Code Section Group

Health and Safety Code - HSC

DIVISION 1. ADMINISTRATION OF PUBLIC HEALTH [135 - 1179.102]

  ( Division 1 enacted by Stats. 1939, Ch. 60. )

PART 4. Healthy California for All Commission [1000 - 1005]
  ( Heading of Part 4 amended by Stats. 2019, Ch. 67, Sec. 1. )

1000.
  

(a) The Legislature finds and declares all of the following:

(1) Health care is a human right and it is in the public interest that all Californians have access to health care that improves health outcomes, manages and lowers health care costs for the state and its residents, and reduces health disparities.

(2) With the implementation of the federal Patient Protection and Affordable Care Act (Public Law 111-148) and other state efforts, California has reduced the uninsured share of its population to less than 10 percent.

(3) As of 2016, nearly three million Californians remained uninsured, 21 percent of Californians remained underinsured, and 11 percent of California adults went without health care because of cost.

(4) The United States spends more per capita than any other industrialized nation on health care, but has low rankings based on many metrics, including access to care, equity, efficiency, and healthy lives.

(5) California has a primary care physician shortage, and the geographic distribution of physicians across California is uneven.

(6) According to the federal Centers for Medicare and Medicaid Services, national health spending is projected to grow 5.5 percent annually, on average, through 2026, representing 19.7 percent of the economy in 2026.

(b) It is the intent of the Legislature to establish a health care delivery system that provides coverage and access through a unified financing system for all Californians.

(c) It is the intent of the Legislature to control health care costs so that California is able to achieve a sustainable health care system with more equitable access to quality health care.

(d) It is the intent of the Legislature that rising health care costs be mitigated and administrative costs be limited so that more money is spent on direct care to patients and less on profits and overhead.

(e) It is the intent of the Legislature that all Californians receive high-quality health care, with positive health care outcomes, regardless of age, income, race, ethnicity, immigration status, gender or gender nonconforming status, sexual orientation, geographic location, health status, or ability.

(f) It is the intent of the Legislature that all Californians have access to affordable health coverage, including health coverage with reasonable out-of-pocket costs relative to household income, or being eligible for appropriate cost-sharing assistance.

(g) It is the intent of the Legislature that California train and employ an adequate number of primary care physicians, specialty care physicians, mental and behavioral health professionals, and allied health care professionals to meet the health care needs of the state.

(h) It is the intent of the Legislature that the health care system ensure that all Californians have timely access to necessary health care, including access that addresses language and geographic barriers.

(Added by Stats. 2018, Ch. 34, Sec. 3. (AB 1810) Effective June 27, 2018. Repealed as of January 1, 2022, pursuant to Section 1005.)

1001.
  

(a) Effective July 1, 2019, there is hereby established the Healthy California for All Commission as an independent body to develop a plan that includes options for advancing progress toward achieving a health care delivery system in California that provides coverage and access through a unified financing system, including, but not limited to, a single-payer financing system, for all Californians.

(b) The commission shall meet for the first time on or before September 1, 2019, and shall convene meetings at least quarterly at locations that are easily accessible to the public in accordance with the Bagley-Keene Open Meeting Act (Article 9 (commencing with Section 11120) of Chapter 1 of Part 1 of Division 3 of Title 2 of the Government Code).

(c) (1) The commission shall be comprised of 13 members as follows:

(A) The Secretary of California Health and Human Services, or the secretary’s designee, who shall serve as the chairperson.

(B) Eight members who shall be appointed by the Governor.

(C) Two members who shall be appointed by the Senate Committee on Rules.

(D) Two members who shall be appointed by the Speaker of the Assembly.

(2) There shall also be five ex officio, nonvoting members of the commission who shall be the Executive Director of the California Health Benefit Exchange, the Director of Health Care Services, the Chief Executive Officer of the Public Employees’ Retirement System, and the chairs of the health committees of the Senate and the Assembly, or their officially designated representatives.

(3) The appointees shall have appropriate knowledge and experience regarding health care coverage or financing, or other relevant expertise.

(4) The members of the commission shall serve without compensation, but shall be reimbursed for necessary traveling and other expenses incurred in performing their duties and responsibilities.

(d) The commission may establish advisory committees that include members of the public with knowledge and experience in health care that support stakeholder engagement and an analytical process by which key design options are developed. A member of an advisory committee need not be a member of the commission.

(e) The commission and each advisory committee shall keep official records of all of their proceedings.

(Amended by Stats. 2019, Ch. 67, Sec. 2. (SB 104) Effective July 9, 2019. Repealed as of January 1, 2022, pursuant to Section 1005.)

1002.
  

(a) On or before July 1, 2020, the commission shall submit a report to the Legislature and the Governor with options that include all of the following:

(1) An analysis of California’s existing health care delivery system, including cost, quality, workforce, and provider consolidation trends and how they impact the state’s ability to provide all Californians with timely access to high-quality, affordable health care.

(2) Options for additional steps California can take to prepare for transition to a unified financing system, including, but not limited to, a single-payer financing system, including, but not limited to, administrative changes, reorganization of state programs, federal waivers, and statutory and constitutional changes.

(3) Options for coverage expansions, including potential funding sources. Options shall include expansion for full-scope Medi-Cal to individuals over 64 years of age, regardless of immigration status.

(b) On or before February 1, 2021, the commission shall submit a report to the Legislature and the Governor that includes options for key design considerations for a unified financing system, including, but not limited to, a single-payer financing system, including all of the following:

(1) Eligibility and enrollment.

(2) Covered benefits and services.

(3) Provider participation.

(4) Purchasing arrangements.

(5) Provider payments, including consideration of global budgets.

(6) Cost containment.

(7) Quality improvement.

(8) Participant cost sharing.

(9) Quality monitoring and disparities reduction.

(10) Information technology systems and financial management systems.

(11) Data sharing and transparency.

(12) Governance and administration, including integration of federal funding sources.

(c) The reports required under this section shall be submitted in compliance with Section 9795 of the Government Code, and shall be posted on the California Health and Human Services Agency’s internet website.

(d) The commission shall provide an update detailing its progress in developing the reports required by subdivisions (a) and (b) to the Governor and the health committees of the Senate and the Assembly on or before January 1, 2020, and shall update those committees every six months thereafter.

(Repealed and added by Stats. 2019, Ch. 67, Sec. 4. (SB 104) Effective July 9, 2019.)

1002.5.
  

(a) The council shall prepare an analysis and evaluation, known as a feasibility analysis, to determine the feasibility of a public health insurance plan option to increase competition and choice for health care consumers.

(b) At a minimum, the feasibility analysis shall include all of the following:

(1) An actuarial and economic analysis of a public health insurance plan.

(2) A plan to expand the participation of public health plans, including state-licensed county organized health systems and local health plans.

(3) A state developed public health insurance plan.

(4) A list of necessary federal waivers for a state-developed public health insurance plan.

(5) A discussion of potential funding and state costs for a public health insurance plan.

(6) An analysis of the extent to which a new public health insurance plan option could address the underlying factors that limit health plan choices in some regions.

(c) In developing the feasibility analysis, the council shall consult with key stakeholders, including, but not limited to, consumer advocates, health care providers, and health plans, including, but not limited to, county organized health systems and local health plans.

(d) (1) The council shall submit the feasibility analysis to the Legislature and the Governor on or before October 1, 2021. The feasibility analysis shall be submitted in compliance with Section 9795 of the Government Code.

(2) The council shall provide an update detailing its progress in developing the feasibility analysis to the Governor and the health committees of the Senate and the Assembly on or before January 1, 2020, and shall update those committees every six months thereafter.

(e) This section does not authorize the council to apply for a waiver under Section 1332 of the federal Patient Protection and Affordable Care Act (Public Law 111-148), as amended by the federal Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), and any amendments to, or regulations or guidance issued under, those acts.

(Added by Stats. 2018, Ch. 677, Sec. 2. (AB 2472) Effective January 1, 2019.)

1003.
  

This part shall not be construed to authorize the commission to implement any provision of the reports developed pursuant to Section 1002 until there is further action by the Legislature and the Governor.

(Amended by Stats. 2019, Ch. 67, Sec. 5. (SB 104) Effective July 9, 2019. Repealed as of January 1, 2022, pursuant to Section 1005.)

1004.
  

(a) The California Health and Human Services Agency is authorized to provide staff support to implement this part.

(b) For purposes of implementing this part, including, but not limited to, hiring staff and consultants, facilitating and conducting meetings, conducting research and analysis, and developing the required plan and updates, the California Health and Human Services Agency may enter into exclusive or nonexclusive contracts on a bid or negotiated basis. Contracts entered into or amended pursuant to this section shall be exempt from Chapter 6 (commencing with Section 14825) of Part 5.5 of Division 3 of Title 2 of the Government Code, Section 19130 of the Government Code, and Part 2 (commencing with Section 10100) of Division 2 of the Public Contract Code and shall be exempt from the review or approval of any division of the Department of General Services.

(Added by Stats. 2018, Ch. 34, Sec. 3. (AB 1810) Effective June 27, 2018. Repealed as of January 1, 2022, pursuant to Section 1005.)

1005.
  

This part shall remain in effect only until January 1, 2022, and as of that date is repealed.

(Added by Stats. 2018, Ch. 34, Sec. 3. (AB 1810) Effective June 27, 2018. Repealed as of January 1, 2022, by its own provisions. Note: Repeal affects Part 4, commencing with Section 1000.)

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