Key Patient Rights Bills to Prevent Unfair Health Care Costs Face Crucial Votes This Week

Media Contacts
Emily Rusch

Vice President and Senior Director of State Offices, The Public Interest Network

CALPIRG

SACRAMENTO, CA—Key legislation to protect patients from unfair health care costs faces crucial votes in the California legislature in the next week, beginning tomorrow in Assembly Health Committee.  The five bills, most of which have already passed one legislative chamber, include some of the most lobbied legislation this session, such as a measure to stop surprise medical bills and another to provide notice and disclosure on prescription drug costs. Overall, the legislative package helps prevent unfair and unreasonable bills, premiums, and cost-sharing, informs consumers of their rights and options, and increases transparency to address the rising cost of care.

“California consumers continue to complain, correctly, about unfair health care costs, from unjustified premium hikes to mid-year co-payment increases to surprise out-of-network charges to rising drug prices. With their votes in the next week, California legislators can put patients first and provide real relief from these unfair health costs,” said Anthony Wright, executive director, Health Access California, the sponsor of the five pending patients’ rights bills. “We appreciate the new legislative effort so that no Californian who follows the rules of their health plan and goes to an in-network hospital should face surprise out-of-network bills of hundreds of thousands of dollars.  We are pushing hard for pending transparency legislation would better inform California patients, about the rising cost of prescription drugs and their choices when charged with an unreasonable premium hikes, as well as their rights to get a timely appointment or a medical interpreter.”

In a conference call today, consumer and labor advocates will unveil the new AB 72 (Bonta, Bonilla, Dahle, Gonzalez, Maienschein, and Wood), a bipartisan proposal to protect patients from surprise medical bills when they go to in-network hospitals and facilities, so they don’t get unexpected and unfair out-of-network bills from doctors and other providers from that visit. Co-sponsored by Health Access California and the California Labor Federation, the new version removes the logjam of last year’s fight on AB533, which stalled by just three votes. Since the failure of the legislature to act, California consumers, such as Cassie Ray of Fairfield who will share her story on the call, have continued to receive surprise medical bills of hundreds or thousands of dollars from out-of-network providers after using in-network medical facilities. After months of negotiations between lawmakers, advocates, insurers, and business, the revised legislation will include even stronger consumer protections to stop these surprise bills while also ensuring that health professionals are fairly reimbursed for their work. AB72 is slated to be heard in Senate Health Committee on Wednesday, June 29th.

“Every dollar that goes to rising premiums is a dollar that does not go into workers’ pockets or to employers to expand their business and create more jobs,” said Steve Smith, Communications Director for the California Labor Federation. “Drug costs are increasing faster than other parts of the health care industry, driving up the cost of coverage for workers, employers and taxpayers.  SB 1010 is an important first step to opening up the black box of prescription drug price increases, arming workers and employers with tools to help contain health care costs. AB 72 will protect workers from surprise medical bills that take money out of workers’ pockets, even when they do the right thing and go to an in-network provider.” He continued, “The California Labor Federation is proud to stand with Health Access and other groups today in support of this package of bills.”

SB 1010 (Hernandez) provides transparency to soaring prescription drug prices for both public and private purchasers, as well as greater disclosure of prescription drug cost trends. In particular, the bill would require 60-day notice for prescription drug price hikes. California law requires such notice and disclosure for almost every player in the health system in order to reduce costs and improve quality. Last Tuesday, Health Access California and the California Labor Federation launched a digital campaign to call out Big Pharma in their attempts to operate behind a veil of secrecy, asking #WhatsPharmaHiding. SB1010 is scheduled to be heard in Assembly Health Committee tomorrow, June 21st.

Betsy Imholz, Special Projects Director for Consumers Union, the policy and advocacy arm of Consumer Reports noted that, “Consumer Reports’ survey results and the hundreds of California stories we have collected vividly illustrate that a significant number of insured Californians, through no fault of their own, are stuck with unexpected medical bills and drug price increases.” Imholz continued, “Families spending their hard earned dollars on health insurance premiums each month deserve the protection AB 72 will provide from these unfair, surprise out-of-network extra charges. SB 1010 provides the transparency on prescription drug prices essential to creating a competitive marketplace and fair negotiating landscape to contain costs for the state and all purchasers, workers and consumers.”

SB908 (Hernandez) would inform Californians if the health plan they are in is charging a premium hike that is determined to be “unreasonable” or “unjustified”, and give consumers time to shop for another plan.

“It is unacceptable so many consumers have been stuck with health insurance rate hikes that are unreasonable and unjustified. SB 908 will ensure consumers are notified if their rate isn’t justified and given the option to find a better deal for their dollar,” said Emily Rusch, Executive Director of CALPIRG. “Californians expect and should have assurance that their insurance co-pays and deductibles will not unexpectedly increase mid-year.”

SB 923 (Hernandez) prohibits a health plan or insurer from changing any cost sharing requirements (such as co-pays and deductibles) during a plan year, clarifying the law that is already in place for premium increases. This allows consumers to plan and budget for their annual out-of-pocket expenses for medical services and prescription drugs. Assembly Health Committee is slated to vote on SB908, SB923, and SB1010 tomorrow, June 21st.

Next week, on Tuesday, June 28th, Assembly Health Committee will hear SB1135 (Monning), which would better inform patients of their right to timely care and language access, in the packets of mail they already send.

“With more low-income and communities of color now in the health system under the Affordable Care Act, it now more crucial than ever to prevent these unfair costs that could be destabilizing for the family’s finances,” said Sara de Guia, executive director of the California Pan Ethnic Health Network. “Patients should be informed of their rights and options. We strongly support SB1135, so Californians know they can get the care they need, and also have the right to a medical interpreter and a timely appointment.”