Press Releases

Press inquiries may be directed to:

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

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

    More Californians to Stay Covered Under New Bill Introduced by Senator Hurtado

    SB 260 helps to ensure Californians do not lose health insurance during life transitions, by providing proactive outreach
    READ MORE

    For immediate release: Tuesday, February 12, 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)

    MORE CALIFORNIANS TO STAY COVERED UNDER NEW BILL INTRODUCED BY SENATOR HURTADO
    SB 260 helps to ensure Californians do not lose health insurance during life transitions, by providing proactive outreach

    Bill will prevent gaps in coverage during job and family changes, moves, and as a scheduled minimum wage hike shifts many from Medi-Cal to Covered California

    SACRAMENTO, CA—Today, State Senator Melissa Hurtado (D – Fresno) made health care coverage for Californians one of her top priorities by introducing SB 260. The new bill ensures more people can stay covered when their life circumstances change.

    “SB 260 is a critical piece of legislation for communities in the Central Valley and throughout California,” said Senator Hurtado. “Experiencing life transitions is inevitable, particularly in the Valley where communities face poverty at an alarming rate. This bill’s proactive approach eliminates extra steps and makes it easier for someone who is undergoing a transition in their life to keep health coverage and avoid coverage gaps.”

    When Californians undergo changes in their lives – like a marriage or divorce, moving to a new home in a new area, losing a job, or aging out of their parents’ insurance coverage, they may also face gaps in health care coverage. Currently, these Californians are notified of their options to enroll in Covered California or Medi-Cal. SB 260 improves this notice by allowing Covered California to reach out directly to these consumers and inform them of their coverage options in order to help minimize gaps in coverage. SB 260 also makes it easier for Californians who lose Medi-Cal coverage when their income rises to gain access to a subsidized health plan through Covered California.

    “This legislation helps ensure that the scheduled increase in the minimum wage, or any other pay raise, doesn’t inadvertently lead to a gap in health coverage. When Californians make a change in their lives and income, whether moving to a new home, getting married, or losing a job, this bill ensures that consumers can get the direct help they need to re-enroll in health care coverage without any lapse, ” said Anthony Wright, Executive Director of Health Access California and co-sponsor of SB 260. “Keeping California consumers covered during life transitions helps not just the insured individual and family but the whole health system work better.”

    With a much needed minimum wage increase coming for California workers, making slightly more money may mean they are no longer income-eligible for Medi-Cal. SB 260 eases that transition by assigning them to a low-cost Covered California plan. They then have the option to opt out of that plan or shop for another.

    “When someone loses Medi-Cal, they don’t have enough time to enroll in a Covered California plan that will start when their Medi-Cal ends. This legislation will help consumers avoid gaps in coverage when they start earning a little more money,” said Jen Flory, Policy Advocate for Western Center on Law and Poverty, a co-sponsor of SB 260.

    About 4 million Californians are estimated to be uninsured in 2020 and about 2 million of them are eligible for comprehensive Medi-Cal or financial subsidies through Covered California. By taking a more proactive approach, SB 260 addresses these gaps in coverage so more people have access to comprehensive, affordable health care insurance and don’t face being uninsured, even for short periods of time.

    Maintaining health care coverage keeps families and communities healthy, both physically and financially, and creates a better health care system for everyone.

    Resources:

    SB 260 (Hurtado) Fact Sheet

      In first State of the State, Governor Newsom Outlines Big Ideas on Health Care

      Governor Highlights Specific Steps to Help Californians Access & Afford Coverage
      READ MORE

      For immediate release: Tuesday, February 12, 2018

      IN FIRST STATE OF THE STATE, GOVERNOR NEWSOM OUTLINES BIG IDEAS ON HEALTH CARE
       

      Governor Highlights Specific Steps to Help Californians Access & Afford Coverage

      • Governor Newsom continues to embrace the long-term vision of universal coverage; Advocates urge the Legislature to scale up the “down payment” for universal coverage to match the rhetoric and to provide tangible help to Californians this year.
      • Governor highlights specific support for major expansions of health coverage and other key health reforms, including first-in-the-nation actions applauded by health advocates: increasing affordability assistance to middle-income Californians who buy coverage in Covered California, and expanding Medi-Cal to low-income undocumented adults up to age 26.
      • Advocates welcomed that the Governor went beyond his drug price purchasing pool to address high health prices broadly, including those driven by the consolidation of hospitals and health plans.
      • The #Care4AllCA campaign of over 60 consumer and community groups thankful the Governor has taken up many legislative and budget proposals we championed protect and expand coverage – seek further steps to fulfill these shared goals.

      Here is a comment from Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition, and co-convener of the #Care4AllCA campaign in response to Governor Gavin Newsom’s first State of the State address:

      OVERALL COMMENT ON THE SPEECH: “Governor Newsom is right to focus on the affordability crisis in California, given the costs of health care, housing and other expenses in our state. From premiums to prescription drug prices, the Governor pinpointed the problem that Californians are struggling with high health care costs and offered salient solutions we can get to this year.”

      “The Legislature should follow the Governor’s call to action on health care affordability, and take it even further. The Legislature should pass proposals the Governor suggested he might sign to reign in health consolidation and health costs. The Legislature should also make the investments beyond the Governor’s proposals for a real ‘downpayment’ to the goal of universal health care, providing the relief needed to low- and middle-income Californians across the state as soon as possible.”

      COVERAGE EXPANSIONS: “Governor Newsom again called out the Trump Administration’s vandalism of our health care system, and is seeking state action to shield Californians from the premium increases and lost coverage that federal changes may cause. All Californians will benefit when more consumers are covered, getting primary and preventive care, in 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 for low-income young adults 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 acknowledgments that our health system is stronger when everyone is included. These steps outlined today would put California on an aspirational and achievable path to universal coverage.”

      “While these steps are significant, there are more steps we can take to get us closer to universal coverage. To match the Governor’s rhetoric, we urge the Legislature to increase specific investments to align with what the Assembly proposed last year. Last year’s proposed ‘down payment’ to universal coverage was a billion dollars, a small fraction of the surplus, but a sizable sum to get our uninsured rate down below 5% where most developed countries are. The Care4All California campaign of over 60 health, consumer, and community organizations proposed many parts of this agenda last year, and we are glad that Governor Newsom is taking up these goals. Our campaign will champion these and other efforts to move our state forward on our health care goal to universal coverage.”

      BEYOND COVERAGE, ON COSTS: “The Governor is right in the speech to focus on controlling costs, particularly prescription drug prices. We are especially heartened to see that the Governor wants to tackle consolidation and other issues that lead to higher health care costs. Governor Newsom’s call to action should be the first step to using the state’s market and moral power to address high health costs overall. Health, consumer and labor advocates are itching to address health care costs head-on.”

      “The California electorate clearly expects to not just keep us where we are, but to address the affordability crisis in health care and other areas. Governor Newsom made it clear today that he plans to protect California’s progress while taking steps to guaranteed, affordable, quality, health care coverage for all.”

      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, although not the coverage expansion elements. 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.

      UC Berkeley Labor Center and UCLA Center for Health Policy Research recently released a report titled “California’s Health Coverage Gains to Erode Without Further State Action” detailing the negative state-level impacts of the elimination of the Affordable Care Act’s (ACA) individual mandate. Researchers find that because of the removal of the requirement to have health insurance, the uninsurance rate of people under age 65 could grow to 11.7% in 2020 (about 4 million people) and then to 12.9% in 2023 (or 4.4 million people), undoing the historic gains that California has made under the ACA. The largest groups of the remaining uninsured are undocumented Californians who are barred from accessing most health coverage options and Californians who struggle to afford their care.

        New Report Underscores Urgency for #Health4All

        Study highlights stark health disparities for undocumented Californians; #Health4All Act to expand Medi-Cal to all adults regardless of immigration status is key antidote to Trump Administration’s attacks
        READ MORE

        For immediate release: Tuesday, February 5, 2019

        For more information contact:
        Shervan Sebastian, CIPC (202) 709-2024
        Rachel Linn Gish, Health Access CA, (916) 532-2128

        NEW REPORT UNDERSCORES URGENCY FOR #HEALTH4ALL

        Study highlights stark health disparities for undocumented Californians; #Health4All Act to expand Medi-Cal to all adults regardless of immigration status is key antidote to Trump Administration’s attacks

        Sacramento, CA — Today, researchers at the UC Berkeley Center for Labor Research and Education unveiled a new report: “Towards Universal Health Coverage: Expanding Medi-Cal to Low-Income Undocumented Adults.”

        The report identifies that 90% of undocumented adults do not have access to comprehensive health care coverage, leading to poorer health outcomes for families and communities. Researchers find that expanding Medi-Cal to all low-income adults regardless of immigration status would extend health coverage to approximately 1.15 million undocumented adults in 2020 and would close one of the biggest remaining coverage gaps in the state’s health care system, reducing the state’s uninsured population by as much as one-quarter.

        Two #Health4All bills have been introduced in the state legislature to expand access to Medi-Cal for all income-eligible adults, regardless of immigration status, AB 4 (Arambula, Bonta, Chiu) and SB 29 (Durazo).

        In reaction to the report’s findings, the California Immigrant Policy Center and Health Access California, co-chairs of the #Health4All campaign, issued the following statements:

        “Undocumented Californians are a vital and inseparable part of our families and our communities, contributing powerfully to our state’s economic prowess. Yet, as this new study demonstrates, nine out of ten low-income undocumented adults lack health coverage – let alone affordable care. These same community members are more likely to lack a usual source of care than their citizen and documented neighbors,” said Cynthia Buiza, Executive Director of the California Immigrant Policy Center

        “The report also projects that if the Trump administration’s cruel “public charge” rule is finalized, it would likely have a sizeable chilling effect on enrollment in Medi-Cal even if eligibility restrictions were lifted. This is alarming, particularly since the rule has not been implemented and does not directly impact Medi-Cal. This finding only furthers the cause of #Health4All in order to combat the Trump administration’s policies of fear-mongering and exclusion. California has been a leader in inclusion and we must continue to defend the principle that no one should suffer or die from a treatable condition – no matter where they were born,” said Buiza.

        “This study shows that allowing undocumented adults to have the same eligibility requirements as their neighbors to get Medi-Cal coverage would reduce the ranks of uninsured in our state by up to a quarter. Expanding Medi-Cal regardless of immigration status is a crucial step towards the goal and benefits of attaining universal health care coverage in our state,” said Anthony Wright, Executive Director of Health Access California.

        “Exclusionary federal policies have built a virtual wall which cuts our undocumented neighbors off from live-saving health care. This report shows how we can apply our state’s values of compassion and inclusion to our health system, and in doing so make it stronger for everyone. We are pleased Governor Newsom and our Legislature’s leadership have endorsed the concept of expanding Medi-Cal, regardless of immigration status. We need our political leaders to embrace, and follow-through, on the concept that our health system is stronger when everyone is included,” said Wright.

        For immediate release: Tuesday, February 5, 2019

        For more information contact:
        Shervan Sebastian, CIPC (202) 709-2024
        Rachel Linn Gish, Health Access CA, (916) 532-2128

        NEW REPORT UNDERSCORES URGENCY FOR #HEALTH4ALL

        Study highlights stark health disparities for undocumented Californians; #Health4All Act to expand Medi-Cal to all adults regardless of immigration status is key antidote to Trump Administration’s attacks

        Sacramento, CA — Today, researchers at the UC Berkeley Center for Labor Research and Education unveiled a new report: “Towards Universal Health Coverage: Expanding Medi-Cal to Low-Income Undocumented Adults.”

        The report identifies that 90% of undocumented adults do not have access to comprehensive health care coverage, leading to poorer health outcomes for families and communities. Researchers find that expanding Medi-Cal to all low-income adults regardless of immigration status would extend health coverage to approximately 1.15 million undocumented adults in 2020 and would close one of the biggest remaining coverage gaps in the state’s health care system, reducing the state’s uninsured population by as much as one-quarter.

        Two #Health4All bills have been introduced in the state legislature to expand access to Medi-Cal for all income-eligible adults, regardless of immigration status, AB 4 (Arambula, Bonta, Chiu) and SB 29 (Durazo).

        In reaction to the report’s findings, the California Immigrant Policy Center and Health Access California, co-chairs of the #Health4All campaign, issued the following statements:

        “Undocumented Californians are a vital and inseparable part of our families and our communities, contributing powerfully to our state’s economic prowess. Yet, as this new study demonstrates, nine out of ten low-income undocumented adults lack health coverage – let alone affordable care. These same community members are more likely to lack a usual source of care than their citizen and documented neighbors,” said Cynthia Buiza, Executive Director of the California Immigrant Policy Center

        “The report also projects that if the Trump administration’s cruel “public charge” rule is finalized, it would likely have a sizeable chilling effect on enrollment in Medi-Cal even if eligibility restrictions were lifted. This is alarming, particularly since the rule has not been implemented and does not directly impact Medi-Cal. This finding only furthers the cause of #Health4All in order to combat the Trump administration’s policies of fear-mongering and exclusion. California has been a leader in inclusion and we must continue to defend the principle that no one should suffer or die from a treatable condition – no matter where they were born,” said Buiza.

        “This study shows that allowing undocumented adults to have the same eligibility requirements as their neighbors to get Medi-Cal coverage would reduce the ranks of uninsured in our state by up to a quarter. Expanding Medi-Cal regardless of immigration status is a crucial step towards the goal and benefits of attaining universal health care coverage in our state,” said Anthony Wright, Executive Director of Health Access California.

        “Exclusionary federal policies have built a virtual wall which cuts our undocumented neighbors off from live-saving health care. This report shows how we can apply our state’s values of compassion and inclusion to our health system, and in doing so make it stronger for everyone. We are pleased Governor Newsom and our Legislature’s leadership have endorsed the concept of expanding Medi-Cal, regardless of immigration status. We need our political leaders to embrace, and follow-through, on the concept that our health system is stronger when everyone is included,” said Wright.

          CoveredCA Sign-Up Numbers Signal Need for More Affordability Assistance, Individual Mandate

          Covered California sees steady enrollment from renewals, but sees decline in new sign-ups due to federal actions to undo parts of the ACA.
          READ MORE

          For immediate release: Wednesday, January 30, 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)

          COVERED CALIFORNIA SEES STEADY ENROLLMENT FROM RENEWALS, BUT SEES DECLINE IN NEW SIGN-UPS DUE TO FEDERAL ACTIONS TO UNDO PARTS OF THE ACA;
          A CLARION CALL FOR MORE AFFORDABILITY ASSISTANCE AND STATE INDIVIDUAL MANDATE

            • Covered California releases analysis showing total enrollment remains steady at 1.5 million, but sees big drop in new sign-ups, down 23% due to elimination of the individual mandate and affordability barriers
            • Other states have seen larger drops in new sign-ups since 2016, but California has largely blunted these losses with state action to keep open enrollment periods longer, maintain broad marketing efforts, and other steps to shield Californians from Trump & Congressional sabotage of our health system
            • Consumer advocates want to go beyond Governor Newsom’s proposal to reinstate state-level mandate for health insurance, by increasing the proposed financial help to afford coverage
            • #Care4AllCA campaign of over 60 consumer and health groups will advocate for legislation and budget investments that help low- and middle-income Californians purchase health care for themselves and their families

          SACRAMENTO, CA—Today, Covered California released its 2019 enrollment numbers, showing sharp declines in new sign-ups, but overall enrollees holding steady. The new report shows Covered California’s resiliency despite federal sabotage, with 1.2 million renewals and nearly 300,000 new enrollees. However, new sign-ups were down significantly – 23.7% – due to the elimination of the penalty to have health insurance by the Trump Administration & Congress and continued affordability barriers for those buying insurance through Covered California.

          “Covered California’s strong re-enrollment numbers show our state’s strategy to shield consumers from the sabotage of the Trump Administration has so far been successful. But the drop in new enrollments are a clarion call for continued and further state action to help people afford and enroll in coverage,” said Anthony Wright, executive director of Health Access California, a co-chair of the #Care4AllCA campaign. “These numbers provide new urgency to Governor Newsom’s health proposals, and prove that we should go further in providing additional affordability assistance. By enhancing subsidies to sign-up for coverage and continuing the individual mandate at the state level, California can prevent the federal sabotage of our health system and ultimately get us to a universal health system where everyone has the care and coverage they need and can afford.”

          The stability of Covered California’s enrollment despite federal sabotage is largely due to actions taken by the state to shield consumers from these attacks, such as longer open enrollment periods and broad marketing efforts, and more. But California has the power to take additional steps to encourage health care coverage such as increasing subsides for those that still find insurance unaffordable, and reinstating the penalty for not having health coverage. Governor Newsom has proposed a state level individual mandate which would raise money to assist people in affording care. But this Covered California report highlights the reality that Californians are struggling to afford care now, and cannot wait for longer solutions. The Care4All California campaign of over 60 health and consumer groups will advocate for immediate budget investments that help low-and middle-income Californians purchase health care for themselves and their families.

          “These numbers affirm that the steps we are taking towards universal coverage are working, but that we must keep taking strides forward. In additional to increased affordability assistance, we can also expand access to health care by opening up Medi-Cal regardless of immigration status. Together, these will get California closer to the goal of 1-3% uninsured rate seen in most European countries,” said Wright.

          For immediate release: Wednesday, January 30, 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)

          COVERED CALIFORNIA SEES STEADY ENROLLMENT FROM RENEWALS, BUT SEES DECLINE IN NEW SIGN-UPS DUE TO FEDERAL ACTIONS TO UNDO PARTS OF THE ACA;

          A CLARION CALL FOR MORE AFFORDABILITY ASSISTANCE AND STATE INDIVIDUAL MANDATE

          Covered California releases analysis showing total enrollment remains steady at 1.5 million, but sees big drop in new sign-ups, down 23% due to elimination of the individual mandate and affordability barriers
          Other states have seen larger drops in new sign-ups since 2016, but California has largely blunted these losses with state action to keep open enrollment periods longer, maintain broad marketing efforts, and other steps to shield Californians from Trump & Congressional sabotage of our health system
          Consumer advocates want to go beyond Governor Newsom’s proposal to reinstate state-level mandate for health insurance, by increasing the proposed financial help to afford coverage
          #Care4AllCA campaign of over 60 consumer and health groups will advocate for legislation and budget investments that help low- and middle-income Californians purchase health care for themselves and their families
          SACRAMENTO, CA—Today, Covered California released its 2019 enrollment numbers, showing sharp declines in new sign-ups, but overall enrollees holding steady. The new report shows Covered California’s resiliency despite federal sabotage, with 1.2 million renewals and nearly 300,000 new enrollees. However, new sign-ups were down significantly – 23.7% – due to the elimination of the penalty to have health insurance by the Trump Administration & Congress and continued affordability barriers for those buying insurance through Covered California.

          “Covered California’s strong re-enrollment numbers show our state’s strategy to shield consumers from the sabotage of the Trump Administration has so far been successful. But the drop in new enrollments are a clarion call for continued and further state action to help people afford and enroll in coverage,” said Anthony Wright, executive director of Health Access California, a co-chair of the #Care4AllCA campaign. “These numbers provide new urgency to Governor Newsom’s health proposals, and prove that we should go further in providing additional affordability assistance. By enhancing subsidies to sign-up for coverage and continuing the individual mandate at the state level, California can prevent the federal sabotage of our health system and ultimately get us to a universal health system where everyone has the care and coverage they need and can afford.”

          The stability of Covered California’s enrollment despite federal sabotage is largely due to actions taken by the state to shield consumers from these attacks, such as longer open enrollment periods and broad marketing efforts, and more. But California has the power to take additional steps to encourage health care coverage such as increasing subsides for those that still find insurance unaffordable, and reinstating the penalty for not having health coverage. Governor Newsom has proposed a state level individual mandate which would raise money to assist people in affording care. But this Covered California report highlights the reality that Californians are struggling to afford care now, and cannot wait for longer solutions. The Care4All California campaign of over 60 health and consumer groups will advocate for immediate budget investments that help low-and middle-income Californians purchase health care for themselves and their families.

          “These numbers affirm that the steps we are taking towards universal coverage are working, but that we must keep taking strides forward. In additional to increased affordability assistance, we can also expand access to health care by opening up Medi-Cal regardless of immigration status. Together, these will get California closer to the goal of 1-3% uninsured rate seen in most European countries,” said Wright.

            On day one, Governor Newsom takes key steps towards health care to all Californians

            A comment on Governor Newsom's inauguration speech and today's announcement on health care.
            READ MORE

            For immediate release: Monday, January 7, 2018

            ON DAY ONE, GOVERNOR NEWSOM TAKES KEY STEPS TOWARD HEALTH CARE TO ALL CALIFORNIANS
            Health Consumer Groups Applaud Both Long-Term Vision for Health Care for all Californians, and the Governor’s Specific Steps to Help Californians Access & Afford Coverage This Year

            • Governor Newsom announces support for major expansions of health coverage and other key health reforms, including first-in-the-nation expansions: increasing affordability assistance post-ACA in the individual market to middle-income Californians, and expanding Medi-Cal to low-income undocumented adults up to age 26.
            • The #Care4AllCA campaign of over 50 consumer and community groups last year championed a number of legislative and budget proposals that would protect and expand coverage that are included in the Governor’s announcements today, including removing exclusions in Medi-Cal based on immigration status, increasing affordability assistance in Covered California, reinstituting a state individual requirement o have coverage, expanding the state’s prescription drug purchasing collaborative, and more.
            • California had the biggest drop in the uninsured rate of all 50 states, from nearly 7 million to around 3 million, but this could increase to over 4 million without further state action according to a recent UC Berkeley/UCLA report.

            Here is a comment from Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition, and co-convener of the #Care4AllCA campaign in response to the health care announcement made today by Governor Gavin Newsom:

            “We applaud Governor Newsom’s announcement to take significant steps to increase health care access and affordability, from premiums to prescription drug prices. Last year, voters supported Governor Newsom in a health care election, and were clamoring not just to protect their care, but for the real, tangible steps to improve access and affordability to care.”

            FIRSTS: “Under these proposals, California would be the first state in the nation post-ACA to increase financial help to middle-income California trying to afford individual insurance. By removing exclusions in Medi-Cal for low-income young adults regardless of immigration status, California would also be the first state in the nation to extend Medicaid coverage to undocumented adults, beyond pregnant women and children. Our health system is stronger when everyone is included. These steps outlined today would put California on an aspirational and achieveable path to universal coverage.”

            PATH TO UNIVERSAL COVERAGE: “Even after historic coverage gains under the ACA, around three million Californians continue to be uninsured, largely because they need help to pay for their health care in an admittedly high cost-of-living state, or because they are excluded from existing help due to age, disability, or immigration status. Governor Newsom’s announcement to back key state investments that address these barriers, and which do not need federal approval, would bring down our uninsured rate even further, getting us that much closer to the 1-3% uninsurance rate seen in most European countries. If better affordability assistance can be provided, the Governor’s proposal to join other states like New Jersey and Vermont in reinstituting the requirement to have individual insurance would help get more Californians covered and reduce premiums. The Care4All California campaign of over 50 health, consumer, and community organizations proposed many parts of this agenda last year, and we are glad that Governor Newsom is taking up this expansive agenda on day one.”

            “Governor Newsom is right to both seek the federal permissions needed for a single-payer system, and to insist California take the actions we can without federal approval, providing tangible help to California consumers this year. We cannot allow federal obstacles to be an excuse for state inaction towards our universal coverage.”

            BEYOND COVERAGE, ON COSTS: “On top of coverage expansions, the Governor is right to focus on controlling costs, particularly prescription drug prices. Allowing state agencies to combine together when buying prescription drugs could drive down costs using bulk purchasing power. Governor Newsom’s support for our proposed legislation on expanding prescription drug purchasing pools should be the first step to using the state’s market and moral power to address high health costs overall.”

            “A new focus on prevention and public health, elevated by a new position of California Surgeon General, will hopefully not just keep costs down but keep Californians healthy and out of needing care to begin with.”

            PROTECTING PROGRESS PLUS: “Due to the continued sabotage of our health care system by the Trump Administration, our state might see an increase in our uninsured rate and may backslide on our progress without these actions taken promptly by our new Governor and Legislature. The California electorate clearly expects to not just keep us where we are, but to improve the system and make it work better for more people. Governor Newsom made it clear today that he plans to not just protect California’s progress, but take further steps to guaranteed, affordable, quality, health care coverage for all.”

            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 around 20 bills and budget items, and had eight pieces of legislation signed into law, although not the coverage expansion elements. 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.

            UC Berkeley Labor Center and UCLA Center for Health Policy Research recently released a report titled “California’s Health Coverage Gains to Erode Without Further State Action” detailing the negative state-level impacts of the elimination of the Affordable Care Act’s (ACA) individual mandate. Researchers find that because of the removal of the requirement to have health insurance, the uninsurance rate of people under age 65 could grow to 11.7% in 2020 (about 4 million people) and then to 12.9% in 2023 (or 4.4 million people), undoing the historic gains that California has made under the ACA. The largest groups of the remaining uninsured are undocumented Californians who are barred from accessing most health coverage options and Californians who struggle to afford their care.

            Health and Political Reporters:

            Below is a comment on Governor Newsom’s inauguration speech and today’s anouncement on health care. For more information, contact Anthony Wright, 916-870-4782 (cell) or Rachel Linn Gish, 916-532-2128 (cell).

            For immediate release: Monday, January 7, 2018

            ON DAY ONE, GOVERNOR NEWSOM TAKES KEY STEPS TOWARD HEALTH CARE TO ALL CALIFORNIANS

            Health Consumer Groups Applaud Both Long-Term Vision for Health Care for all Californians, and the Governor’s Specific Steps to Help Californians Access & Afford Coverage This Year

            Governor Newsom announces support for major expansions of health coverage and other key health reforms, including first-in-the-nation expansions: increasing affordability assistance post-ACA in the individual market to middle-income Californians, and expanding Medi-Cal to low-income undocumented adults up to age 26.
            The #Care4AllCA campaign of over 50 consumer and community groups last year championed a number of legislative and budget proposals that would protect and expand coverage that are included in the Governor’s announcements today, including removing exclusions in Medi-Cal based on immigration status, increasing affordability assistance in Covered California, reinstituting a state individual requirement o have coverage, expanding the state’s prescription drug purchasing collaborative, and more.
            California had the biggest drop in the uninsured rate of all 50 states, from nearly 7 million to around 3 million, but this could increase to over 4 million without further state action according to a recent UC Berkeley/UCLA report.
            Here is a comment from Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition, and co-convener of the #Care4AllCA campaign in response to the health care announcement made today by Governor Gavin Newsom:

            “We applaud Governor Newsom’s announcement to take significant steps to increase health care access and affordability, from premiums to prescription drug prices. Last year, voters supported Governor Newsom in a health care election, and were clamoring not just to protect their care, but for the real, tangible steps to improve access and affordability to care.”

            FIRSTS: “Under these proposals, California would be the first state in the nation post-ACA to increase financial help to middle-income California trying to afford individual insurance. By removing exclusions in Medi-Cal for low-income young adults regardless of immigration status, California would also be the first state in the nation to extend Medicaid coverage to undocumented adults, beyond pregnant women and children. Our health system is stronger when everyone is included. These steps outlined today would put California on an aspirational and achieveable path to universal coverage.”

            PATH TO UNIVERSAL COVERAGE: “Even after historic coverage gains under the ACA, around three million Californians continue to be uninsured, largely because they need help to pay for their health care in an admittedly high cost-of-living state, or because they are excluded from existing help due to age, disability, or immigration status. Governor Newsom’s announcement to back key state investments that address these barriers, and which do not need federal approval, would bring down our uninsured rate even further, getting us that much closer to the 1-3% uninsurance rate seen in most European countries. If better affordability assistance can be provided, the Governor’s proposal to join other states like New Jersey and Vermont in reinstituting the requirement to have individual insurance would help get more Californians covered and reduce premiums. The Care4All California campaign of over 50 health, consumer, and community organizations proposed many parts of this agenda last year, and we are glad that Governor Newsom is taking up this expansive agenda on day one.”

            “Governor Newsom is right to both seek the federal permissions needed for a single-payer system, and to insist California take the actions we can without federal approval, providing tangible help to California consumers this year. We cannot allow federal obstacles to be an excuse for state inaction towards our universal coverage.”

            BEYOND COVERAGE, ON COSTS: “On top of coverage expansions, the Governor is right to focus on controlling costs, particularly prescription drug prices. Allowing state agencies to combine together when buying prescription drugs could drive down costs using bulk purchasing power. Governor Newsom’s support for our proposed legislation on expanding prescription drug purchasing pools should be the first step to using the state’s market and moral power to address high health costs overall.”

            “A new focus on prevention and public health, elevated by a new position of California Surgeon General, will hopefully not just keep costs down but keep Californians healthy and out of needing care to begin with.”

            PROTECTING PROGRESS PLUS: “Due to the continued sabotage of our health care system by the Trump Administration, our state might see an increase in our uninsured rate and may backslide on our progress without these actions taken promptly by our new Governor and Legislature. The California electorate clearly expects to not just keep us where we are, but to improve the system and make it work better for more people. Governor Newsom made it clear today that he plans to not just protect California’s progress, but take further steps to guaranteed, affordable, quality, health care coverage for all.”

            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 around 20 bills and budget items, and had eight pieces of legislation signed into law, although not the coverage expansion elements. 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.

            UC Berkeley Labor Center and UCLA Center for Health Policy Research recently released a report titled “California’s Health Coverage Gains to Erode Without Further State Action” detailing the negative state-level impacts of the elimination of the Affordable Care Act’s (ACA) individual mandate. Researchers find that because of the removal of the requirement to have health insurance, the uninsurance rate of people under age 65 could grow to 11.7% in 2020 (about 4 million people) and then to 12.9% in 2023 (or 4.4 million people), undoing the historic gains that California has made under the ACA. The largest groups of the remaining uninsured are undocumented Californians who are barred from accessing most health coverage options and Californians who struggle to afford their care.

              2018 Year in Review in Health Care

              Health Access California, the statewide health care consumer advocacy coalition, released its assessment of 2018 today, detailing the progress in the past year on care and coverage in California.
              READ MORE

              For immediate release: Wednesday, December 26, 2018

              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)

              2018 YEAR IN REVIEW IN HEALTH CARE: California Protected Our Progress, By Policy and By Ballot Box;

              California Also Took Pro-Active Steps Toward Improved Industry Oversight and Universal Coverage

              · After Two Years of Actions to #Fight4OurHealth, Californians Flipped the Seats of Seven Representatives Who Voted to Take Away Coverage and Consumer Protections from their Constituents

              · California Policymakers Took Action to Shield Consumers from the Trump Administration’s Sabotage of our Health System with Legislation to Ban Junk Plans

              ​· New Industry Oversight Bills Passed on Prescription Drug Prices and Insurers; Additional Administrative Oversight Led to Conditions on Several Proposed Health Mergers, and 2019 will see California’s Authority on Health Plan Mergers Strengthened

              · #Care4AllCA Campaign of Community and Consumer Groups Creates Momentum and a Mandate to Win #Health4All, a More Accountable and Affordable Health System, and Move Closer to Universal Coverage in 2019

              Full 2018 Year In Review available on the Health Access website: https://health-access.org/wp-content/uploads/2018/12/2018-Year-In-Review_final.pdf

              SACRAMENTO, CA—Health Access California, the statewide health care consumer advocacy coalition, released its assessment of 2018 today, detailing the progress in the past year on care and coverage in California.

              “Despite the ongoing attempts to undermine our health care system by the Trump Administration, California policymakers and the public took significant steps to protect our progress on coverage expansions and consumer protections. Lawmakers passed patient protection legislation and took administrative action to prevent harm to our health system. Ultimately, voters made a clear statement against any new attempts to rollback or repeal our hard-won health reforms,” said Anthony Wright, executive director, Health Access California. “Californians not only prevented cuts and caps to our health system, but took action toward a more universal, accountable and affordable health system. California passed new patient protections like banning junk insurance, preserving a cap on prescription drug copays, and instituting stronger state oversight over health plan mergers.”

              “Because of pro-active politics the state put in place this year, more Californians will have coverage, and premiums increases will be less, than what would have been. Prescription drug prices will have additional oversight, and co-pays will continue to be capped to prevent extreme cost-sharing that otherwise impact the ones with the most expensive conditions. Health corporations will make investments and improvements to meet new conditions placed on their merger agreements,” said Wright. “So much more is needed to increase coverage, reduce premiums, hold down prescription drug and other prices, and keep the industry accountable, but the steps taken in 2018 provide momentum for bigger efforts with a new Governor and Legislature in 2019.”

              In addition to detailing the bills passed, the administrative actions taken, the conditions placed on mergers, the campaigns continued and launched, and more, the 2018 Year in Review looks at the political changes that will have a big impact on 2019:

              “Dozens of organizations came together to campaign for a path to universal health coverage that can provide direct and immediate help to Californians, by increasing affordability assistance in Covered California and expanding Medi-Cal to all income-eligible Californians regardless of age, disability, or immigration status. We are excited at the possibility of Governor-elect Newsom and the new Legislature taking big and bold steps to the goal of universal coverage, as they indicated would be a priority,” said Wright. “Real progress at the state level in 2019 is possible thanks to the changed federal landscape following the 2018 midterm elections, which solidifies the foundation of the ACA and Medicaid for California to build on. While voters kicked out many of the California Congressmembers who sought to undo their health care, they were clear at the ballot box they want to see pro-efforts at the federal and state level to provide tangible help in accessing and affording health care in the new year.”

              ###

                California Health Plans Still Struggle to Meet Long-Established Timely Access Standards

                A new report by California's Department of Managed Health Care (DMHC) is the first of its kind to provide data on timely access to care separating out commercial, individual/family, and Medi-Cal health plans.
                READ MORE

                For immediate release: Wednesday, December 19, 2018

                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)

                CALIFORNIA HEALTH PLANS STILL STRUGGLE TO MEET LONG-ESTABLISHED TIMELY ACCESS STANDARDS 

                CARE DELAYED IS CARE DENIED

                • This is the first report to show wait time standards separately for commercial, individual, and Medi-Cal health plans, a result of SB 964 (Hernandez) of 2014 that required annual, detailed reports on timely access to care.
                • Timely access to care has been required since 1975 but not until 2014 were health plans required to document compliance with these longstanding standards.
                • Report shows industry-wide difficulty with meeting standard, with Sutter Health performing far worse than any other plan; a majority of Medi-Cal and behavioral health plans shown to provide timely access less than 80% of the time.
                • Consumer advocates look to new data for greater accountability so health plans meet the promise of giving consumers the care they need when they need it. 

                SACRAMENTO, CA—A new report by California’s Department of Managed Health Care (DMHC) is the first of its kind to provide data on timely access to care separating out commercial, individual/family, and Medi-Cal health plans. The report found industry-wide difficulty providing timely access to care, with no plans providing an appointment within the designated time frame 100% of the time. Very few health plans provided timely access over 90% of the time.

                For commercial coverage, 14 out of 22 plans, a clear majority, provided timely access more than 80% of the time but for Medi-Cal managed care a distinct minority of plans, 7 out of 18 plans, provided timely access 80% of the time. For both commercial and individual/family plans, Sutter Health was by far the worse plan, only able to find a timely appointment for a patient 63% of the time, while Valley Health Plan was able to provide an appointment 99% of the time. For Medi-Cal managed care, Santa Clara Family Health Plan was only able to meet the timely access standards 65% of the time, while the Health Plan of San Joaquin was able to meet it 99% of the time.

                The DMHC report also looked at the access times for behavioral health plans finding worse results in ensuring that patients are receiving the mental health care they need in a timely manner. Only 2 out of 6 plans provided timely access to care at least 80% of the time. OptumHealth Behvioral Solutions of California was only able to find patients a timely appointment 64% of the time, while Value Behavioral Health of CA was able to do so 83% of the time. 

                California law requires health plans to provide timely access to care. This means that there are limits on how long patients have to wait to get health care appointments. For example, patients must get urgent care appointments within 48-96 hours, primary care appointments within 10 business days, and specialist appointments within 15 business days. Health plans must monitor their networks, measure appointment availability and submit compliance reports to the DMHC. 

                DMHC’s findings suggest that most Californians in private plans are not getting the access to care they are promised in exchange for their premiums, and Californians in Medi-Cal are struggling even more to get these timely appointments. Since 1975, the Knox-Keene Act has required health plans to make “all services readily available at reasonable times consistent with good professional practice.” More than forty years later, both private and public health plans cannot document that they provide timely access to care for consumers—even over a decade after regulations put in place clear appointment wait time standards. 

                “What this new data tells us is that health plans, whether in the private market or in public programs, continue to shirk their decades-long obligation to provide timely access to care for California patients. We are particularly disappointed in the lack of timely access for mental health services. Health plans have had over 40 years to figure out how to ensure that patients are getting the care they need when they need it, and the lack of compliance is not just frustrating but harmful for consumers. Care delayed is care denied,” said Anthony Wright, executive director, Health Access California, the statewide health care consumer advocacy coalition, which sponsored 2014’s SB 964 (Hernandez) that requires this annual report. “These health plans must be held accountable for their obligations to provide timely care to consumers. The plans accept premiums and public payments on the promise that they provide timely access to care, a promise too many of them fail. Patients demand accountability, and health plans should have some consequences for failing to comply with the law and forced to meet these long-established obligations.”

                ###

                About Health Access California

                Health Access California is the statewide health care consumer advocacy coalition, advocating for the goal of quality, affordable health care for all Californians. We represent consumers in the legislature, at administrative and regulatory agencies, in the media, and at public forums. For more information, please visit www.health-access.org

                  Decision in Texas V. US Strikes ACA, Puts the Health Coverage of Millions at Risk

                  Today, Judge Reed O'Conner ruled in Texas vs. United States to strike the entirety of the Affordable Care (ACA), due to the unconstitutionality of the individual mandate in the law and its inseparability from the ACA as a whole.
                  READ MORE

                  For immediate release: December 14, 2018

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

                  DECISION IN TEXAS V. US STRIKES ACA, PUTS THE HEALTH COVERAGE OF MILLIONS AT RISK

                  • Today’s decision by Texas Judge O’Connor imperils health coverage of tens of millions of Americans, at least 5 million in California alone
                  • Ruling is especially confusing as consumers face a December 15 enrollment deadline to sign up for coverage to start January 1st.
                  • With an appeal by California AG Becerra and others, advocates warn consumers not to panic and to continue to enroll in coverage options available.
                  • 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 — Today, Judge Reed O’Conner ruled in Texas vs. United States to strike the entirety of the Affordable Care (ACA), due to the unconstitutionality of the individual mandate in the law and its inseparability from the ACA as a whole. While the decision will likely be appealed by California Attorney General Xavier Becerra, and thus does not impact any coverage immediately, the ruling if upheld would take away coverage from millions of Californians and Americans.

                  “This completely ridiculous court decision, if upheld, would be catastrophic for our health system, undoing coverage and affordability assistance for tens of millions of Americans–over five million in California alone–and undermining consumer protections, including patients with pre-existing conditions, for many more. We can’t let one right-wing judge in Texas 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 appreciate our Attorney General Xavier Becerra appealing this decision and protecting our progress here in California. 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. California’s health system is interwoven with the federal government, and we would be severely impacted if the framework and financing of the ACA were to be struck down. We are glad California is taking the lead against this decision, to prevent us from going back to the days where denials for pre-existing conditions were commonplace, and millions more uninsured.”

                  “Given the Attorney General Becerra is appealing, nothing will change immediately. Consumers should not panic, and should continue to sign up for coverage. Folks should continue to sign up for coverage before the deadline so their coverage can start January 1 and be guaranteed that peace of mind for the whole of 2019.” said Wright. “This is a real threat to every Californian’s coverage if it is upheld–but we are confident that higher courts and cooler heads will prevail. Folks should continue to sign up for coverage, and continue to be part of the fight against those who wish to take it away.”

                  California consumers purchasing through Covered California have until December 15th to sign up for coverage to begin on January 1, 2019. But that is not the final deadline as Californians will have until January 15th to continue to sign up for care that begins later in 2019. Sign up for coverage at www.CoveredCA.com

                  # # #

                    California DMHC Approves Cigna-Express Scripts Merger with Conditions

                    Today, California's Department of Managed Health Care (DMHC) approved the merger of Cigna and Express Scripts. Continuing the trend of "diagonal mergers," the approval of the merger of Express Scripts, a major pharmacy benefit manager (PBM), and Cigna, one of the nation's largest insurers is just weeks before new laws take effect in California to increase public oversight over health mergers and PBMs.
                    READ MORE

                    For immediate release: Thursday, December 13, 2018

                    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)

                    MERGER WATCH: 

                    CALIFORNIA DMHC APPROVES CIGNA-EXPRESS SCRIPTS MERGER WITH CONDITIONS

                    HEALTH ADVOCATES STILL CONCERNED ABOUT IMPACTS, CALL ON NEW GOVERNOR TO USE STRONGER OVERSIGHT OVER HEALTH INDUSTRY THAT GOES INTO EFFECT IN 2018

                    • California’s Department of Managed Care today approved a “diagonal” merger between Cigna and Express Scripts, with conditions on correcting deficiencies, improving access to care and quality, and making investments in the state’s health system.
                    • Health & consumer advocates raised concerns about the proposed merger at state agencies in hearings earlier this year, arguing that it reduces competition, potentially driving up costs for consumers. 
                    • Legislation passed this year, going into effect on January 1, 2019, will create additional oversight for pending and future mergers
                      • AB 595 (Wood) gives Department of Managed Health Care (DMHC) increased authority over health plan mergers like this, and
                      • AB 315 (Wood) requires more transparency on pharmacy benefit managers.

                    SACRAMENTO, CA—Today, California’s Department of Managed Health Care (DMHC) approved the merger of Cigna and Express Scripts. Continuing the trend of “diagonal mergers,” the approval of the merger of Express Scripts, a major pharmacy benefit manager (PBM), and Cigna, one of the nation’s largest insurers is just weeks before new laws take effect in California to increase public oversight over health mergers and PBMs.

                    “Mergers like this have major impacts on the health care system we all rely on, including what choices consumers have and what we pay. While we appreciate the conditions placed on this merger, we continue to be concerned about the impact this deal will have on our health system, and about the broader trend towards greater consolidation and higher health costs,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition.

                    “Many of these conditions placed on Cigna are about getting them to comply with existing consumer protections with regard to timely and geographic access to care, and to correct deficiencies in the company’s reporting and behavior. We hope the DMHC is vigilant in ensuring Cigna addresses its deficiencies, and that meets its other commitments, on improving access to care and boosting its quality ratings. The investments announced are important, but we note they are a relatively small fraction of the billions of dollars of the newly-merged corporation’s profit. In addition to the condition that the new company contract with unaffiliated entities, we need to watch closely to see how the increased market power of Cigna and Express Scripts impacts the health care system for all Californians.”

                    Earlier this year, consumer advocates expressed concern over the continuing consolidation of the health industry, and the Cigna-Express Scripts merger in specific, in public hearings and in this letter to the Department of Managed Health Care, archived on the Health Access website: https://health-access.org/wp-content/uploads/2018/10/Final-HAC-Letter-on-Cigna-Express-Scripts-Merger-10-10-2018.pdf 

                    As the letter states, between 2015 and 2017, Cigna had 14 enforcement actions, which amounted to $285,000 in fines. Additionally, a recent June 2018 DMHC Routine Plan Survey Follow-Up Report found that Cigna had not corrected 9 out of 15 deficiencies identified in the 2016 Final Report. The conditions require these problems to be corrected, and address some, but not all, of the requests by consumer advocates. Health Access had requested additional protection on prescription drug access,and clearer standards to prevent premium increases and ensure any savings is passed to payers and the public.

                    The California Legislature and Governor Brown passed AB 595 by Assemblymember Wood this year which would institute stronger state oversight over health plan mergers and protects Californians from changes to the health plan market that may lead to higher health costs. Also enacted was AB 315 by Assemblymember Wood which adds oversight to pharmacy benefit managers like Express Scripts. By regulating PBMs and requiring disclosure of information on rebates and discounts, this new law will help ensure that consumers and purchasers actually benefit from savings that are reaped by PBMs. Both of these laws will take effect on January 1, 2019 and will affect any pending and future health plan mergers.

                    “We look forward to the implementation of new laws next year in California that will bring a stronger voice for patients and the public interest for these mergers in general, and for pharmacy benefit managers specifically. New leadership in California, including a new governor, can and should exercise new authority to put tougher oversight over such transactions in the future. California policymakers need to watch closely to ensure that these companies fulfill the promises they made under the conditions of the merger,” said Wright.