of dollars. The legislation is co-sponsored by Health Access California, California Labor Federation, SEIU California, UNITE HERE, and Teamsters.
          • SB 343 (Pan), passed from the Senate Health Committee today, creates a uniform reporting standard for health plan data and hospital financial reporting. The bill removes special exemptions in law that have allowed Kaiser Permanente to have an unfair advantage over its competitors. Since Kaiser covers over half of all workers in large firms with coverage through their employer, and one in ten California hospitals, these exemptions have created a massive information gap and prevented regulators from doing their jobs to protect the public from unfair pricing. This bill is sponsored by SEIU California.
          • AB 824 (Wood) will be heard in the Assembly Judiciary Committee April 9. This bill targets the practice of “pay for delay” for prescription drugs, seeking to end the collusive agreements where drug manufacturers pay generic companies to delay the introduction of lower-price medication to the market which keep drug prices too high. This bill is sponsored by Attorney General Xavier Becerra.
          • AB 1611 (Chiu) will be heard in the Assembly Health Committee April 23. The bill bans “surprise” out-of-network Emergency Room visits consumers are only billed for their co-pay or deductible, and caps the rate that can be charged. This bill is co-sponsored by the California Labor Federation and Health Access California.

          Nationally, there is a vigorous debate about the best path to expanding and strengthening our healthcare system. But whether the debate is about pursuing single-payer healthcare or achieving universal health care through augmentations to the Affordable Care Act, both paths will require addressing rising health care prices in order to be sustainable. The Care4All California bills advance California’s leadership in confronting increasing health care costs that are devastating California families.

          “Being healthy is essential to the California Dream, but out-of-control healthcare costs are crushing opportunities for Californians and our families,” said Kimberly Samuel, a Laboratory Technician at Kaiser South Sacramento. “We see patients who are worried about money when they should be focusing on their health. And the cost of healthcare is a concern for SEIU members who see our hard-earned raises going to insurance companies, and in turn to doctors, hospitals, and pharmaceutical companies. We are proud to lead the fight to make healthcare corporations accountable for fair and reasonable prices because we are tired of our own families and the people we serve going broke over outrageous healthcare bills.”

          # # #

            Response to US Justice Department Brief to Strike Down #ACA in Full

            The U.S. Justice Department filed a letter today indicating a major shift in position, agreeing with a December 2018 ruling by Judge Reed O'Conner in Texas vs. United States to strike the  entirety of the Affordable Care (ACA), due to the supposed unconstitutionality of the individual mandate in the law and its inseparability from the ACA as a whole.
            READ MORE

            For immediate release: March 25th, 2019

            Contact: Anthony Wright, Executive Director, Health Access, 916-870-4782 (cell)
            Rachel Linn Gish, Director of Communications, Health Access, 916-532-2128 (cell) 

            NEW U.S. JUSTICE DEPARTMENT LETTER  IN TEXAS V. US SEEKS TO STRIKE ACA IN FULL, PUTTING THE HEALTH COVERAGE OF MILLIONS AT RISK

            • The U.S. Justice Department filed a letter to support the court decision by Texas Judge O’Connor, which imperils the health coverage of tens of millions of Americans, at least 5 million in California alone–and the consumer protections for millions more.
            • The decision goes well beyond the Trump Administration’s previous briefs, which was focused on striking down protections for patients with pre-existing conditions.
            • California AG Xavier Becerra is leading the appeal, given catastrophic impact in California on coverage and consumer protections. California would lose over $25 billion for our health system–more than CA spends on higher education and prisons combined.
            • If upheld, this decision will undo all pre-existing condition protections, as well as eliminate premium subsidies, expanded Medicaid, preventive services, and much more. 

            SACRAMENTO, CA — The U.S. Justice Department filed a letter today indicating a major shift in position, agreeing with a December 2018 ruling by Judge Reed O’Conner in Texas vs. United States to strike the  entirety of the Affordable Care (ACA), due to the supposed unconstitutionality of the individual mandate in the law and its inseparability from the ACA as a whole. While the decision is being appealed by California Attorney General Xavier Becerra, the ruling if upheld would take away coverage from millions of Californians and Americans, and consumer protections from millions more.

            “The Trump Administration’s legal attack on our health system went from callous to catastrophic. Instead of just seeking to strike down protections for people with pre-existing conditions, their legal attack now seeks to rollback the entirety of the Affordable Care Act, including undoing coverage and affordability assistance for tens of millions of Americans–over five million in California alone. In this Justice Department letter, the Trump Administration is seeking to use the courts to undo all the coverage expansions and consumer protections that voters just resoundingly endorsed in the last election,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition. “We are thankful our Attorney General Xavier Becerra is appealing this decision and protecting our progress here in California.”

            “California has the most to lose from this legal attack on the ACA. California saw the largest drop in the uninsured rate of all 50 states since 2013, after having one of the highest rates in the nation. What the Texas judge ruled, and the Justice Department is now agreeing with, is to defund California’s health system by over $25 billion/year–more than what the state spends on all of higher education, and all of prisons, combined. While California can and has done a lot to counter the federal government’s sabotage of our health system, this outcome advocated by the Trump Administration may be too overwhelming to overcome. California must continue to fight, against the Trump Administration’s doubling down on seeking to go back to the days of denials for pre-existing conditions, and millions more uninsured.”

            # # #

              CA Consumers Could Save Millions Under Bills Up in Assembly Health Committee Tuesday

              On Tuesday, March 26th, the Assembly Health Committee will hear legislation likely to provide significant savings to California patients and the public.
              READ MORE

              For Immediate Release: Monday, March 25th, 2019

              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)

              CA ASSEMBLY HEALTH COMMITTEE TO VOTE TUESDAY ON KEY HEALTH CARE COST BILLS, TO SAVE CA CONSUMERS HUNDREDS OF MILLIONS OF DOLLARS, HOLD INSURERS & DRUG COMPANIES ACCOUNTABLE

              On Tuesday, CA Assembly Health Committee will vote on AB 731 (Kalra) to collect better data on premiums and enhance health insurance rate review, expanding it to protect 10 million more Californians in large group plans from being charged unreasonable rates.

              o    Rate review for individual and small group market has already saved $417 million for a smaller set of California consumers.

              Committee will also vote on AB 824 (Wood) to discourage drug companies from paying generic manufacturers to delay the entry of competitive alternatives– a practice that keeps the price of prescriptions artificially high.

              o    FTC says Americans pay at least $3.5 billion a year more in drugs because of these “pay for delay” practices. 

              SACRAMENTO, CA — On Tuesday, March 26th, the Assembly Health Committee will hear legislation likely to provide significant savings to California patients and the public. Strongly backed by a broad coalition of consumer and community organizations and others, these bills require greater oversight and transparency from insurers and drug companies, building on proven strategies to prevent unreasonable premiums and prescription drug prices.

              AB 731, by Assemblymember Ash Kalra, seeks to expand and enhance health plan rate review, which has helped save consumers hundreds of millions of dollars by preventing unreasonable rate increases for those in the individual and small group insurance markets. The bill would require additional information and transparency from health plans, and extend rate review to the large group market of ten million Californians. More health plans would have to justify that their rates are reasonable, and provide more data, including by region, and by how much they pay providers in comparison to Medicare.

              Also being heard in committee on Tuesday is AB 824, by Assembly Health Committee chair Jim Wood, and sponsored by Attorney General Xavier Becerra, to prevent harmful “pay for delay” practices. This is when pharmaceutical companies pay generic drug makers to slow down or stop lower-cost alternative medications from entering the marketplace as options for consumers. The bill would put the burden of proof on the drug companies to provide the information that any such payments were not for “pay-for-delay” anti-competitive purposes. The Federal Trade Commission estimated Americans pay $3.5 billion more for medications because of these practices, and many believe the figure has gone up significantly since that finding.

              Consumer, community, patient, and purchaser organizations have prioritized this legislation, as part of a broader Care4All California package to get to a universal, affordable, and accountable health care system. Other bills to help lower costs for consumers, such as legislation to crack down on “surprise” emergency room bills, will be heard in Health Committee in the next few weeks.

              “By building on proven practices and increasing oversight of health insurers, hospitals, and prescription drug companies, our legislators can provide significant savings of hundreds of millions of dollars for California patients,” said Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition. “While Washington DC debates what to do about drug prices and premiums, California can take action this year with these bills to get us closer to a health system that is affordable and accountable to all.”

              ON AB 731, RATE REVIEW: “Health care premiums continue to rise, yet ten million Californians who work for larger employers don’t have the benefit of the state reviewing those rate hikes to ensure they are reasonable. California consumers have saved hundreds of millions of dollars under the existing rate review by regulators, and this bill would expand that oversight and benefit to three times the people,” said Yasmin Peled, policy advocate for Health Access California, a co-sponsor of the AB 731 with California Labor Federation, SEIU, UNITE HERE, and the Teamsters. “On top of extending these oversight protections to ten million more Californians and their employers, AB 731 also improves and enhances that oversight for all California health consumers. This bill will reveal how much providers are getting paid as a percentage of Medicare rates, both to better explore the drivers of high health costs, and the effectiveness of insurers in negotiating better prices.”

              ON AB 824, PAY FOR DELAY: “When drug companies pay to prevent a lower-price medication from entering the market, we all pay more, at the pharmacy and in our premiums. With this bill, California can take the lead in preventing this problematic, price-gouging practice of pay-for-delay by the prescription drug companies,” said Ronald Coleman, Policy Director for Health Access California, a strong supporter of AB 824. “It’s bad enough that the drug companies abuse the patents they get by charging sky-high prices, it’s worse when they pay to keep cheaper options off the market to make patients pay more for longer.”

              Last month, Governor Newsom proposed a statewide prescription drug purchasing pool, to consolidate the purchasing power of various state agencies, and ultimately other payers, to negotiate the best possible deal on pharmaceutical prices for Californians.

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                California Legislative Committees to Consider Major Health Coverage Expansions This Week

                This week, California legislators will hear and consider major proposals to expand access and increase affordability for hundreds of thousands of Californians, and which together would cut the state's uninsured rate in half.
                READ MORE
                For immediate release: Tuesday, March 18, 2018   
                For more information, contact Anthony Wright, 916-870-4782 (cell)

                CALIFORNIA LEGISLATIVE COMMITTEES TO CONSIDER MAJOR HEALTH COVERAGE EXPANSIONS THIS WEEK

                • On WEDNESDAY, MARCH 20th, the CA Senate Health Committee to vote on the #Health4All bill SB 29 (Durazo), to expand Medi-Cal to all income-eligible Californians regardless of immigration status.
                • On THURSDAY, MARCH 21st, the CA Senate Budget Subcommittee on Health and Human Services will hear several coverage expansion proposals, including greater affordability assistance in Covered California, a state-level individual mandate, expanding Medi-Cal to all regardless of age, disability, or immigration status, and greater outreach for enrollment.
                • Together, these proposal go beyond the Governor’s budget proposals, and would potentially cut the number of uninsured in half, and bring us to around 5% or lower uninsured rate than universal coverage. These efforts will be supported by the #Care4AllCA campaign of over 70 consumer and community groups who seek a down payment-level investment towards the goal of universal coverage this year.
                SACRAMENTO–This week, California legislators will hear and consider major proposals to expand access and increase affordability for hundreds of thousands of Californians, and which together would cut the state’s uninsured rate in half.
                One proposal, to expand Medi-Cal to all income-eligible Californians regardless of immigration status, will be voted on in Senate Health Committee on Wednesday, as SB 29 (Durazo), and will also be heard in the Senate Budget Subcommittee on Health and Human Services on Thursday. Many health care, consumer, immigrant rights, and community groups will be on hand to support this longstanding priority, building on the expansion of Medi-Cal to all children a few years ago. SB 29 would go beyond the Governor’s proposal to cover undocumented young adults up to age 26.
                Other proposals to help Californians afford and access care and coverage will also be heard Thursday in the Senate Budget Subcommittee as well, including enhancing subsidies in Covered California, preventing premium increases by instituting a state-level individual requirement to have coverage, fixing the “senior penalty” in Medi-Cal, investing in greater enrollment outreach assistance, and more.
                “All Californians benefit when more consumers are covered, getting primary and preventive care, through these first-in-the-nation proposals to expand coverage beyond the ACA. California would be the first to increase financial help to middle-income families trying to afford individual insurance. By removing exclusions in Medi-Cal regardless of immigration status, California would also be the first to extend Medicaid coverage to undocumented adults, beyond pregnant women and children. These investments are important acknowledgements that our health system is stronger when everyone is included,” said Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition, and co-convener of the #Care4AllCA campaign. “The Legislature is right to consider proposals that go beyond what the Governor has proposed, to put down a real downpayment to the goal of universal health care along the path the Governor laid out. Low- and middle-income Californians across the state need the help as soon as possible, to be able to afford care and coverage.”
                “These bold proposals–to invest in greater affordability assistance, to continue the individual requirement to have coverage at the state level, to expand Medi-Cal to all income-eligible Californians regardless of age, disability, or immigration status–would work together to cut the uninsured rate in half. Listening to the voters in a health care election, the Legislature should insist we take a significant step toward universal coverage by removing exclusions and providing tangible assistance to California consumers this year.”
                The Care4All California campaign of over 70 health, consumer, and community organizations proposed many parts of this agenda last year, and are backing over 20 bills and budget items this year, many aligned with Governor Newsom’s goals.
                Background
                In March 2018, over 50 organizations came together in the #Care4AllCA campaign to advance universal coverage in the near future, without the need for federal approvals. The campaign advanced 20 bills and budget items last year, and had eight pieces of legislation signed into law, however, coverage expansion elements were not included. The path to universal coverage that campaign endorsed that did not need federal approval, but was complementary with longer-term efforts like a Medicare-for-All system, included expanding Medi-Cal to remove exclusions based on age, disability, or immigration status; providing greater affordability assistance in the individual insurance market and Covered California; reinstituting a state-level individual requirement to purchase coverage; and other reforms, including expanding prescription drug purchasing collaboratives. This year, the coalition unveiled a revised package of 21 bills and budget items, some returning, toward these goals.
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                  Consumer Groups Cheer New Bill to Prevent “Pay-for-Dealy” PhRMA Efforts that Keep Prescription Drug Prices High

                  Assembly Health Committee Chair Jim Wood introduces legislation to counter harmful "pay-for-delay" practices of PhRMA. AB 824 (Wood) announced today alongside Attorney General Xavier Becerra discourages drug companies from paying generic manufacturers to delay the entry of competitive drugs and thus keeping the price of medications artificially high.
                  READ MORE

                  For Immediate Release: Wednesday, February 20th, 2019

                  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)

                  CONSUMER GROUPS CHEER NEW BILL TO PREVENT “PAY-FOR-DELAY” PHRMA EFFORTS THAT KEEP PRESCRIPTION DRUG PRICES HIGH

                  • Assembly Health Committee Chair Jim Wood introduces legislation to counter harmful “pay-for-delay” practices of PhRMA.
                  • AB 824 (Wood) announced today alongside Attorney General Xavier Becerra discourages drug companies from paying generic manufacturers to delay the entry of competitive drugs and thus keeping the price of medications artificially high.
                  • This initiative joins recent efforts by California to lead on prescription drug prices, including Governor Newsom’s push for a state prescription drug purchasing pool, and 2017’s SB 17 (Hernandez) which required advance notice of drug price hikes over 16% over two years.

                  SACRAMENTO, CA — Consumer advocates cheered the introduction of a bill to address the outrageous pharmaceutical company practice of “pay for delay,” where drug manufacturers offer patent settlements to pay generic companies to delay the introduction of lower-price medication to the market. According to an FTC study, “these anti-competitive deals cost consumers and taxpayers $3.5 billion in higher drug costs every year.” The new bill, AB 824, was announced today by Assemblymember Jim Wood and Attorney General Xavier Becerra at a joint press conference.

                  Here is a comment from Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition on the introduction of this new bill and how it impacts consumers:

                  “When drug companies pay to prevent a lower-price medication from entering the market, we all pay more, at the pharmacy and in our premiums. With this bill, California can take the lead in preventing this problematic, price-gouging practice of pay-for-delay by the prescription drug companies.”

                  “It’s bad enough that the drug companies abuse the patents they get by charging sky-high prices, it’s worse when they pay to keep cheaper options off the market and engage in other problematic pricing policies to make patients pay more for longer. While a solution to prevent this prescription drug company practice has been discussed for in DC for years, if the federal government won’t act, then California must to protect consumers and our health system overall.”

                  BACKGROUND

                  California has been a national leader is confronting the issue of prescription drug prices. In 2017, SB 17 (Hernandez) was signed into law to require all drug price hikes over 16% over a two-year span to be subject to transparency requirements, which discourages double-digit price increases and encourages better negotiations between drug companies and purchasers. This advance notice is given to public purchasers like Medi-Cal and CalPERS and private purchasers including health plans and insurers. It also enhances public disclosure of information about drug pricing by requiring drug manufacturers to file information about the rationale for pricing increase, marketing costs, and other specifics with the Office of Statewide Health Planning and Development. The law also requires health plans and insurers to disclose information about drug pricing through existing rate review processes at the Department of Managed Health Care and Department of Insurance. SB 17 was strongly backed by a broad coalition of consumer, labor, business, insurer, and other health organizations, but opposed by the pharmaceutical industry who hired dozens of lobbyists, ran radio and newspaper ads, and otherwise spent significantly in their campaign against the transparency protections of the legislation.

                  Other recent legislation around prescription drug have included AB 315 (Wood) to regulate pharmacy benefit managers and SB 1021 (Wiener) to maintain co-pay caps to keep life-saving drugs affordable.

                  Last month, Governor Newsom proposed a statewide prescription drug purchasing pool, to consolidate the purchasing power of various state agencies, and ultimately other payers, to negotiate the best possible deal on pharmaceutical prices for Californians.

                    Consumer and Worker Coalition Unveils Bills to Lower Premiums and Shine a Light on Health Care Cost Drivers for 10 Million Californians

                    A coalition of health care, consumer and worker advocates today announced the introduction of two bills that could deliver savings to 10 million Californians with employer-based health insurance and increase transparency in health care pricing.
                    READ MORE

                    For immediate release: Tuesday, February 19, 2019

                    Contacts:
                    Roseryn Bhudsabourg, Director of Communications
                    Office of Assembly Member Ash Kalra
                    (916) 319-2027
                    roseryn.bhudsabourg@asm.ca.gov

                    Shannan Martinez, Director of Communications
                    Office of Senator Dr. Richard Pan
                    (916) 271-2867
                    Shannan.Martinez@sen.ca.gov

                     

                    Consumer and Worker Coalition Unveils Bills to Lower Premiums and Shine a Light on Health Care Cost Drivers for 10 Million Californians

                     

                    Sacramento, CA – A coalition of health care, consumer and worker advocates today announced the introduction of two bills that could deliver savings to 10 million Californians with employer-based health insurance and increase transparency in health care pricing. The two bills, AB 731 by Assemblymember Ash Kalra (D-San Jose) and SB 343 by Senator Richard Pan (D-Sacramento), come as the U.S. debates the next round of reform following the Affordable Care Act. Despite coverage gains, people across the nation still struggle to afford monthly premiums and put off doctors’ visits and tests because they can’t afford co-pays and deductibles. Unsustainable insurance costs are eating into wages for all workers, but the biggest bite is being taken from workers with the lowest wages, according to a recent report from the Economic Policy Institute. Yet, the health care industry—hospitals, health plans, insurers, drug companies—is profiting from increased coverage and rising prices.

                    Under AB 731 (Kalra), existing rate review for health plans and insurers on individual and small group markets will be extended to plans purchased in the large group market. The bill expands the “rate review” process, requiring insurance companies to disclose what is driving rising premiums, co-pays and deductibles for workers. If state regulators deem rate increases as unreasonable or unjustified, insurance companies must notify the large employer or union trust fund that purchases the coverage. Since a similar law (SB 1163, Leno) went into effect for individual and small business plans in 2011, consumers have saved an estimated $226 million. Large employers and workers could save even more. The bill is cosponsored by the California Labor Federation, UNITE HERE, SEIU California State Council, Health Access California and the California Teamsters Public Affairs Council.

                    “The skyrocketing cost of health care is contributing to wage stagnation and fueling income inequality in our state. Many are struggling with ever rising co-pays and health insurance premiums that have risen 249% since 2002—more than six times the increase in the state’s overall inflation,” said Assemblymember Kalra. “That is why I introduced AB 731, building upon rate review that’s already working for millions of workers and using this proven tool for greater transparency and scrutiny on unreasonable health insurance rates. Consumers are in desperate need of relief and Californians deserve a clearer picture of what’s driving health care costs.”

                    “Rising health care costs are stealing workers’ wages,” said Art Pulaski, Executive Secretary-Treasurer of the California Labor Federation. “As demonstrated in a recent Economic Policy Institute report, if health insurance premiums had not increased as a share of average earnings, workers would have had an increase in annual pay of 8.6%, or $3,032 for individuals or $9,161 for family. That’s $9,161 that families could have spent on food, housing, education, countless other necessities. The insurance industry negotiates with doctors and big hospital and drug corporations on our behalf. AB 731 will get to the bottom of what is driving our rising health care costs.”

                    “Last fall, our members went on strike for 61 days because we believe one job should be enough to live with dignity and respect when you work for the largest hotel company in the world,” said Anand Singh, President of UNITE HERE Local 2, the hotel and restaurant workers union of San Francisco and San Mateo. “But the mercenary high price of health care is threatening to turn that historic strike into a simple transfer of wealth from a hotel corporation to health insurance corporations. If health care costs had only grown as fast as the cost of living since 2000, hotel workers would be making $7,000 a year more. That’s money that should be in workers’ pockets, not insurance, hospital and drug companies’ CEOs bank accounts.”

                    “SEIU California is fighting for new and expanded healthcare price and quality transparency information from healthcare providers in order to lower the cost of healthcare,” said Roxanne Sanchez, President of SEIU Local 1021 and SEIU California. “We know families can’t keep stretching their paychecks to cover unjustified insurance costs and our state won’t achieve our vision for universal, accessible, affordable and equitable care until we tackle unjustified skyrocketing health care prices.”

                    “Health care premiums continue to rise for all Californians, yet the ten million who work for larger employers don’t have the benefit of the state reviewing those rates to ensure they are reasonable. California consumers have saved hundreds of millions of dollars with existing authority, and this would expand rate review protection to three times the people,” said Anthony Wright, executive director of Health Access California, the statewide health consumer advocacy coalition. “This bill also improves and enhances oversight for all California health consumers. By revealing how much providers are getting paid as a percentage of Medicare rates, we can better explore the drivers of high health costs and the effectiveness of insurers in negotiating better prices.”

                    “The California Teamsters Public Affairs Council is a proud co-sponsor of AB 731 by Assembly Member Ash Kalra. AB 731 will require large healthcare plans to provide greater transparency in pricing; thereby allowing large purchasers like union trust funds to negotiate more competitive rates for our members and all Californians.”

                    SB 343 (Pan) updates current transparency and disclosure requirements for the health care industry to include Kaiser Permanente. Kaiser’s status as an integrated system of insurance, hospitals and doctors means the health care giant falls outside some key disclosure requirements. This exemption in state law has allowed them to not report key insurance and hospital financial information like the rest of the industry. With Kaiser representing one in ten California hospitals and more than 40 percent of insured Californians with commercial coverage, this information gap means state regulators lack data on a significant portion of the health care market. When Kaiser is required to report the same data as its competitors, regulators can make “apple to apple” comparisons of health care pricing. This means greater transparency for the public, advocacy groups and regulatory agencies concerned with health care costs affecting all Californians, and for the significant portion of Californians covered by Kaiser.

                    “Kaiser and all other health insurers and hospitals in California should play by the same rules for transparency,” said Dr. Richard Pan, state senator representing the Sacramento region. “Consumers need clear pricing and financial information so they are able to make informed choices regarding the value of their health coverage.”

                    Additional support for AB 731 (Kalra):

                    CALPIRG: “Reviewing health insurance rates in detail is critical to both catching unjustified rate hikes and better understanding the areas in our health care system where we need to do even more to rein in high costs.” – Emily Rusch, Executive Director

                    Consumer Reports: “No Californian should be overcharged for health insurance, no matter the source of that insurance. The insurance rate review process has saved consumers in the individual and small group markets hundreds of millions of dollars, but the millions of Californians who get insurance from their employers haven’t seen the same progress. AB 731 will help oversight and transparency of large group coverage catch up to that for the individual and small group, giving consumers the protection they deserve.” – Dena B. Mendelsohn, Senior Policy Counsel

                    Small Business Majority: “Anything California can do to contain healthcare costs will ultimately benefit the state’s small businesses. Although the Affordable Care Act delivered quality, affordable insurance for millions of Americans–including about 370,000 self-employed entrepreneurs in California–actions by the Trump administration destabilized the ACA marketplaces and premiums are rising. California must do everything possible to contain healthcare costs throughout the system, including in the large group market, in order to ensure entrepreneurs continue to have quality healthcare options at an affordable price.” – Mark Herbert, California Director