- The 2022 state legislative and budget year saw major progress towards lowering costs, improving quality, and increasing equity for California’s health care consumers.
- Key bills and budget items that didn’t succeed this session will continue to be a focus in the new year.
SACRAMENTO, CA — With the Governor’s final actions on bills last week, health consumer advocates applauded a major year in health reform, where California continued its leadership on health care access, affordability, and equity. While advocates were disappointed in some missed opportunities to help Californians better afford health coverage, they highlighted many of the concrete steps taken this year to improve our health care system. Here’s a round-up of actions from the 2022 legislative and budget session that will affect millions of Californians:
IMPROVING MEDI-CAL ACCESSIBLITY AND EQUITY:
- #Health4All: The state budget signed in June of this year makes the historic step to remove ALL barriers in Medi-Cal based on immigration status. Starting in January 2024, all income-eligible undocumented Californians will be able to enroll for comprehensive health care coverage through Medi-Cal, and finally have access to preventative health care services along with vision, dental, and specialist care. California will be the first state in the nation to advance such a reform, building off years of work to expand Medi-Cal access to undocumented kids (2016), young adults (2020) and older adults (2022).
- Additional 2022-23 budget investments:
- Eliminates premiums in Medi-Cal for hundreds of thousands of children, people with disabilities and others who were just over certain income thresholds.
- Reduces Medi-Cal share-of-cost for low-income seniors and people with disabilities.
- Continuous coverage for Medi-Cal for young children up to age five.
- The Governor signed SB 1019 (Gonzalez) that prioritizes culturally and linguistically relevant outreach to Medi-Cal enrollees about mental health benefits covered by their plans. An important step to address racial disparities in accessing mental health care in Medi-Cal.
- Missed opportunity: The Governor vetoed AB 1930 (Arambula), a #Care4AllCA priority bill, that would have ensured comprehensive perinatal services in Medi-Cal, making it more difficult for moms with social needs to access low-cost care the first year after a baby is born.
OFFICE OF HEALTH CARE AFFORDABILITY:
- A years-long effort to create an Office Health Care Affordability within the Department of Health Care Access and Information culminated in a budget investment this year. It represents California’s biggest effort in years to address the longstanding concern about rising health care costs.
- The purpose of the new Office is to slow the fast-inflating price of health care for all Californians, regardless if they get coverage through an employer, public program, or individually.
- Once it’s up and running it will accomplish this by setting enforceable cost targets for the health industry, with accountability and commensurate fines if they are not able to justify higher increases.
LOWERING COSTS IN COVERED CALIFORNIA:
- Missed opportunity: Deductibles and co-pays continue to be a major barrier to accessing care for many in Covered California. The state had funds allocated to allow Covered California to eliminate or lower these costs for hundreds of thousands of Californians. After the enactment of the Inflation Reduction Act this summer, premium spikes in Covered California were prevented, but Governor Newsom did not take the next step to use state funds to lower cost-sharing, instead vetoing SB 944 (Pan). Covered California enrollees in silver plans will now see their deductibles rise to nearly $5,000 next year.
HEALTH INSURER ACCOUNTABILITY:
- Governor Newsom signed SB 858 (Wiener) to modernize and increase penalties levied by the Department of Managed Health Care – from a maximum of $2,500 to $25,000 – when health plans violate the law and patient protections such as timely access to care, adequate network standards, language access, behavioral health care services, gender-affirming care, and more. Some of these fine amounts had not been updated since 1975.
- Governor Newsom signed SB 923 (Wiener) making California the first state to require training and professional standards for health care providers for their transgender and TGI patients. SB 923 also requires health plans to indicate in their network directories which physicians provide gender-affirming care.
- Missed opportunity: AB 2080 (Wood) stalled in the legislature this year, but advocates plan to continue the push to give California’s Attorney General enhanced oversight on for-profit hospital and health industry mergers to ensure they are in the public interest.
- In the budget, the Administration included $100 million to directly contract to manufacture generics, starting with insulin, in order to bring the price of the drug down.
- Governor Newsom signed SB 838 (Pan), in relation to the budget investment, to better define the state’s plan to directly contract to manufacture generic prescription drugs.
CONNECTING CALIFORNIANS TO CARE:
- Governor Newsom signed a series of bills that will help keep Californians get on and stay on health coverage, connecting them to their health plan options.
- SB 644 (Leyva) allows California’s Employment Development Department to share contacts with Covered California for follow-up, ensuring that those losing their jobs, and likely their health benefits as well, are aware of their options for affordable health care plans through the state’s health insurance marketplace.
- AB 2530 (Wood) provides health benefits through Covered California to workers and their families who lose health benefits during a labor dispute.
- SB 967 (Hertzberg) adds a check box on state tax forms for people to indicate if they are interested in receiving information about low-cost health care coverage options.
“Californians will see both short and long-term benefits from the bills and budget items adopted by Governor Newsom and the state legislature this year,” said Anthony Wright, executive director of Health Access California, the statewide health care consumer advocacy coalition. “Californians should see lower costs—whether from reduced premiums in Medi-Cal immediately, or from the broader oversight eventually provided by a new Office of Health Care Affordability. Hundreds of thousands of Californians will have better access to care in Medi-Cal and private plans, including children, seniors, undocumented, and LGBTQ Californians. State regulators will have more tools to ensure patient protections are followed and Californians can access care when and where they need it. Californians will hopefully find it easier to get on and stay on care, especially when filing their taxes, for unemployment insurance, or when going on strike.”
“California policymakers took impressive steps toward a vision of a more accessible, affordable, and equitable health system this year. We look forward to the work to implement these reforms as well as continue the unfinished work toward universal coverage,” said Wright.