As the nation braces for potential policy shifts under President-elect Donald Trump’s “Make America Healthy Again” mantra, the nation’s most populous state and most significant healthcare market is preparing for a few changes.
With supermajorities in both houses, Democrats in the California Legislature passed—and Democratic Gov. Gavin Newsom signed—laws taking effect this year that will erase medical debt from credit reports, allow public health officials to inspect immigrant detention centers, and require health insurance companies to cover fertility services such as in vitro fertilization.
Still, industry experts say it was a relatively quiet year for health policy in the Golden State, with attention focused on a divisive presidential election. Several state legislators sought to avoid controversial issues as they ran for Congress in competitive swing districts.
Newsom shot down some of the legislators’ most ambitious healthcare policies, including proposals to regulate pharmaceutical industry intermediaries and give the state more power to stop private equity deals in healthcare.
Health policy experts report that advocates and legislators are currently focusing on defending progressive California policies, including sweeping abortion access and health coverage for immigrants living in the U.S. without authorization.
“I think everyone’s just thinking about how we’re going to enter 2025,” said Rachel Linn Gish, a spokesperson with the consumer health advocacy group Health Access California. “We’re figuring out what is vulnerable, what we are exposed to on the federal side, and what budget changes mean for our work. That’s kind of putting a cloud over everything.”
Here are some of the most significant new healthcare laws Californians should know about:
Medical debt
California becomes the eighth state where medical debt will no longer affect patients’ credit reports or scores. SB 1061 bars health care providers and debt collectors from reporting unpaid medical bills to credit bureaus, a practice that supporters of the law say penalizes people for seeking critical care and can make it harder for patients to get a job, buy a car, or secure a mortgage.
Critics, including the California Association of Collectors, called Sen. Monique Limón’s (D-Santa Barbara) measure a “tremendous overreach” and successfully lobbied for amendments that limited the bill’s scope, including an exemption for any medical debt incurred on credit cards.
The Biden administration has finalized federal rules that would stop unpaid medical bills from affecting patients’ credit scores, but the fate of those changes remains unclear as Trump takes office.
Psychiatric hospital stays for violent offenders
Violent offenders with severe mental illness can now be held longer after a judge orders them released from a state mental hospital.
State officials and local law enforcement will now have 30 days to coordinate housing, medication, and behavioral health treatment for those parolees, giving them far more time than the five-day deadline previously in effect.
The bill drew overwhelming bipartisan support after a high-profile case in San Francisco in which a 61-year-old man was charged with the repeated stabbing of a bakery employee just days after his release from a state mental hospital. The bill’s author, Assemblymember Matt Haney (D-San Francisco), called the previous five-day timeline “dangerously short.”
Cosmetics and ‘forever chemicals’
California was the first state to ban PFAS chemicals, also known as “forever chemicals,” in all cosmetics sold and manufactured within its borders. The synthetic compounds found in everyday products, including rain jackets, food packaging, lipstick, and shaving cream, have been linked to cancer, congenital disabilities, and diminished immune function and have been increasingly detected in drinking water.
Industry representatives argue that using PFAS—perfluoroalkyl and poly-fluoroalkyl substances—is critical in some products and that certain levels can be used safely.
Immigration detention facilities
After COVID-19 outbreaks, contaminated water, and moldy food became the subjects of detainee complaints and lawsuits, and state legislators gave local county health officials the authority to enter and inspect privately run immigrant detention centers. SB 1132, from Sen. María Elena Durazo (D-Los Angeles), allows public health officials to evaluate whether privately run facilities comply with state and local public health regulations regarding proper ventilation, basic mental and physical health care, and food safety.
Although the federal government regulates immigration, the GEO Group operates six federal detention centers in California. One of the country’s largest private prison contractors, GEO, has faced a litany of complaints related to health and safety. Unlike public prisons and jails, which are inspected annually, these facilities would be inspected only as necessary.
The contractor filed suit in October to stop the law’s implementation, saying it unconstitutionally oversteps the federal government’s authority to regulate immigration detention centers. Bethany Lesser, a spokesperson for California Attorney General Rob Bonta, said a hearing in the case is set for March 3. The law took effect Jan. 1.
Doctors vs. insurance companies using AI
As significant insurance companies increasingly use artificial intelligence to analyze patient claims and authorize some treatment, trade groups representing doctors are concerned that AI algorithms are increasing denials for necessary care. Legislators unanimously agreed.
SB 1120 states that decisions about whether a treatment is medically necessary can be made only by licensed, qualified physicians or other healthcare providers who review a patient’s medical history and other records.
Sick leave and protected time off
Two new laws expand the circumstances under which California workers may use sick days and other leave. SB 1105 entitles farmworkers who work outdoors to take paid sick leave to avoid heat, smoke, or flooding when local or state officials declare an emergency.
AB 2499 expands the list of reasons employees may take paid sick days or use protected unpaid leave to include assisting a family member who is experiencing domestic violence or other violent crimes.
Prescription labels for the visually impaired
Starting this year, pharmacies will be required to provide drug labels and use instructions in Braille, large print, or audio for blind patients.
Advocates of the move said state law, which already required translated instructions in five languages for non-English speakers, has overlooked blind patients, making it difficult for them to monitor prescriptions and take the correct dosage.
Maternal mental health screenings
Health insurers will be required to bolster maternal mental health programs by mandating additional screenings to detect better perinatal depression, which affects 1 in 5 people who give birth in California, according to state data. Pregnant people will now undergo screenings at least once during pregnancy and then six weeks postpartum, with further screenings as providers deem necessary.
Penalties for threatening healthcare workers (abortion clinics)
With abortion care at the center of national policy fights, California is cracking down on those who threaten, post personal information about, or otherwise target providers or patients at clinics that perform abortions. Penalties for such behavior will increase under AB 2099, and offenders can face felony charges, up to three years in jail, and $50,000 in fines for repeat or violent offenses. Previously, state law classified many of those offenses as misdemeanors.
Insurance coverage for IVF
Starting in July, state-regulated health plans covering 50 or more employees would be required to cover fertility services under SB 729, which was passed and signed last year. Advocates have long fought for this benefit, which they say is essential care for many families who have trouble getting pregnant and would ensure LGBTQ+ couples aren’t required to pay more out-of-pocket costs than straight couples when starting a family.
In a signing statement, Newsom asked legislators to delay the law’s implementation until 2026 while state officials consider whether to add infertility treatments to the list of benefits that insurance plans are required to cover.
It’s unclear whether legislators intend to address that this session, but a governor spokesperson said that Newsom “clearly stated his position on the need for an extension” and that he “will continue to work with the legislature.”
Plans under CalPERS, the California Public Employees’ Retirement System, would have to comply by July 2027.
SOURCE: Story By Christine Mai-Duc | California Healthline