These 5 bills before California lawmakers seek to expand health coverage, lower costs

Early this month, advocates of moving California to a single-payer health care system renewed their push in Sacramento. Hundreds of them crowded into a hearing of a special state Assembly committee that's exploring whether and how to bring universal health care to the state.

Many of the presenters at the final hearing expressed support for the concept of single-payer, but didn’t agree that the single-payer bill (SB562) shelved in the Assembly last year has enough detail to get California there in the next few years. Some key groups and lawmakers are looking at a more gradual, incremental approach. 

Some bills have already been introduced. Advocates are working on other new legislation. Many of these ideas focus on protecting California’s expansion of health coverage under the Affordable Care Act.

5 bills in the legislature:

• SB 910 — Introduced by Senate Health Committee Chair Sen. Ed Hernandez (D-West Covina), the bill would prohibit the sale of short-term health insurance policies starting in 2019. The Trump administration ordered the Department of Health and Human Services to lift restrictions on such plans last year. On Tuesday, HHS responded by proposing a rule to expand short-term plans from less than 3 month terms to just under a year. SB 910's supporters call these short-term plans "junk insurance" because they don't have to cover the 10 essential benefits required by the Affordable Care Act. 

• SB 974 — This bill, introduced by Sen. Ricardo Lara (D-Bells Gardens), would allow low-income adults who are in the U.S. illegally to sign up for Medi-Cal. Experts estimate that nearly 2 million of the 3 million uninsured Californians are in the country without legal documentation. State law already offers Medi-Cal to individuals under the age of 19 who are here illegally. 

• SB 538 — Sen. Bill Monning (D-Santa Cruz) authored this bill, which would prohibit anti-competitive contracts between hospitals and insurers. Monning believes the legislation would create more price competition among health care providers.

• AB 587 — This measure would expand the state's bulk prescription drug purchasing program by allowing counties and local governments to join. The idea is that the larger group would have more purchasing power, which could push drug costs lower. Assemblyman David Chiu (D-San Francisco) authored this bill.

• AB 595 — Chair of the Assembly Health Committee, Jim Wood (D-Healdsburg) authored this bill that gives the state oversight of potential mergers between health insurance plans. California could veto the marriage of insurance carriers to avoid insurance monopolies in the state.

Ideas that may take bill form soon:

• Anthony Wright, executive director of Health Access, testified at Wednesday’s hearing in favor of a fix to what he called the “family glitch.” People who get health insurance at work may find it too costly to include their dependents on their health plans. Wright proposed state subsidies that would help those individuals buy health care through Covered California.

• John Arensmeyer, CEO of Small Business Majority, encouraged lawmakers to keep Association Health Plans out of the California small group health insurance market. President Trump loosened rules governing these health plans. The president argues they spur competition. Arensmeyer and others believe these health plans offer incomplete benefits and reduce the size of the risk pools of the larger individual and group markets.

• Arensmeyer also asked lawmakers to consider creating a "public option" that could give all Californians the opportunity to buy in to Medi-Cal. Arensmeyer argued that would create more competition between the state-run program and private health insurers.

• Wright and Arensmeyer both called for offering state subsidies to ensure Californians pay no more than 8 to 10 percent of their income on health care. This would extend subsidies to families who don’t get federal subsidies or those who don’t get enough to cover their health costs.

This story has been updated.