While the Trump administration continues its assault on the Affordable Care Act and health care benefits with its recently proposed “public charge rule” aimed at punishing immigrants for seeking publicly funded health care and other safety net (or foundational, societal) services, California forges ahead to strengthen affordable, comprehensive health coverage for all individuals and families. That goal is a becoming a reality as Calif. Governor Jerry Brown recently signed into law seven bills to make health care more accessible and affordable to low-and-middle income Californians.
Care4All California, a coalition of more than 50 consumer, community, labor, progressive, and health care organizations, developed numerous legislative and budget proposals aimed at advancing and securing quality affordable health care for all, without need for federal government approval. The effort included goals of expanding access to health care, removing barriers to eligibility, making care affordable, and addressing quality.
The seven coalition health care bills that will now become law:
• SB 910 (Hernandez) and SB 1375 (Hernandez) ban “junk insurance” – short-term insurance and associated health plans – that are exempt from many of the ACA’s coverage requirements and consumer protections, such as pre-existing condition protections and covering essential health benefits (EHBs), such as prescription drugs, maternity care, and mental health. By eliminating the sale of these substandard plans, it will maintain stability of California’s individual insurance market at a time when the Trump administration is pushing junk insurance plans.
• SB 1108 (Hernandez) clearly declares the purpose of Medi-Cal is to provide health care to low-income Californians. SB 1108 prohibits California lawmakers from seeking a Medi-Cal waiver not related to providing health care, such as schemes to impose work requirements, lock out periods, and drug testing on Med-Cal beneficiaries. California is pushing back against the Trump administration’s ongoing efforts to roll back Medicaid by approving state Medicaid waivers that impose work requirements, among other obstacles to accessing Medicaid health care services. National Health Law Program sued Trump’s Health and Human Services in Kentucky and Arkansas to stop Medicaid waivers that flout the purpose of the Medicaid Act.
• AB 2499 (Arambula) upholds the integrity of health coverage by requiring health plans to spend at least 80 percent of premium dollars on health care, instead of PR and marketing, administrative overhead and other superfluous costs – referred to as an 80 percent medical loss ratio (MLR). Particularly at a time when the Trump team is working to lower the MLR standard to 70 percent, this bill shows California’s commitment to preserving medical care and quality improvement standards.
• AB 2472 (Wood) creates a council to conduct a feasibility study of a “public option” in Covered California and the individual health insurance marketplace. Supporters believe this is an avenue to create a public insurance plan that is competitive with private plans. Advocates have long supported a public option in federal health reforms and look forward to seeing what may make sense here in California.
• SB 1021 (Weiner) ensures consumers have access to vital medications by continuing existing consumer protections on prescription drug copays and formulary standards that were established in AB 339 (Gordon, Chapter 619 of 2015). AB 339 capped co-pays for a 30-day supply of a prescription drug at $250. SB 1021 continues the co-pay cap of $250 for prescription drugs by extending the sunset on that provision, ensuring that consumers’ drug co-pays will remain affordable.
• AB 595 (Wood) strengthens the Department of Managed Health Care (DMHC)’s authority and oversight over health plan mergers. Current law gives DMHC, which regulates health coverage for 96 percent of covered people in California, some oversight over health plan mergers, though that law is insufficient. AB 595 ensures DMHC can disapprove a merger if it would negatively impact competition and gives DMHC the tools to scrutinize mergers and ensure they are good for California consumers.
The success California advocates had in advancing these vital health care coverage protections through the legislative process and signed into law illustrates the state’s zealous commitment to combat the Trump’s efforts to gut Medicaid and the ACA, and to put Californians health care first.