Although COVID-19 pressured California leaders to reduce their bold well being care agenda, they nonetheless managed to enact important new legal guidelines meant to decrease client well being care spending and increase 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 in the beginning of the yr. However the dozens of well being care measures they authorised included first-in-the-nation insurance policies to require extra complete protection of psychological well being and habit, 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 essential,” mentioned Anthony Wright, government director of Well being Entry California, a Sacramento-based client advocacy group.
The governor additionally signed into legislation a raft of COVID-related payments meant to handle the largest public well being emergency in a century, reminiscent of measures to stockpile protecting gear for well being care employees.
This yr’s legislative season came about 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 funds deficit.
Among the many most controversial modifications Newsom signed into legislation was the biggest growth of the state’s household go away program because it was enacted in 2014, an improve opposed by the state’s enterprise pursuits. The tobacco trade additionally took successful when Newsom authorised 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 docs’ foyer by granting nurse practitioners the flexibility to apply 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 might have given the state legal professional 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 have been a pair of payments that sought to increase telemedicine, in addition to laws to undertake affected person privateness protections for COVID-19 genetic testing.
“I feel all of us want we might had extra alternatives to maneuver extra issues ahead,” mentioned Meeting member Jim Wooden (D-Santa Rosa), who chairs the Meeting Well being Committee. “Underneath the circumstances, I feel we did job.”
Here is a have a look at a few of the main well being measures Newsom signed into legislation this yr. Most will take impact on Jan. 1.
Behavioral well being
Lawmakers made important modifications to psychological well being protection, and maybe essentially 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 obligatory for psychological well being and substance abuse issues, from despair to opioid habit. 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 frequently do not cowl the vital 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 enable peer suppliers — folks 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 providers.
Scope of apply
Newsom gave nurse practitioners, who’re nurses with superior coaching and levels, the ability to apply independently, after years of failed makes an attempt and regardless of main opposition from the California Medical Affiliation, which represents docs. Supporters say AB-890 will assist tackle well being care supplier shortages, particularly in rural and underserved communities.
Licensed nurse-midwives may even be allowed to attend low-risk pregnancies in each hospital and residential settings with no doctor’s supervision underneath SB-1237.
Slicing healthcare prices
California will enter the extremely aggressive generic drug market on account of SB-852, a first-in-the-nation legislation that may put the state authorities in direct competitors with non-public drug producers.
“The price of well being care is manner too excessive,” Newsom mentioned in a press release upon signing the invoice.
By January, California should forge partnerships with a number of drug firms to make or distribute a broad vary of generic and biosimilar medicine 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 authorised 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 providers, from knee replacements to bronchial asthma remedies. The info might assist policymakers establish 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 Court docket strike down the legislation.
SB-406 will ban well being insurers in California from imposing annual or lifetime limits on protection, and in addition requires well being insurers to cowl a spread of preventive care providers, from ldl cholesterol and blood stress 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 authorised a set of payments in response to the pandemic, largely meant to guard important employees.
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 need 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 employees and different front-line employees contaminated with the coronavirus to get employees’ compensation. SB-1159 took impact Sept. 17, the day the governor signed it.
State legislation now presumes these front-line employees have 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 even have extra paid sick go away time. Underneath AB-1867, food-processing firms with at the very least 500 employees should present two weeks of paid sick go away to employees who’ve been uncovered to COVID-19 or have been suggested to quarantine.
The legislation additionally grants well being care employees and emergency responders two weeks of paid sick go away, closing a loophole in a COVID-relief invoice Congress authorised this spring.
Two new legal guidelines will tackle one other main problem uncovered by the coronavirus pandemic: the dearth of enough private protecting gear for well being care employees. 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 employees to final 90 days throughout a pandemic.
Nursing houses, which have been on the epicenter of COVID-19 deaths, shall 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 houses 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 shall be allowed to manage COVID-19 vaccines which have been authorised 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.