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

For Immediate Release: Tuesday, December 29, 2020

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



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

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

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

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

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

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

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

See the full list of Twenty Takeaways for 2020.

Here’s an abridged version of TWENTY TAKEAWAYS FOR 2020


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


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

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

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

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