SACRAMENTO – Although COVID-19 forced California executives to scale back their ambitious healthcare agenda, they still managed to pass important new laws designed to cut consumer healthcare spending and expand access to healthcare. health coverage.
When Democratic Gov. Gavin Newsom concluded the chaotic legislative year on Wednesday – his deadline to sign or veto bills – what emerged was not the broad platform he and state lawmakers had had described at the beginning of the year. But the dozens of healthcare measures they approved included leading policies nationwide to demand more comprehensive coverage for mental health and addictions, and pushing the state into drug manufacturing. generics.
“We had less time, less money and less focus, but COVID makes the causes of expanding coverage and efforts to control health care costs much more important,” said Anthony Wright, director executive of Health Access California, a consumer advocacy organization based in Sacramento. group.
The governor also enacted a series of COVID-related bills aimed at addressing the biggest public health emergency in a century, such as measures to stockpile protective equipment for healthcare workers.
This year’s legislative season unfolded against the backdrop of an unprecedented pandemic that triggered a statewide stay-at-home order, consecutively emergency legislative holidays, the Capitol’s first foray into remote voting and a project $ 54 billion budget deficit.
Among the most controversial changes Newsom enacted into law was the state’s largest extension of family leave program since its promulgation in 2014, an upgrade thwarted by the commercial interests of the state. The tobacco industry was also hit when Newsom approved a measure banning the retail sale of scented tobacco products, including menthol, except flavored hookah products. And Newsom has resisted the powerful physician lobby by allowing nurse practitioners the ability to practice without physician supervision.
But several contentious health bills were blocked by the legislature and never reached Newsom’s office, including steps that would have given the state attorney general more power to dismiss the hospital. groupings, expanded the state’s Medicaid program, called Medi-Cal, to unauthorized immigrants aged 65 and over, and capped personal spending by consumers for insulin.
“I think we all wish we had more opportunities to get more things done,” said Assembly Member Jim Wood (D-Santa Rosa), who chairs the Assembly Health Committee. “Under the circumstances, I think we did a good job. ”
Here’s a look at some of the key health measures Newsom has enacted this year. Most will come into effect on January 1.
Lawmakers have made significant changes to mental health coverage, and perhaps the most important is a mental health parity bill. SB-855 requires state-regulated health insurers in California to cover all treatments deemed medically necessary for mental health and substance abuse disorders, from depression to opioid dependence. Health insurers opposed the bill, arguing that it would increase healthcare spending.
Mental health parity is already enshrined in federal and state laws, but advocates say insurers routinely does not cover intensive care that patients need.
Julie Snyder, a lobbyist for the Sacramento-based Steinberg Institute, which advocates for policy changes in mental health care, called the new law a model for the rest of the country.
“There is no other state that has something this comprehensive,” Snyder said.
Another invoice, SB-803, will allow peer providers – people with their own history of mental illness or addiction who help other Californians overcome behavioral health issues – to be certified by the state. Once certified, they can bill Medi-Cal for their services.
Scope of practice
Newsom gave nurse practitioners, who are nurses with advanced training and diplomas, the power to practice independently, after years of unsuccessful attempts and despite major opposition from the California Medical Association, which represents physicians. Supporters say AB-890 will help address health care provider shortages, particularly in rural and underserved communities.
Certified nurse midwives will also be permitted to attend low risk pregnancies both in hospital and at home without the supervision of a physician under SB-1237.
Reduce health care costs
California will enter the highly competitive generic drug market due to SB-852, an unprecedented law that will put the state government in direct competition with private drug manufacturers.
“The cost of health care is far too high,” Newsom said in a statement upon signing the bill.
By January, California must forge partnerships with one or more pharmaceutical companies to manufacture or distribute a wide range of generic and biosimilar drugs which are cheaper than branded products. The bill specifically calls for the production of insulin, a diabetes drug, as manufacturers have sharply increased prices in recent years.
Newsom also approved a sub-radar healthcare transparency measure require the state to collect data on how much state-regulated health insurers pay for specific medical services, from knee replacements to asthma treatments. The data could help policymakers identify overspending for certain treatments and fuel proposals to control healthcare costs.
“Although the cost review has slowed, it is not over,” said State Senator Richard Pan (D-Sacramento), who chairs the Senate Health Committee.
Newsom also signed legislation debt consolidation key provisions of state law into the Affordable Care Act, a ruling ensuring Californians will not lose coverage protections if the United States Supreme Court repeals the law.
SB-406 will prohibit California health insurers from imposing annual or lifetime limits on coverage, and will also require health insurers to cover a range of preventative care services, from cholesterol and blood pressure screens to vaccinations, without bill patients for co-payments or deductibles.
As California continues to battle the nation’s highest number of COVID-19 cases, lawmakers have approved a series of bills in response to the pandemic, primarily aimed at protecting essential workers.
Employers will be required to provide written notice within one business day to employees who may have been exposed to the COVID-19 virus in their workplace. They must also declare the details of workplace epidemics to local public health authorities within 48 hours. AB-685 was caused by major outbreaks this year at food processing plants.
Newsom has also signed legislation to make it easier to compensate firefighters, healthcare workers and other frontline workers infected with the coronavirus. SB-1159 entered into force on September 17, the day the governor signed it.
State law now assumes that these frontline workers have been infected with the virus on the job, unless their employers prove otherwise.
Some employees who have been exposed to the virus will also have more paid sick leave. Under AB-1867, agribusiness companies with 500 or more workers must grant two weeks of paid sick leave to workers who have been exposed to COVID-19 or who have been advised to quarantine.
The law also grants healthcare workers and emergency responders two weeks of paid sick leave, filling a gap in a COVID relief bill approved by Congress this spring.
Two new laws will tackle another major challenge exposed by the coronavirus pandemic: the lack of adequate personal protective equipment for healthcare workers. AB-2537 will require hospitals to stockpile a three-month supply of protective equipment by April, while SB-275 Requires the California Department of Public Health to establish additional stockpiles for healthcare workers and other essential workers for 90 days during a pandemic.
Nursing homes, which have been at the epicenter of deaths from COVID-19, will need to have a full-time “infection preventer” on staff to help stem the spread of the disease. The law project, AB-2644, will also require nursing homes to report deaths from a communicable disease to the state within 24 hours during an emergency related to the disease.
And California’s roughly 40,000 licensed pharmacists will be licensed to administer COVID-19 vaccines that have been approved by the Food and Drug Administration under AB-1710.
Subscribe at the free morning briefing from KHN.