Care4All California backs multiple health reform bills

Over 50 organizations have launched the Care4All California campaign, which is focused on achieving universal coverage while improving quality, affordability, and equity.

Care4All outlines three main legislative priorities:

  1. Cover all Californians, increasing universality and affordability
  2. Reduce health care prices, improving quality and equity through accountability
  3. Protect patients, stopping the sabotage of our health system

Legislation is currently being considered this session to directly achieve these priorities.

Cover all Californians

Senator Lara’s SB 974 would allow all income-eligible adults regardless of immigration status to enroll in Medi-Cal. Approximately 58 percent of California’s 2.8 million uninsured are undocumented adults. The bill has been referred to the Senate Health Committee but has not yet been scheduled for a hearing.

Senator Lara helped an estimated 170,000 undocumented children become eligible for Medi-Cal coverage in 2015 with the passage of his Health for All Kids Act.

Assemblymember Arambula has introduced legislation to expand eligibility for the Medi-Cal Aged and Disabled Program by increasing the income disregard amounts from 100% FPL to 138% FPL. This bill has been referred to the Assembly Health Committee, with a hearing date of April 3rd.

Reduce health care prices

Asm. Arambula has also introduced AB 2275, which would ensure the Medi-Cal managed care plans are accountable for improving health care quality and reducing disparities. The State Department of Health Care Services would establish a quality assessment and performance improvement program, through which the plans would be required to meet annual improvements.

Nearly one-third of Californians are covered by a Medi-Cal managed care plan. The bill is scheduled for a hearing next month in the Assembly Health Committee.

Asm. Wood has two bills that would help reduce health care prices. AB 595 would increase oversight on health industry consolidation by requiring:

“a health care service plan that intends to merge or consolidate with, or enter into an agreement resulting in its purchase, acquisition, or control by, any entity, as defined, including another health care service plan or a licensed health insurer, to give notice to, and secure prior approval from, the Director of the Department of Managed Health Care.”

The bill has passed out of the Assembly 54-22 and has been referred to the Senate Health Committee.

Asm. Wood’s other bill, which would regulate pharmacy benefit managers, remains in inactive file at the request of Senator Hernandez back in 2017.

Asm. Wood is not alone in seeking to increase oversight on health industry consolidation and prevent prescription drug price spikes. Senator Monning’s SB 538, which hasn’t seen movement this session, would prohibit certain contract clauses between hospitals and contracting agents, health care service plans, or health insurers.

Senator McGuire, Senator Wiener, and Asm. Chiu have introduced bills related to prescription drug prices. Senator McGuire’s bill to prohibit manufacturer gifts to providers remains inactive and Asm. Chiu’s bill to pool state purchasing power for prescription drugs also hasn’t moved this session.

But Senator Wiener’s SB 1021 is scheduled for a hearing in the Senate Health Committee next month. The bill would extend existing consumer protections on prescription co-pays and formulary standards indefinitely. These protections are currently set to sunset at the end of 2019.

Protect patients

Senator Hernandez has introduced two bills that would protect the intent of the ACA. His bill to prohibit the sale of short-term medical plans passed out of the Senate Health Committee 7-0 and has been referred to the Senate Appropriations Committee.

Senator Hernandez’s SB 1108 would prohibit requiring work requirements or community engagement as a Medi-Cal eligibility requirement. It would also prohibit creating waiting periods, time limits or coverage lockouts for Medi-Cal enrollees.

Asm. Arambula introduced a bill this session to increase the minimum medical loss ratio percentages by 5 percent to 90 percent in the large group market and 85 percent in the individual market. According to the bill:

“By increasing the number of health care service plans that would be required to pay a rebate, the bill would increase potential violations of an existing crime”

The bill has been referred to the Assembly Health Committee but has not been scheduled for a hearing.