California continues to build its reputation as a progressive health policy state as Gov. Gavin Newsom signed bills expanding paid sick leave, adding miscarriage leave and raising wages for health care workers.
Newsom blessed a rare agreement between labor and the health care industry to phase in a nation-leading $25 an hour minimum wage for health care workers. Estimates based on earlier versions of the bill found it would increase health care costs by billions of dollars each year and put pressure on the state’s Medicaid program to raise reimbursement levels for long-term care to maintain patient access to services. Other new laws aim to strengthen reproductive rights as well as protect patients against errant doctors and pharmacists and surprise ambulance bills.
Still, in a possible sign of his national ambitions and experience as a businessman and father, the Democrat softened the bill-signing season by vetoing free condoms in schools and the possession of psychedelic mushrooms.
He rejected the decriminalization of such hallucinogens, although he supported their therapeutic potential as an “exciting frontier”. He urged lawmakers to try again next year, this time adding specific treatment guidelines, including recommended doses and protections for people with latent psychosis. The bill’s lead author, state Sen. Scott Wiener of San Francisco, introduced the proposal amid successful decriminalization efforts in Colorado, Oregon and some cities, saying veterans and others suffering from PTSD and depression should not be punished for seeking relief.
Newsom also dropped the $35 price cap for a 30-day supply of insulin in favor of his own price-cutting efforts, touting a $50 million contract from his administration to begin supplying its own insulin as early as next year. He argued that this approach would avoid indirect price spikes for consumers that could come in the form of higher premiums to cover cheaper insulin.
The governor similarly showed caution in vetoing health and safety protections for domestic workers, arguing that “private households and families cannot be regulated in exactly the same way as traditional businesses.”
The new laws will take effect in 2024, unless otherwise noted:
Sick days
California workers would be entitled to five paid sick days a year under SB 616, by state Sen. Lena Gonzalez, D-Long Beach. That’s more than the three days required in California since 2014, but less than the seven days Gonzalez originally requested. Advocates say workers shouldn’t show up sick, potentially spreading disease, because they can’t afford to stay home. But the California Chamber of Commerce included the bill on its annual list of job killers and said it would hurt struggling small businesses.
Leave due to miscarriage and failed adoption
Parents who experience miscarriages, stillbirths, failed adoptions or the termination of a surrogacy arrangement would all be eligible for bereavement leave under SB 848. The bill by state Sen. Susan Rubio, D-San Gabriel Valley, would include unpaid leave due to reproductive loss under existing state law allowing up to five days of bereavement leave upon the death of a family member. She called reproductive loss “one of the most traumatic events a person can experience,” noting that Illinois and Utah passed similar laws in 2022. The bill applies to companies with five or more employees.
Abortion protection
A year after the US Supreme Court was overruled Roe v. Wade, Newsom signed nine abortion-related bills, adding to the strong protections for the procedure that California lawmakers passed a year ago. Among them is SB 345, which increases protections for medical providers who live in California but mail abortion pills or sex-selective drugs to states where they are illegal. The bill’s lead author, state Sen. Nancy Skinner, D-Berkeley, said in a statement that the laws strengthen California’s position “as a national leader in reproductive freedom.” Another bill, AB 1646, by Assemblywoman Stephanie Nguyen, D-Elk Grove, would allow doctors from other states to receive abortion training in California without having to obtain a California medical license.
Financing Behavioral Health
Voters will get a direct say in March on Proposition 1, Newsom’s key behavioral health initiative. After signing a bipartisan package of bills, Newsom will ask voters to approve billions of dollars aimed at easing California’s seemingly intractable homelessness crisis. He says it represents a paradigm shift in how California deals with the dilemma, but the proposal is opposed by those who worry about expanding involuntary treatment and diverting funding from existing community-based programs. He also signed SB 43, expanding the state’s conservatorship law to make it easier to force people into treatment for mental illness or addiction.
Medical license fees
The Medical Board of California will have to follow new procedures while investigating complaints, while doctors will pay higher licensing fees to help fund those investigations. SB 815 by Sen. Richard Roth, D-Riverside, mandates the new complaint procedures amid criticism of the board from patient advocates who say bad doctors often avoid sanction. It would gradually increase the license renewal fee to $1,255 every two years, up from $863 currently. It also repeals AB 2098, passed last year, which made it unprofessional conduct for doctors to spread misinformation or misinformation related to covid-19. The law has been mired in multiple cases with conflicting rulings, including one by a federal judge who called it “unconstitutionally vague.”
Pharmacy errors
Medication errors harm at least 1.5 million Americans annually and are among the most common medical errors, according to the National Academy of Medicine. In California, they are the leading violation that results in a citation. AB 1286, by Assemblyman Matt Haney, D-San Francisco, imposes what he says is a first-in-the-nation requirement that retail pharmacies report every error. It also gives the pharmacist in charge of each store the power to increase staff and the duty to inform store management of unsafe conditions. The California State Board of Pharmacy may close a pharmacy if conditions do not improve.
Surprising ambulance bills
Patients who call an ambulance can sometimes receive “surprise bills” exceeding $1,000, according to Health Access California. AB 716, by Assemblywoman Tasha Boerner, D-Encinitas, protects consumers from being charged out-of-network costs for ambulance services and uninsured Californians from being charged what she calls inflated ambulance rates. An analysis by the California Health Benefits Review Program says that would require health plans and insurers to pay more for out-of-network services.
Life saving drugs
AB 1651, by Assemblywoman Kate Sanchez, R-Rancho Santa Margarita, would require schools to have emergency epinephrine auto-injectors to be used by school nurses or trained volunteers to treat life-threatening anaphylactic reactions. More than 15 percent of children with food allergies have had a reaction at school, according to the Latino Food Allergy Network, which requested the bill.
Food Safety
By 2027, California will become the first US state to ban four chemicals widely used in processed foods and beverages, following the lead of the European Union and other nations. AB 418, by Democratic Assembly members Jesse Gabriel and Buffy Weeks, initially grabbed headlines because it would have banned titanium dioxide, which is used in Skittles, but that chemical was removed from the bill. Opponents said the U.S. and California already have enough food safety and food labeling requirements. Newsom and supporters of the bill chided the Food and Drug Administration for not acting.
This article was created by KFF Health Newswhich issues California Healthlineeditorially independent service of California Health Care Foundation.
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