SACRAMENTO, Calif. — As the nation braces for potential policy shifts beneath President-elect Donald Trump’s “Make America Healthy Again” mantra, the nation’s most populous state and largest well being care market is getting ready for just a few modifications 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 reviews, permit public well being officers to examine immigrant detention centers, and require medical insurance corporations to cowl fertility services equivalent to in vitro fertilization.
Still, business 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 will have regulated pharmaceutical business middlemen and given the state extra energy to cease non-public fairness offers in well being care.
Health coverage consultants say advocates and legislators are actually targeted on easy methods to defend progressive California insurance policies equivalent to sweeping abortion access within the state and health coverage for immigrants dwelling within the U.S. with out authorization.
“I think everyone’s just thinking about how we’re going to enter 2025,” mentioned Rachel Linn Gish, a spokesperson with the buyer well being advocacy group Health Access California. “We’re figuring out what is vulnerable, what we are exposed to on the federal side, and what do budget changes mean for our work. That’s kind of putting a cloud over everything.”
Here are among the largest new well being care legal guidelines Californians ought to learn about:
Medical debt
California turns into the eighth state during 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 important care and might make it tougher for sufferers to get a job, purchase a automobile, or safe a mortgage.
Critics together with the California Association 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 will cease unpaid medical payments from affecting sufferers’ credit score scores, however the destiny of these modifications 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 decide orders them launched from a state psychological hospital.
State officers and native regulation enforcement will now have 30 days to coordinate housing, treatment, and behavioral well being therapy for these parolees, giving them much more time than the five-day deadline beforehand in impact.
The bill drew overwhelming bipartisan assist after a high-profile case in San Francisco during 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, Assembly member Matt Haney (D-San Francisco), known as the earlier five-day timeline “dangerously short.”
Cosmetics and ‘forever chemicals’
California was the primary state to ban PFAS chemical substances, also referred to as “forever chemicals,” in all cosmetics bought 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, delivery 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 important in some merchandise and that some could be safely used at sure ranges.
Immigration detention amenities
After covid-19 outbreaks, contaminated water, and moldy meals grew to become 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 judge whether or not privately run amenities are complying with state and native public well being laws concerning correct air flow, primary psychological and bodily well being care, and meals security.
Although the federal authorities regulates immigration, six federal detention facilities in California are operated by the GEO Group. One of the nation’s largest non-public jail contractors, GEO has confronted a litany of complaints associated to health and security. Unlike public prisons and jails, that are inspected yearly, these amenities could 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, mentioned Bethany Lesser, a spokesperson for California Attorney General Rob Bonta. The regulation took impact Jan. 1.
Doctors vs. insurance coverage corporations utilizing AI
As main insurance coverage corporations more and more use synthetic intelligence as a software to investigate affected person claims and authorize some therapy, commerce teams representing medical doctors 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 therapy is medically needed could be made solely by licensed, certified physicians or different well being care suppliers who overview a affected person’s medical historical past and different information.
Sick depart and guarded day off
Two new legal guidelines develop the circumstances beneath which California employees 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 staff could take paid sick days or use protected unpaid depart to incorporate helping a member of the family who’s experiencing home violence or different violent crimes.
Prescription labels for the visually impaired
Starting this yr, pharmacies shall be required to supply drug labels and use instructions in Braille, massive print, or audio for blind sufferers.
Advocates of the transfer mentioned state regulation, which already required translated directions in 5 languages for non-English audio system, has ignored blind sufferers, making it troublesome for them to observe prescriptions and take the right dosage.
Maternal psychological well being screenings
Health insurers shall be required to bolster maternal mental health programs by mandating further screenings to raised detect perinatal melancholy, which impacts 1 in 5 individuals who give birth in California, in response to state information. Pregnant individuals will now endure screenings at the very 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 employees (abortion clinics)
With abortion care on the heart of nationwide coverage fights, California is cracking down on those that threaten, publish 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 costs, as much as three years in jail, and $50,000 in fines for repeat or violent offenses. Previously, state regulation categorised lots of these offenses as misdemeanors.
Insurance protection for IVF
Starting in July, state-regulated well being plans protecting 50 staff or extra could be required to cowl fertility providers beneath SB 729, handed and signed final yr. Advocates have lengthy fought for this profit, which they are saying is important care for a lot of households who’ve bother 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 contemplate 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 mentioned that Newsom “clearly stated his position on the need for an extension” and that he “will continue to work with the legislature” on the matter.
Plans beneath CalPERS, the California Public Employees’ Retirement System, must comply by July 2027.
This article was produced by KFF Health News, which publishes California Healthline, an editorially impartial service of the California Health Care Foundation.
Christine Mai-Duc:
[email protected],
@cmaiduc
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