Although COVID-19 compelled California leaders to reduce their bold well being care agenda, they nonetheless managed to enact vital new legal guidelines meant to decrease shopper well being care spending and develop entry to well being protection.
When Democratic Gov. Gavin Newsom concluded the chaotic legislative yr Wednesday — his deadline to signal or veto payments — what emerged wasn’t the sweeping platform he and state lawmakers had outlined at the start of the yr. However the dozens of well being care measures they permitted included first-in-the-nation insurance policies to require extra complete protection of psychological well being and dependancy, and thrusting the state into the generic drug-making enterprise.
“We had much less time, much less cash and fewer focus, however COVID makes the causes of increasing protection and making an attempt to regulate well being care prices that rather more necessary,” mentioned Anthony Wright, government director of Well being Entry California, a Sacramento-based shopper advocacy group.
The governor additionally signed into legislation a raft of COVID-related payments meant to handle the most important public well being emergency in a century, reminiscent of measures to stockpile protecting gear for well being care staff.
This yr’s legislative season befell in opposition to the backdrop of an unprecedented pandemic that sparked a statewide stay-at-home order, back-to-back emergency legislative recesses, the Capitol’s first foray into distant voting and a projected $54 billion price range deficit.
Among the many most controversial modifications Newsom signed into legislation was the biggest enlargement of the state’s household depart program because it was enacted in 2014, an improve opposed by the state’s enterprise pursuits. The tobacco trade additionally took successful when Newsom permitted a measure banning retail sale of flavored tobacco merchandise, together with menthol, with exceptions made for flavored hookah merchandise. And Newsom bucked the highly effective medical doctors’ foyer by granting nurse practitioners the flexibility to observe with out doctor supervision.
However a number of contentious well being payments stalled within the legislature and by no means made it to Newsom’s desk, together with measures that will have given the state lawyer normal extra authority to reject hospital consolidations, expanded the state’s Medicaid program, known as Medi-Cal, to unauthorized immigrants ages 65 and up, and capped customers’ out-of-pocket prices for insulin.
Amongst Newsom’s vetoes had been a pair of payments that sought to develop telemedicine, in addition to laws to undertake affected person privateness protections for COVID-19 genetic testing.
“I believe all of us want we would had extra alternatives to maneuver extra issues ahead,” mentioned Meeting member Jim Wooden (D-Santa Rosa), who chairs the Meeting Well being Committee. “Below the circumstances, I believe we did a great job.”
This is a have a look at a number of the main well being measures Newsom signed into legislation this yr. Most will take impact on Jan. 1.
Behavioral well being
Lawmakers made vital modifications to psychological well being protection, and maybe probably the most consequential is a psychological well being parity invoice. SB-855 requires state-regulated well being insurers in California to cowl all therapy deemed medically essential for psychological well being and substance abuse issues, from melancholy to opioid dependancy. Well being insurers opposed the invoice, arguing it will drive up well being care spending.
Psychological well being parity is already enshrined in state and federal legislation, however advocates say insurers usually do not cowl the essential care that sufferers want.
Julie Snyder, a lobbyist for the Sacramento-based Steinberg Institute, which advocates for psychological well being care coverage modifications, known as the brand new legislation a mannequin for the remainder of the nation.
There is no different state that has something this complete,” Snyder mentioned.
One other invoice, SB-803, will permit peer suppliers — individuals with their very own histories of psychological sickness or substance abuse who assist different Californians navigate behavioral well being points — to be licensed by the state. As soon as licensed, they will invoice Medi-Cal for his or her companies.
Scope of observe
Newsom gave nurse practitioners, who’re nurses with superior coaching and levels, the ability to observe independently, after years of failed makes an attempt and regardless of main opposition from the California Medical Affiliation, which represents medical doctors. Supporters say AB-890 will assist deal with well being care supplier shortages, particularly in rural and underserved communities.
Licensed nurse-midwives may also be allowed to attend low-risk pregnancies in each hospital and residential settings with no doctor’s supervision underneath SB-1237.
Reducing healthcare prices
California will enter the extremely aggressive generic drug market because of SB-852, a first-in-the-nation legislation that can put the state authorities in direct competitors with personal drug producers.
“The price of well being care is approach too excessive,” Newsom mentioned in an announcement upon signing the invoice.
By January, California should forge partnerships with a number of drug corporations to make or distribute a broad vary of generic and biosimilar medication which are cheaper than brand-name merchandise. The invoice particularly requires the manufacturing of the diabetes drugs insulin, as a result of makers have hiked costs sharply in recent times.
Newsom additionally permitted an under-the-radar well being care transparency measure requiring the state to gather information on the quantity state-regulated well being insurers pay for particular medical companies, from knee replacements to bronchial asthma remedies. The information may assist policymakers determine extreme spending on sure remedies and supply fodder for proposals to regulate healthcare prices.
“Whereas the examination of value has slowed down, it hasn’t ended,” mentioned state Sen. Richard Pan (D-Sacramento), who chairs the Senate Well being Committee.
Newsom additionally signed laws cementing into state legislation key provisions within the Inexpensive Care Act, a transfer guaranteeing Californians is not going to lose protection protections ought to the U.S. Supreme Courtroom strike down the legislation.
SB-406 will ban well being insurers in California from imposing annual or lifetime limits on protection, and likewise requires well being insurers to cowl a variety of preventive care companies, from ldl cholesterol and blood strain screenings to immunizations, with out charging sufferers copays or deductibles.
As California continues to grapple with the very best COVID-19 case counts within the nation, lawmakers permitted a collection of payments in response to the pandemic, largely meant to guard important staff.
Employers should present written discover inside one enterprise day to workers who could have been uncovered to the COVID-19 virus at their worksite. They have to additionally report the small print of office outbreaks to native public well being authorities inside 48 hours. AB-685 was prompted by main outbreaks this yr at food-processing vegetation.
Newsom additionally signed laws making it simpler for firefighters, well being care staff and different front-line staff contaminated with the coronavirus to get staff’ compensation. SB-1159 took impact Sept. 17, the day the governor signed it.
State legislation now presumes these front-line staff had been contaminated with the virus on the job except their employers show in any other case.
Sure workers who’ve been uncovered to the virus may also have extra paid sick depart time. Below AB-1867, food-processing corporations with at the least 500 staff should present two weeks of paid sick depart to staff who’ve been uncovered to COVID-19 or have been suggested to quarantine.
The legislation additionally grants well being care staff and emergency responders two weeks of paid sick depart, closing a loophole in a COVID-relief invoice Congress permitted this spring.
Two new legal guidelines will deal with one other main problem uncovered by the coronavirus pandemic: the dearth of satisfactory private protecting gear for well being care staff. AB-2537 would require hospitals to stockpile a three-month provide of protecting gear by April, whereas SB-275 mandates that the California Division of Public Well being set up a further stockpile for well being and different important staff to final 90 days throughout a pandemic.
Nursing properties, which have been on the epicenter of COVID-19 deaths, can be required to have a full-time “an infection preventionist” on workers to assist stem the unfold of illness. The invoice, AB-2644, additionally would require nursing properties to report deaths from a communicable illness to the state inside 24 hours throughout an emergency associated to that illness.
And California’s roughly 40,000 licensed pharmacists can be allowed to manage COVID-19 vaccines which were permitted by the Meals and Drug Administration underneath AB-1710.
This KHN story first printed on California Healthline, a service of the California Well being Care Basis.
Kaiser Well being Information (KHN) is a nationwide well being coverage information service. It’s an editorially unbiased program of the Henry J. Kaiser Household Basis which isn’t affiliated with Kaiser Permanente.