SACRAMENTO, Calif. — Because the nation braces for potential policy shifts beneath President-elect Donald Trump’s “Make America Wholesome Once more” mantra, the nation’s most populous state and largest well being care market is getting ready for a number of adjustments of its personal.
With supermajorities in each homes, Democrats within the California Legislature handed — and Democratic Gov. Gavin Newsom signed — legal guidelines taking impact this yr that may erase medical debt from credit score stories, enable public well being officers to examine immigrant detention centers, and require medical insurance firms to cowl fertility services corresponding to in vitro fertilization.
Nonetheless, trade consultants say it was a comparatively quiet yr for well being coverage within the Golden State, with extra consideration on a divisive presidential election and with a number of state legislators looking for to keep away from controversial points as they ran for Congress in aggressive swing districts.
Newsom shot down a few of legislators’ most formidable well being care insurance policies, together with proposals that might have regulated pharmaceutical trade middlemen and given the state extra energy to cease non-public fairness offers in well being care.
Well being coverage consultants say advocates and legislators at the moment are centered on the way to defend progressive California insurance policies corresponding to sweeping abortion access within the state and health coverage for immigrants residing within the U.S. with out authorization.
“I feel everybody’s simply serious about how we’re going to enter 2025,” stated Rachel Linn Gish, a spokesperson with the patron well being advocacy group Well being Entry California. “We’re determining what’s weak, what we’re uncovered to on the federal aspect, and what do price range adjustments imply for our work. That’s sort of placing a cloud over all the things.”
Listed here are a few of the largest new well being care legal guidelines Californians ought to learn about:
Medical debt
California turns into the eighth state by which medical debt will now not have an effect on sufferers’ credit reports or credit score scores. SB 1061 bars well being care suppliers and debt collectors from reporting unpaid medical payments to credit score bureaus, a apply that supporters of the regulation say penalizes people for looking for crucial care and may make it more durable for sufferers to get a job, purchase a automobile, or safe a mortgage.
Critics together with the California Affiliation of Collectors known as the measure from Sen. Monique Limón (D-Santa Barbara) a “tremendous overreach” and efficiently lobbied for amendments that restricted the scope of the invoice, together with an exemption for any medical debt incurred on bank cards.
The Biden administration has finalized federal rules that might cease unpaid medical payments from affecting sufferers’ credit score scores, however the destiny of these adjustments stays unclear as Trump takes workplace.
Psychiatric hospital stays for violent offenders
Violent offenders with extreme psychological sickness can now be held longer after a choose orders them launched from a state psychological hospital.
State officers and native regulation enforcement will now have 30 days to coordinate housing, medicine, and behavioral well being remedy for these parolees, giving them much more time than the five-day deadline beforehand in impact.
The bill drew overwhelming bipartisan help after a high-profile case in San Francisco by which a 61-year-old man was charged within the repeated stabbing of a bakery worker simply days after his launch from a state psychological hospital. The invoice’s creator, Meeting member Matt Haney (D-San Francisco), known as the earlier five-day timeline “dangerously brief.”
Cosmetics and ‘eternally chemical substances’
California was the primary state to ban PFAS chemical substances, often known as “eternally chemical substances,” in all cosmetics offered and manufactured inside its borders. The artificial compounds, present in on a regular basis merchandise together with rain jackets, meals packaging, lipstick, and shaving cream, have been linked to cancer, start defects, and diminished immune operate and have been more and more detected in drinking water.
Industry representatives have argued that use of PFAS — perfluoroalkyl and polyfluoroalkyl substances — is crucial in some merchandise and that some might be safely used at sure ranges.
Immigration detention amenities
After covid-19 outbreaks, contaminated water, and moldy meals turned the themes of detainee complaints and lawsuits, state legislators gave native county well being officers the authority to enter and examine privately run immigrant detention centers. SB 1132, from Sen. María Elena Durazo (D-Los Angeles), provides public well being officers the flexibility to guage whether or not privately run amenities are complying with state and native public well being rules concerning correct air flow, fundamental psychological and bodily well being care, and meals security.
Though the federal authorities regulates immigration, six federal detention facilities in California are operated by the GEO Group. One of many nation’s largest non-public jail contractors, GEO has confronted a litany of complaints associated to health and security. In contrast to public prisons and jails, that are inspected yearly, these amenities can be inspected solely as deemed needed.
The contractor filed suit in October to cease implementation of the regulation, saying it unconstitutionally oversteps the federal authorities’s authority to manage immigration detention facilities. A listening to within the case is ready for March 3, stated Bethany Lesser, a spokesperson for California Legal professional Common Rob Bonta. The regulation took impact Jan. 1.
Docs vs. insurance coverage firms utilizing AI
As main insurance coverage firms more and more use synthetic intelligence as a software to research affected person claims and authorize some remedy, commerce teams representing docs are involved that AI algorithms are driving a rise in denials for needed care. Legislators unanimously agreed.
SB 1120 states that selections about whether or not a remedy is medically needed might be made solely by licensed, certified physicians or different well being care suppliers who assessment a affected person’s medical historical past and different data.
Sick depart and guarded time without work
Two new legal guidelines broaden the circumstances beneath which California staff could use sick days and different depart. SB 1105 entitles farmworkers who work open air to take paid sick depart to keep away from warmth, smoke, or flooding when native or state officers declare an emergency.
AB 2499 expands the listing of causes workers could take paid sick days or use protected unpaid depart to incorporate aiding a member of the family who’s experiencing home violence or different violent crimes.
Prescription labels for the visually impaired
Beginning this yr, pharmacies shall be required to offer drug labels and use instructions in Braille, massive print, or audio for blind sufferers.
Advocates of the transfer stated state regulation, which already required translated directions in 5 languages for non-English audio system, has missed blind sufferers, making it tough for them to observe prescriptions and take the right dosage.
Maternal psychological well being screenings
Well being insurers shall be required to bolster maternal mental health programs by mandating further screenings to raised detect perinatal melancholy, which impacts 1 in 5 folks who give birth in California, in response to state knowledge. Pregnant folks will now endure screenings at the least as soon as throughout being pregnant after which six weeks postpartum, with additional screenings as suppliers deem needed.
Penalties for threatening well being care staff (abortion clinics)
With abortion care on the middle of nationwide coverage fights, California is cracking down on those that threaten, submit private details about, or in any other case goal suppliers or sufferers at clinics that carry out abortions. Penalties for such habits will improve beneath AB 2099, and offenders can face felony fees, as much as three years in jail, and $50,000 in fines for repeat or violent offenses. Beforehand, state regulation labeled lots of these offenses as misdemeanors.
Insurance coverage protection for IVF
Beginning in July, state-regulated well being plans overlaying 50 workers or extra can be required to cowl fertility companies beneath SB 729, handed and signed final yr. Advocates have lengthy fought for this profit, which they are saying is crucial care for a lot of households who’ve hassle getting pregnant and would guarantee LGBTQ+ {couples} aren’t required to pay extra out-of-pocket prices than straight {couples} when beginning a household.
In a signing assertion, Newsom asked legislators to delay implementation of the regulation till 2026 as state officers think about whether or not so as to add infertility therapies to the list of benefits that insurance plans are required to cowl.
It’s unclear whether or not legislators intend to deal with that this session, however a spokesperson for the governor stated that Newsom “clearly said his place on the necessity for an extension” and that he “will proceed to work with the legislature” on the matter.
Plans beneath CalPERS, the California Public Staff’ Retirement System, must comply by July 2027.
This text was produced by KFF Health News, which publishes California Healthline, an editorially impartial service of the California Health Care Foundation.