2018 Healthcare Legislation in California

In 2018, the California legislature considered a series of important bills that will impact healthcare organization operations, access to care, and transparency.

Healthcare law is a rapidly developing and contentious landscape, especially in California. In 2018, the California Assembly and Senate considered a variety of healthcare bills that had the potential to significantly change our healthcare system. They addressed access to care, the opioid crisis, short-term health insurance, and other issues.

California Bans Short-Term Health Insurance

Governor Brown signed SB 910 into law on September 22, 2018. Beginning on January 1, 2019, health insurers can no longer offer short-term health plans in California. These controversial policies offer healthcare benefits for less than one calendar year and typically charge lower premiums than traditional health plans and COBRA.

These short-term plans are not required to offer the Affordable Care Act’s essential healthcare benefits and can refuse to cover pre-existing conditions. Opponents of short-term health plans also believe these plans divert healthy young people away from traditional health insurance risk pools, increasing the cost of these plans. Canopy Health has never participated in the short-term health insurance market.

SB 1156: Governor Brown Vetoes an Attempt to Limit Premium Assistance Profiteering — But Doesn’t Disagree with Its Goals

California’s legislature passed SB 1156, which takes steps to protect dialysis and other patients from companies that profit off “premium assistance programs.” While some legitimate charities help patients with their insurance premiums, other for-profit companies use these programs to steer patients away from public health plans like Medicare and Medi-Cal and toward insurance plans that offer higher provider payments.

While Governor Brown vetoed the bill on September 30, 2018, he did not disagree with the overarching aim of curtailing premium assistance profiteering. He sent this message to the California Senate:

[SB 1156] attempts to prohibit the questionable practice of financially interested entities providing premium assistance to patients for the purpose of obtaining higher fees for medical service. I believe, however, that this bill goes too far as it would permit health plans and insurers to refuse premium assistance payments and to choose which payments they will cover. I encourage all stakeholders to continue to work together to find a more narrowly tailored solution that ensures patients’ access to coverage.

The Senate is currently considering the veto.

A Multi-Pronged Approach to California’s Opioid Crisis

A bipartisan coalition of lawmakers presented more than a dozen bills that aim to reduce and address opioid dependence in California. The package of bills included:

  • AB 1751: Permits prescription drug data sharing across jurisdictions within the Controlled Substance Utilization Review and Evaluation Systems (CURES).
  • AB 1753: Requires prescriptions of controlled medications to carry a unique serial number and other safeguards designed to fraudulent prescriptions.
  • AB 2487: Requires opioid dependency training for physicians and surgeons.
  • AB 2789: Mandates that pharmacies and physicians send and process electronic prescriptions, with the goal of preventing fraudulent prescriptions and opioid abuse.

Governor Brown signed all four of these bills in September 2018. He also approved bills addressing Naloxone (Narcan) access and standards of care for rehabilitation centers.

However, some of the opioid bills died in the legislature or were vetoed. For example, Governor Brown vetoed AB 2384, which would have required health plans to cover certain types of narcotic replacement medications without prior authorization or lifetime dollar limits.

California Funds a Healthcare Payments Database

The 2018 state budget allocates $60 million for the development of a healthcare payments database that will track the cost of healthcare and health plan payment data. Called the Health Care Cost Transparency Database, this system would compile payment data from health plans and other organizations. Stakeholders could then use this data to identify issues with access to care, health disparities, and overall health costs in the state. This database should be operating no later than July 1, 2023, according to the California legislature.

Single-Payer Proposals Fail to Gain Traction in the Legislature

While multiple Assembly members proposed broadening Medi-Cal and Covered California or transitioning to a single-payer health system, these bills did not gain traction with the legislature as a whole. For example, AB 2517, which would have established an Advisory Panel on Health Care Delivery Systems and Universal Coverage, did not make it out of the Senate Committee on Health.

Canopy Health Is Invested in the Health and Wellness of All Bay Area Residents

With all the uncertainty in today’s healthcare industry, Canopy Health is committed to our core values of transparency and improved accessibility. Like you, we are carefully monitoring healthcare developments in our state and region.

If you have questions about healthcare legislation or how it might impact your clients, please contact Canopy Health by completing  this brief online form or by calling 888-8-CANOPY.