Press Releases

Press inquiries may be directed to:

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

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

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

For Immediate Release: Tuesday, January 5, 2022

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

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

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

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

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

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

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

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

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

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

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

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

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

###

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

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

    For immediate release: Thursday, December 30, 2021

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

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

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

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

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

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

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

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

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

    ###

      California Health Consumer Champions Revealed in Health Access’ 2021 Legislative Scorecard

      Health Access 2021 Legislative Scorecard analyzes how California legislators voted on bills to improve our health care system for California health consumers, including efforts to expand coverage, lower the cost of care, and hold the health care industry accountable for quality and equity. More than half of all legislators (27 Senators & 42 Assemblymembers) voted with health care consumers 100% of the time for the 2021 legislative session, with 26 lawmakers (10 Senators & 16 Assemblymembers) earning the title of "Health Consumer Champion" for receiving 100% for 3 years running (2019-2021).
      READ MORE

      For immediate release: Monday, December 6, 2021

      Contact:
      Rachel Linn Gish, Director of Communications, Health Access California, 916-532-2128 (cell)

      CALIFORNIA HEALTH CONSUMER CHAMPIONS REVEALED IN HEALTH ACCESS’ 2021 LEGISLATIVE SCORECARD

      • Health Access 2021 Legislative Scorecard analyzes how California legislators voted on bills to improve our health care system for California health consumers, including efforts to expand coverage, lower the cost of care, and hold the health care industry accountable for quality and equity.
      • More than half of all legislators (27 Senators & 42 Assemblymembers) voted with health care consumers 100% of the time for the 2021 legislative session, with 26 lawmakers (10 Senators & 16 Assemblymembers) earning the title of “Health Consumer Champion” for receiving 100% for 3 years running (2019-2021).

      SACRAMENTO, CALIFORNIA –  Health Access California, the statewide health care consumer advocacy coalition, releases its 2021 Legislative Scorecard, which highlights key bills supported by health care consumer advocates in the 2021 legislative session. Several of the bills listed sought to respond to the problems of the pandemic, which highlighted the gaps and inequities in our health care system, from lack of access to care, to the resulting economic hardships faced by millions of California families which put health costs at odds with many other needs. In the face of this, with the support of health advocates and state Legislators, California was able to make great progress towards universal, affordable, and equitable health care coverage for many more Californians. This 2021 scorecard details how state policymakers voted on key bills to expand coverage, reduce health care costs, and improve quality and equity in our health care system.

      “We thank the California legislators who have stood with health care consumers every step of the way, taking historic steps to remove barriers to care and increase quality and accountability in the health system. Health care costs and access continues to be a top of mind issue for voters, and we hope this scorecard lets them easily see how their legislator sided on key bills to improve the system for patients and the public,” said Anthony Wright, the executive director of Health Access California. “The work of securing and expanding coverage for all Californians, controlling health care costs, and working for health quality and equity was even more important than ever as the pandemic continued on. Health advocates thank the lawmakers that have stood with us this year and over many years, and urge them to continue to fight for the reforms still needed to fully make our health care system one for all Californians.”

      The scorecard has its limits in telling the full story in health policy for 2021, particularly as major health care progress was made in the state budget, rather than in specific bills. Yet the scorecard serves as a resource to show, when given an opportunity to publicly vote on key legislation that affect health care consumers in committee or on the Assembly or Senate floor, the percentage of time lawmakers sided with California health care consumers.

      Health advocates particularly want to highlight the twenty-six lawmakers that have voted with health care consumers 100% of the time for three years running, for the 2019-2021 legislative sessions, deeming them “Health Consumer Champions”. The 10 Senators with this distinction include Senators Allen, Atkins, Durazo, Gonzalez, Hertzberg, Leyva, Pan, Skinner, Wieckowski, and Wiener. The 16 Assemblymembers with this distinction include Aguiar-Curry, Berman, Chiu, Friedman, Gabriel, Cristina Garcia, Holden, Levine, Rendon, Reyes, Luz Rivas, Santiago, Stone, Ting, Wicks, and Wood. You can find all of Health Access previous scorecards here.

      Legislation scored includes the following bills in these key categories:

      Expanding Coverage, Access, and Affordability

      • Health4All (Expanding Medi-Cal Regardless of Immigration Status): Over 250,000 Californians will be eligible for coverage under the new 2021-2022 state budget that includes an expansion of Medi-Cal to older adults age 50+, regardless of immigration status, building upon earlier extensions to children and young adults. Leading up to that budget, legislators voted on two bills to advance the goals of Health4All.
        • AB 4 (Arambula) removes the exclusion in Medi-Cal for undocumented Californians entirely. (Status: Senate Appropriations) 
        • SB 56 (Durazo) expands Medi-Cal to Californians age 60 and over regardless of immigration status. (Status: Assembly Appropriations) 
      • Eliminating the Medi-Cal Asset Test: AB 470 (Carrillo) removes the asset test to ensure seniors and those with disabilities do not lose Medi-Cal coverage for having over $2,000 in assets. The 2021-2022 budget included removal of the asset test. (Status: Senate Appropriations) 
      • Timely Access to Care for Mental Health: SB 221 (Wiener) codifies timely access to care regulations at the Department of Managed Health Care and Department of Insurance, and strengthens regulations related to behavioral health care. (Status: Signed by Governor Newsom) 
      • Free COVID-19 Testing and Vaccination Cost-Sharing: SB 510 (Pan) requires health plans to cover COVID-19 testing and vaccinations free from cost-sharing and prior authorization, including for out-of-network providers through a public health emergency. (Status: Signed by Governor Newsom) 
      • Connecting EDD Applicants with Covered California: SB 644 (Leyva) requires the Employment Development Department to share information on all unemployment insurance applicants with Covered California, enabling it to conduct outreach to those experiencing employment transitions. (Status: Assembly Rules Committee) 

      Reducing Health Care Costs

      • Office of Health Care Affordability: AB 1130 (Wood) creates the Office of Health Care Affordability within the Department of Health Care Access and Information (HCAI), to set enforceable cost targets across all sectors of the health care industry to contain health care costs. (Status: Senate Health) 
      • Hospital Charity Care and Payment Policies: AB 532 (Wood) requires hospitals to provide uninsured and underinsured individuals with information on financial assistance and charity care programs. (Status: Signed by Governor Newsom) 
      • Improving the Hospital Fair Pricing Act: AB 1020 (Friedman) updates protections for the uninsured and underinsured against inflated hospital bills by strengthening and expanding provisions of the Hospital Fair Pricing Act. (Status: Signed by Governor Newsom) 
      • Tracking Deductible and Maximum Out of Pocket Costs: SB 368 (Limon) requires health plans to track consumers’ annual accrual towards their deductibles and out-of-pocket maximums, and provide such accrual information regularly. (Status: Signed by Governor Newsom) 

      Improving Quality and Equity

      • Office of Racial Equity: SB 17 (Pan) establishes the Office of Racial Equity and the Racial Equity Advisory and Accountability Council to address systemic and institutional racism that has resulted in poorer health outcomes and disparities in black, indigenous, and other communities of color. (Status: Assembly Appropriations) 
      • “Momnibus”: SB 65 (Skinner) improves perinatal outcomes and reduces racial disparities in maternal and infant health for Medi-Cal enrollees, including supporting coverage of doula services, expanding California’s Pregnancy-Associated Mortality Review Committee, and supporting the midwifery workforce. Early versions of the bill included expanding post-partum coverage to one year, which was later included in the 2021-2022 budget. (Status: Signed by Governor Newsom) 
      • C.R.I.S.E.S. Act: AB 118 (Kamlager) establishes the Community Response Initiative to Strengthen Emergency Systems (C.R.I.S.E.S.) Act pilot grant program to fund community-based organizations in providing emergency responses to vulnerable populations. (Status: Signed by Governor Newsom) 
      • Consumer Participation Program: AB 326 (L. Rivas) permanently establishes the Consumer Participation Program which has since 2003 provided advocacy and witness fees to community organizations that contribute substantially to the adoption of regulations within the Department of Managed Health Care on behalf of consumers. (Status: Signed by Governor Newsom) 
      • California Health Equity Fund: AB 1038 (Gipson) provides resources to support local health departments, non-profits, clinics, and tribes that serve disproportionately impacted communities hardest hit by COVID-19, to target housing, nutrition, and other needs. (Status: Senate Appropriations) 
      • Hospital Equity Reporting: AB 1204 (Wicks) requires hospitals to share race-disaggregated health care quality and workforce data to the Department of Health Care Access and Information (HCAI). (Status: Signed by Governor Newsom) 

      ###

        California Health Consumers to Benefit as U.S. House Passes Build Back Better Bill

        This morning, the U.S. House of Representatives passed the Build Back Better Act, with 42 California congressmembers voting to advance the historic legislation that would help lower health care costs and otherwise make investments to improve our health care system. The bill now goes to the Senate for consideration, and would come back to the House for a concurrence vote before heading to President Biden for a signature.
        READ MORE

        U.S. HOUSE PASSES BUILD BACK BETTER BILL WITH MAJOR HEALTH INVESTMENTS TO HELP CALIFORNIANS AFFORD COVERAGE & CARE

        • The Build Back Better Act marks the most significant investment in health care since the Affordable Care Act, with major provisions to lower the cost of care, from insulin to hearing aids to prescription drugs to health premiums.
        • The bill includes additional affordability ACA assistance through 2025, helping 1.4 million Covered California enrollees, lowering prescription drugs for millions of Californians, and expanding Medicare benefits.
        • California health and consumer advocates urged passage of Build Back Better plan for its help in health coverage, hearing benefits in Medicare, home care, child care, and more – and will continue to fight for permanent affordability assistance, further expansions in Medicare and greater prescription drug price relief. 

        SACRAMENTO, CA – This morning, the U.S. House of Representatives passed the Build Back Better Act, with 42 California congressmembers voting to advance the historic legislation that would help lower health care costs and otherwise make investments to improve our health care system. The bill now goes to the Senate for consideration, and would come back to the House for a concurrence vote before heading to President Biden for a signature.

        Important victories that will help Californians and our health system include:

        • LOWER HEALTH PREMIUMS: The bills keeps health care affordable for those who purchase coverage on their own, by extending the financial assistance through 2025 that was initially implemented in the American Rescue Plan. This will continue to help almost all of the 1.4 million Covered California enrollees who are seeing a savings of an average of $1,000 per year to their health care coverage, giving all who buy coverage as individuals a guarantee they don’t have to spend more than 8.5% of income on coverage.
        • LOWER PRESCRIPTION DRUG PRICES: The bill would help save billions in drug costs for Californians. Most notably, the bill allows Medicare, for the first time, to directly negotiate the price of some prescription drugs, starting in 2025. Even sooner, it caps co-payments for insulin at $35, and caps overall prescription drug out-of-pocket costs in Medicare Part D at $2,000, and prevents prescription price spikes that are higher than inflation.
        • IMPROVEMENTS IN MEDICARE AND MEDI-CAL: Over 6 million Californians on Medicare would get coverage to get hearing aids, which are expensive, costing thousands of dollars. Other investments in Medicaid would invest in improvements for children and mothers, and home care for older Americans and people with disabilities.

        Consumer advocates have been actively working to support this Build Back Better bill, even as they continue to work to strengthen prescription drug price reform, to make the ACA affordability assistance permanent, and to further expand Medicare to include dental benefits.

        Here is a statement by Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition which has been advocating and organizing in the state for these federal health care reforms:

        “The Build Back Better bill passed by the House is the most significant step to lower health costs and expand coverage since the Affordable Care Act. Millions of Californians will benefit from lower health care premiums, more affordable prescription drugs, and enhanced Medicare benefits. The bill helps lower health care costs for Californians, whether they get coverage in Medicare, Medi-Cal, Covered California, or in a private health plan.”

        “Under this bill, over 1.4 million in Covered California will continue to get additional assistance worth hundreds or, for many, thousands of dollars to better afford coverage. This means all who buy coverage on their own will have a guarantee through 2025 that they won’t have to spend more than a 8.5% of their income on health insurance—help that is especially urgent in our high cost-of-living state. Over 6 million Californians in Medicare will have new help to afford hearing aids, insulin, and other medications. All Californians will benefit from key prescription drug price reforms, like preventing price spikes beyond the rate of inflation, and other investments in our health system.”

        “We thank all our California Congressmembers who supported this package, which could be called the Additional Affordable Assistance for Health Coverage Act, the Cap Insulin Co-Pays Act, the Hearing Aids for All Seniors Act, or the Prescription Drug Price Reform Act. Just one of the health provisions of this bill would be a big benefit in its own right, and together they represent major health reform that will provide real relief on health care costs for California consumers. We urge quick passage in the Senate.”

        ###

          Today Begins 2021-22 Covered California Open Enrollment with Lowest Premiums Ever

          Today marks the first day of the 2021-22 open enrollment period for Covered California, kicking off the most affordable coverage year ever for Californians purchasing care on their own. State efforts, coupled with historic federal investments passed this year, will mean premium help for almost all of the 1.6 million Californians enrolled in Covered California, and even more reason for the 1.1 million remaining eligible uninsured to get covered.  Starting today, November 1, Californians will have a full 3 months to enroll in or change their coverage plan. Many will see savings in their current plans, but Californians could save more by shopping and switching. 
          READ MORE

          For immediate release: Monday, November 1, 2021

          Contact:Rachel Linn Gish, Director of Communications, Health Access California, 916-532-2128 (cell)

          AS COVERED CALIFORNIA STARTS OPEN ENROLLMENT TODAY, MANY CALIFORNIANS WILL GET COVERAGE WITH $0 PREMIUMS

          Launch of Open Enrollment in Covered California with Both State and Federal Financial Help Could Mean Nearly Universal Coverage for Californians Buying Their Own Health Coverage

          • The Biden-Harris American Rescue Plan (ARP), along with state budget investments championed by Health Access, will mean lowest premiums ever for Californians in Covered California.
          • A $1 premium tax credit, a priority for Health Access and other health advocates, passed in the 2021 state budget, leading to 700,000 Covered California enrollees seeing true zero premium coverage beginning January 1, 2022.
          • The newly announced Build Back Better framework will extend ARP subsides through 2025, continuing the cap on health coverage premiums to 8.5% of income, while advocates will continue to work to make this federal help permanent, and push for further cost-sharing reductions. 

          SACRAMENTO, CA – Today marks the first day of the 2021-22 open enrollment period for Covered California, kicking off the most affordable coverage year ever for Californians purchasing care on their own. State efforts, coupled with historic federal investments passed this year, will mean premium help for almost all of the 1.6 million Californians enrolled in Covered California, and even more reason for the 1.1 million remaining eligible uninsured to get covered.

          Starting today, November 1, Californians will have a full 3 months to enroll in or change their coverage plan. Many will see savings in their current plans, but Californians could save more by shopping and switching.

          “California took a leadership role in implementing and improving on the Affordable Care Act, and now along with federal help passed by the Biden-Harris Administration, hundreds of thousands of families are getting more affordable health coverage options. We encourage all Californians—whether enrolled in Covered California, in other individual coverage, and especially if uninsured—to look at these new options for you and your family. Even if you have checked before, you should look at your Covered California options again. With all the new help available, you may be happily surprised,” said Anthony Wright, executive director, Health Access California, the statewide health care consumer advocacy coalition.

          Health Access and other health consumer organizations spearheaded the advocacy for a $20 million 2021-2022 state budget investment to finally realize the goal of true zero premium coverage for a majority of Covered California enrollees. Starting on January 1, 2022, 700,000 current Covered California enrollees will see their plans drop to $0 per month and 85% of the 1.1 million eligible remaining uninsured will be able to get coverage for that price if they enroll through Covered California.

          “Thanks to years of advocacy in California and support from legislators and Governor Newsom, our state is leading the way in making coverage more affordable for our state’s residents and families. Hundreds of thousands of Californians will soon not have any financial barrier to ensure they can keep their coverage,” said Diana Douglas, policy and legislative affairs manager for Health Access California.

          The Biden-Harris American Rescue Plan passed earlier this year, included historic affordability help to almost all Covered California enrollees ensuring that nobody had to spend more than 8.5% of their income for coverage, effectively eliminating all “affordability cliffs” in the ACA marketplaces. The current framework of the federal Build Back Better plan extends this financial assistance through 2025.

          “The need for additional federal subsidies for health coverage is especially urgent in our high-cost-of-living state. Californians greatly appreciate the additional affordability assistance in the pending Build Back Better plan, and it’s vital that these subsidies are made permanent. Families need the peace of mind to know that their premiums won’t spike in a few years,” said Wright.

          Visit www.coveredca.com to shop and compare plans, and either enroll or switch your current coverage. Open enrollment ends January 31, 2022.

          ###

            Federal Build Back Better Framework Includes Major Health Investments, Falls Short on Prescription Drug & Medicare Reform

            Today President Biden announced a federal framework for the Build Back Better proposal that includes historic investments to help Californians afford their health care, but does not include key proposals around prescription drug price reform and expanding Medicare dental and vision benefits. 
            READ MORE

            For Immediate Release: Thursday, October 28, 2021

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

            FEDERAL BUDGET PLAN FRAMEWORK INCLUDES MAJOR HEALTH INVESTMENTS TO HELP CALIFORNIANS AFFORD COVERAGE

            FIGHT WILL CONTINUE ON PRESCRIPTION DRUG REFORM AND EXPANDING MEDICARE BENEFITS

            • Framework extends ACA financial assistance through 2025, helping 1.4 million Covered California enrollee.
            • Crucial drug price reform continues to be blocked by Big Pharma and a handful of holdouts, including CA Rep. Scott Peters
            • California Health and consumer advocates urge passage of Build Back Better plan for its help in health coverage, hearing benefits in Medicare, home care, child care, and more – and continue to fight for permanent affordability assistance, further expansions in Medicare and prescription drug price relief. 

            SACRAMENTO, CA – Today President Biden announced a federal framework for the Build Back Better proposal that includes historic investments to help Californians afford their health care, but does not include key proposals around prescription drug price reform and expanding Medicare dental and vision benefits.

            Important victories that will help Californians and our health system include:

            • Keeping health care affordable for those who purchase coverage on their own. The Build Back Better framework extends the financial assistance through 2025 that was initially implemented in the American Rescue Plan. This will continue to help almost all of the 1.4 million Covered California enrollees who are seeing a savings of an average of $1,000 per year to their health care coverage.
            • Over 6 million Californians are on Medicare, who would be able to have their hearing aids covered.
            • Other investments include providing coverage to low-income Americans in the twelve states that have not expanded Medicaid under the ACA, a significant boost in home care for older Americans and people with disabilities, and other key areas that invest in children and families, like preschool and child care.

            However, this framework falls far short in key areas that are critical to ensuring our health care system is affordable and equitable.

            • Not included is drug price reform, which is being blocked by the influence and deep pockets of Big Pharma, and a handful of Congressional holdouts, including California’s Rep. Scott Peters. If popular provisions, such as allowing Medicare to negotiate drug prices, are included, it could save Californians billions in drug costs.
            • The framework also does not include expanding Medicare to include dental and vision benefits. Almost one quarter of Californians over the age of 65 report they have not seen a dentist in the past year or never at all. Expanding dental benefits in Medicare is crucial to helping our older Californians access this vital care.

            Here is a statement by Anthony Wright, Executive Director of Health Access California, the statewide health care consumer advocacy coalition which has been advocating and organizing in the state for these federal health care reforms:

            “This framework includes important investments to help Californians afford health coverage, providing annual assistance of hundreds or, for many, thousands of dollars. This helps the 1.4 million with coverage in Covered California not have to spend more than a percentage of their income on health insurance—help that is especially urgent in our high cost-of-living state. The health of millions of Californians would benefit from this assistance to afford coverage, have Medicare covering hearing aids, and other investments in home care, child care, and much more.”

            “We are deeply disappointed that despite a broad popular support to have Medicare negotiate drug prices, it is not included in this framework. San Diegans should be angry that California’s Rep. Scott Peters and a few other holdouts have scuttled this rare opportunity to lower the cost of needed medication. By siding with Big Pharma, Rep. Peters and others hampered our ability to further expand Medicare benefits and make other needed investments. We have fought for prescription drug price reform for decades and we aren’t going to stop now.”

            “We will work to ensure that these key health care investments are passed by Congress, and keep up our advocacy to get permanent affordability assistance, prescription drug price reforms and Medicare benefit expansions included.”

            Learn more about what was originally proposed for Build Back Better in specific regions throughout the state:

            ###

              New Data Released on Benefits of Build Back Better for Sacramento County’s’ Health

              Health Access California today released new data on the regional impacts of the proposed federal Build Back Better bill on Sacramento's health care as Congress continues to negotiate a final deal. The new data includes how many in Sacramento County would benefit from improved Medicare benefits and extended ACA affordability assistance, and how much local residents might save from these and other reforms, including efforts to negotiate and lower prescription drug prices.
              READ MORE

              For Immediate Release: Tuesday, October 19, 2021

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

               

               NEW DATA RELEASED ON HOW MANY SACRAMENTANS WOULD BETTER AFFORD COVERAGE & CARE WITH THE FEDERAL “BUILD BACK BETTER” BILL

              Beyond the process and timing of the Build Back Better act in Congress, new factsheet show what’s at stake for Sacramento County’s health

              Advocates urge and appreciate support from Sacramento Reps. Matsui, Bera, and others

              SACRAMENTO, CA – Health Access California today released new data on the regional impacts of the proposed federal Build Back Better bill on Sacramento’s health care as Congress continues to negotiate a final deal. The new data includes how many in Sacramento County would benefit from improved Medicare benefits and extended ACA affordability assistance, and how much local residents might save from these and other reforms, including efforts to negotiate and lower prescription drug prices.

              Alongside statewide and other regional analyses on Health Access’ website, the Sacramento County fact sheet can be found here: Build Back Better: What’s at Stake for Sacramento County’s Health.

              In a virtual event earlier today, Health Access, along with local Sacramento leaders and advocates, including Congressmember Doris Matsui, discussed how those in Sacramento County would be affected by Build Back Better proposal and its health care provisions. California’s congressmembers are a key voting bloc on these important reforms. Sacramento County is largely represented by Congressmember Matsui, as well as Congressmember Bera, with portions also represented by Congressmember John Garamendi and Congressmember Jerry McNerney.

              “Right now, we have a once-in-a-lifetime opportunity to make transformative investments in our kids, our grandkids, and American families,” said Congresswoman Matsui. “The Build Back Better Agenda seeks to unlock tools and create comprehensive solutions to help us close the coverage gap and make health care more affordable. Now is the time to Build Back Better and provide a blueprint for our nation’s future.”

              “In all the back and forth on process and procedure, what’s been lost in the discussion of the Build Back Better bill is the big benefit it will provide patients and our public health in general,” said Anthony Wright, Executive Director of Health Access California. “Under the federal budget plan, millions of Californians, and tens of thousands in Sacramento County, could see substantial savings in their needed medications, families that could keep affordable health care coverage in Covered California, and older Californians who could finally get vision and dental benefits in Medicare.”

              The new regional data identifies what those in Sacramento County could gain – or lose – in the Build Back Better proposal in three key areas:

              1. Lower Prescription Drug Costs: Sacramento County residents could save as much as $260 million in prescription drug costs in just one year.
              2. Keeping Covered California Affordable: The American Rescue Plan provides $132 million annually for financial help to those in Sacramento County who are enrolled in Covered California. Without continued major funding from Congress, over 54,000 in Sacramento County could see increases in their insurance premiums on average of $1,000 per person annually.
              3. Vision and Dental Benefits in Medicare: There are over 260,000 Medicare enrollees in Sacramento County and twenty percent of residents over the age of 65 report they have not seen a dentist in the past year or never at all. If vision and dental benefits are included in the Build Back Better bill, it would ensure many older Sacramento area adults can access basic care to improve their overall health and quality of life.

              “If these major investments are made, this would be the most dramatic improvement in health care since the Affordable Care Act, benefiting millions of Californians and those in the Sacramento area,” said Wright. “Especially in our high cost-of-living state, we appreciate the support from Sacramento Congressional members, including Congressmember Matsui and Congressmember Bera, to help health care consumers to lower their health care costs and provide improved access to care to the system we all rely on.”

              The Sacramento County data released today follows the release of Health Access factsheets on Build Back Better’s impacts in the Central Valley and San Diego County, as well as statewide. Data on Orange County is forthcoming.

              ###

                Leg Recap: CA Takes Key Steps to Universal & Improved Health Care System This Year

                The Governor's final signatures over the weekend capped off a notable year of progress for Californians health care. Through both the legislative session and budget actions, this year saw major expansions to health care coverage, more affordable health care options, and efforts to improve quality and equity in our care. These steps will make improvements to our health care this year, in order to address the urgent needs of Californians during the pandemic and beyond, and bring our state closer than ever to universal coverage.
                READ MORE

                For Immediate Release: Wednesday, October 13, 2021

                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)

                LEGISLATIVE RECAP: California Takes Key Steps to an Improved, Expanded, and Equitable Health Care System with Budget and Legislative Action This Year

                Efforts to expand coverage, reduce costs, and improve quality and equity were passed this year, with support from a broad #Care4AllCA coalition.

                More remains to be done at the state level, including establishing an Office of Health Care Affordability, and at the federal level, to extend affordability assistance to keep Californians covered, and lower the cost of prescription drugs.

                SACRAMENTO, CA – The Governor’s final signatures over the weekend capped off a notable year of progress for Californians health care. Through both the legislative session and budget actions, this year saw major expansions to health care coverage, more affordable health care options, and efforts to improve quality and equity in our care. These steps will make improvements to our health care this year, in order to address the urgent needs of Californians during the pandemic and beyond, and bring our state closer than ever to universal coverage.

                These efforts include the nation-leading work to remove barriers to care for all, regardless of immigration status. Following the expansions of Medi-Cal to all income-eligible children and young adults in previous years, starting in May 2022, all income-eligible adults age 50 and over will be able to access comprehensive health care through Medi-Cal. Additional improvements to Medi-Cal included budget investments to address racial disparities in maternal and infant death, creating more culturally and linguistically appropriate documents, and eliminating the Medi-Cal asset test that prevented some Californians from accessing care for having a small amount of savings. These actions were supported by the over 70 community and health care advocacy groups that comprise the Care4All California coalition.

                “California has once again taken nation-leading steps to ensure that care is more affordable, accessible, and equitable, from removing barriers to care in Medi-Cal, to ensuring greater oversight on quality and disparities,” said Anthony Wright, executive director of Health Access California, which convenes the Care4All California coalition. “Actions this year are providing real relief to Californians to help us get out of the pandemic now, while making meaningful movement to a stronger health care system for the future. While we have a lot more work to do to address the problems in our health system, this year’s budget and legislative actions show that progress is possible, and that hundreds of thousands of Californians will feel real results from these reforms.”

                Since 2017, the Care4All California campaign has worked on what can be done at the state level to build and improve upon the ACA, without the need of federal interventions or an act of Congress. ​​​The coalition has helped make remarkable gains in California since then – instituting first-in-the-nation state subsidies to help more low- and middle-income Californians afford coverage in Covered California, expanding health coverage to more Californians, regardless of immigration status, implementing more tools to fight the skyrocketing cost of prescription drugs, and making our health system more accountable to ensuring equity and higher quality care. These efforts, along with the signing of the American Rescue plan earlier this year, have made health care for Californians more affordable and accessible than ever. Some of these gains are at risk however, if Congress does not make affordability subsidies permanent in their Build Back Better plan, along with lower the cost of prescription drugs.

                In addition to key budget items outlined above, the following bills supported by #Care4AllCA were signed into law this year:

                • SB 65 (Skinner): “Mom”nibus bill to further reduce racial disparities in maternal and infant death
                • AB 1204 (Wicks): Instituting better equity reporting to the Office of Statewide Health Planning and Development

                The coalition also supported key efforts to address the rising cost of care, by establishing an Office of the Health Care Affordability and addressing consolidation issues, which will remain a focus next year. 

                Here is additional comments from some leaders of the Care4All California coalition:

                “As we approach the end of the 2021 legislative session, CPEHN would like to take a moment to applaud the commitment from our partners that went towards ensuring California remains a leader on health care affordability and access. CPEHN understands that California’s BIPOC communities face unique challenges when it comes to their health and we appreciate the State’s continued investment in critical support services, such as community health workers and language accessibility, which are critical to ensuring successful health outcomes for communities of color. However, even as California celebrates historic expansions such as the inclusion of California’s undocumented older adults in Medi-Cal, the elimination of the Medi-Cal assets test, and comprehensive Medi-Cal doula coverage, California still has a long way to go to ensure health equity for all. CPEHN looks forward to continuing the close collaboration with our Care4AllCA allies next year.” – Kiran Savage-Sangwan, Executive Director, California Pan-Ethnic Health Network (CPEHN)

                “This year, California made a number of significant budget investments and program updates that will dramatically improve our healthcare system. From expanding Medi-Cal coverage to undocumented seniors to removing the inequitable asset test for the elderly to reimagining the infrastructure of our health care delivery system through CalAIM — millions will benefit from these changes.  These investments are important steps in the right direction but more can and must be done.  Racial disparity continues to harm those Californians hit hardest by the pandemic, underscoring the need to provide equitable, affordable, and quality healthcare to everyone. The Care4All Coalition stands ready to collaborate and ensure we collectively reach this goal. ” – Elena Santamaria, Policy Advisor, NextGen California

                “Since 1987, CaPA has worked toward a universal healthcare system. We are a proud member of the #Care4AllCA Coalition because we have the same values and mission of seeking to achieve universal, affordable, and equitable healthcare for everyone who calls California home. CaPA is energized to continue organizing and taking action with our partners to achieve the healthcare system we all deserve in our golden state!” – Beatriz Sosa-Prado, M.S., Executive Director, California Physicians Alliance

                “As the pandemic has demonstrated, tackling health inequity is an urgent challenge, and in order to do so we must hold ourselves accountable through tracking and reporting disparities. AB 1204 is a crucially important step in this effort. Data on the health and well-being of people of color and other vulnerable demographic groups in our state will empower us in our future fights to ensure more equitable health outcomes.” –  Georgette Bradford, Sonographer, Kaiser Sacramento and SEIU-UHW African American Caucus President

                ###

                  Governor Newsom Signs New Law to Help Californians Track Their Out-of-Pocket Health Costs

                  Today, California Governor Gavin Newsom signed into law a key patient protection bill, Senate Bill 368 (Limón), which would require consumers to receive timely and accurate information about their progress over the course of a year in meeting their deductible, out-of-pocket maximum, and other spending limits.
                  READ MORE

                  For Immediate Release: Wednesday, October 6, 2021

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

                   NEW LAW WILL HELP CALIFORNIANS TRACK OUT-OF-POCKET HEALTH CARE SPENDING

                  Governor Newsom today signed SB 368 (Limón), to provide health consumers information on how close they are to meeting their deductible and other out-of-pocket spending limits, helping them better plan for their health care and other financial needs

                  SACRAMENTO, CA – Today, California Governor Gavin Newsom signed into law a key patient protection bill, Senate Bill 368 (Limón), which would require consumers to receive timely and accurate information about their progress over the course of a year in meeting their deductible, out-of-pocket maximum, and other spending limits.

                  “SB 368 provides Californians with accurate and timely information regarding the costs of their health care needs,” said Senator Limón. “The signing of this bill comes at a much-needed time as healthcare is in the minds of many across our state. I am thankful for our sponsors and supporters as this becomes law.”

                  Most consumers with health coverage still have to pay out-of-pocket for care through co-payments and deductible. The Affordable Care Act placed an cap on annual out-of-pocket spending, a huge relief for many patients who faced high-cost medical needs and were often forced into bankruptcy to cover medical bills. These Californians need timely and updates information for when the cap is reached, in order to make financial planning decisions for themselves and their family, and better manage their conditions. Similarly, the increasing number of California consumers with deductibles need to know if they are about to reach their deductible, and when coverage will finally kick in to cover the care they need. Currently health plans already track this information for their records, but it is not shared with consumers unless explicitly requested. The new law will require health plans regulated by the Department of Managed Health Care to track and communicate these accruals to enrollees.

                  “Patients already experiencing significant health needs should have access to the same up-to-date deductible information health plans have available. This new law will shift the burden for tracking these accruals from people to the health plans,” said Diana Douglas, policy advocate for Health Access California, sponsor of SB 368. “With these regular communication on spending towards these limits, Californians can better stay on top of their health and financial well-being.”

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

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

                  ###

                    New Data Released on Benefits of Build Back Better for Californians’ Health

                    Health Access California today released new data on the statewide impacts of the proposed federal Build Back Better bill on California's health care as Congress continues to negotiate a final deal. The new data includes how many Californians would benefit from improved Medicare benefits and extended ACA affordability assistance, and how much Californians might save from these and other reforms, including efforts to negotiate and lower prescription drug prices. You can find the statewide fact sheet here: Build Back Better: What's at Stake for California's Health.
                    READ MORE

                    For Immediate Release: Wednesday, October 6, 2021

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

                     NEW DATA RELEASED ON HOW MANY CALIFORNIANS WOULD GET HELP TO AFFORD COVERAGE & CARE IN FEDERAL “BUILD BACK BETTER” BILL

                    Beyond the process and timing of the Build Back Better act in Congress, new factsheets show what’s at stake for Californians’ health

                    SACRAMENTO, CA – Health Access California today released new data on the statewide impacts of the proposed federal Build Back Better bill on California’s health care as Congress continues to negotiate a final deal. The new data includes how many Californians would benefit from improved Medicare benefits and extended ACA affordability assistance, and how much Californians might save from these and other reforms, including efforts to negotiate and lower prescription drug prices. You can find the statewide fact sheet here: Build Back Better: What’s at Stake for California’s Health.

                    In a virtual event earlier today, Health Access, along with local central valley leaders and advocates, including Congressmember Jim Costa, also released data for the Central Valley: Build Back Better: What’s at Stake for Health in the Central Valley. Data is forthcoming for the California regions of Sacramento, Orange County, and San Diego.

                    “Big things are hard to do, but that doesn’t mean we shouldn’t try. Lowering prescription drug costs, fully funding the Affordable Care Act, and improving Medicare are some of the most important things we can do to improve the lives of American citizens. We can and we will pass this transformational legislation and I’m proud to support it,” said Congressmember Jim Costa.

                    “In all the back and forth on process and procedure, what’s been lost in the discussion of the Build Back Better bill is the big benefit it will provide patients and our public health in general,” said Anthony Wright, Executive Director of Health Access California. “Under the federal budget plan, millions of Californians could see substantial savings in their needed medications, families that could keep affordable health care coverage in Covered California, and older Californians who could finally get vision and dental benefits in Medicare.”

                    The new report identifies what Californians could gain – or lose – in the Build Back Better proposal in three key areas:

                    1. Lower Prescription Drug Costs: Californians could save as much as $6.4 billion in prescription drug costs in just one year.
                    2. Keeping Covered California Affordable: The American Rescue Plan provides $1.4 billion annually for financial help to Covered California enrollees. Without continued major funding from Congress, over 1.4 million Covered California enrollees could see increases in their premiums on average of $1,000 per person annually.
                    3. Vision and Dental Benefits in Medicare: There are over six million Californians with Medicare coverage, and half report they do not have dental coverage. Almost one quarter of Californians over the age of 65 report they have not seen a dentist in the past year or never at all. If vision and dental benefits are included in the bill, it would ensure many older Californians can access basic care to improve their overall health and quality of life.

                    “If these major investments are made, this would be the most dramatic improvement in health care since the Affordable Care Act,” said Wright. “Especially in our high cost-of-living state, we need all California Congressional members to support this package to help health care consumers to lower their health care costs and provide improved access to care to the system we all rely on.”

                    ###