Findings and Declarations
The people of the State of California find and declare all of the following:
(a) In 2019, Governor Newsom and the Legislature embarked on a series of investments and initiatives to improve the health care delivery system in California. These actions included extending health care coverage to all low-income Californians, starting California’s own generic drug production to deliver low-cost insulin to patients, providing much-needed mental health services to all California schoolchildren, and initiating a multiyear commitment to the improvement of the Medi-Cal program.
(b) While these past several years have seen significant
investment and initial outcomes appear to be successful, these investments are at risk in future years and need to be protected.
(c) About 2 out of every 5 Californians, between 12 million and 15 million people, rely on the Medi-Cal program for health care coverage. This includes approximately four million children and two million seniors and people with disabilities.
(d) However, just being enrolled in the Medi-Cal program does not guarantee access to quality health care. Most Medi-Cal reimbursement rates have not been adjusted in more than a decade, and some providers have not seen a payment increase in over 25 years. As a result, doctors and other health care providers struggle to take on new Medi-Cal patients. Relatedly, Medi-Cal patients, and in some areas entire communities, face a loss of access to critical and emergency care as essential hospital services such as labor and
delivery are at risk of being reduced or eliminated.
(e) The problem is exacerbated by a shortage of health care professionals in our state. The current strains on our health care system have left many health care workers physically and mentally exhausted, and thousands have left the profession altogether. This has left our health care system overstretched and made it even harder for the most vulnerable Californians to get access to care, including access to family planning services and other reproductive health care.
(f) Medi-Cal patients may wait weeks or months to see doctors who are specialists. The situation is more challenging in rural areas of the state that have fewer primary care providers per person, which results in delays or inability to access basic health care services.
(g) Obtaining adequate mental
health services can take even longer. California suffers not only from a shortage of mental health care professionals, but also from a shortage of psychiatric beds and treatment for patients with serious mental health conditions. When patients with serious mental health needs cannot obtain adequate care, they frequently wait days in the emergency room or may ultimately be left untreated and become homeless.
(h) All Californians continue to struggle with high prescription drug prices. When Californians cannot access the medications they need, our entire health care system suffers.
(i) The lack of health care access and affordable prescription drugs for patients poses a health care risk for all Californians. When Medi-Cal patients are unable to refill a prescription or find a doctor, mental health facility, or other health care provider to treat them, they often end up in emergency
rooms. This puts additional, and avoidable, strains on our state’s emergency rooms. When Medi-Cal patients are forced to rely on emergency rooms as their primary source of health care, the additional strain makes it harder for all patients to obtain life-saving care.
(j) Medi-Cal patients need the same access to health care and prescription medications as patients with private or employer-based health insurance. This is best and most directly accomplished by increasing reimbursement rates for doctors, hospitals, and other health care providers that treat Medi-Cal patients to at least cover the costs of providing care and by bringing down the cost of prescription drugs.
(k) California is one of several states that levy taxes on managed care plans to obtain extra federal dollars to help pay for health care access. This chapter addresses many of the current flaws in Medi-Cal funding.
First, it ensures the existing tax is continued permanently so that California obtains its fair share of federal health care funding. Second, it guarantees that all of the revenue from the continued tax will be spent on investments to improve access to critical health care services and makes it impossible to divert these dollars to unrelated uses.
(l) In addition, this chapter helps make essential medications affordable and accessible to more patients by increasing funding for the state to produce and distribute generic prescription drugs. By expanding California’s capacity to produce its own generic prescription drugs, this chapter will inject competition into the prescription drug market and help address critical drug shortages. This will reduce prescription drug prices for all Californians.
(m) By ensuring permanent funding for increased Medi-Cal provider payments, generic
prescription drug programs, and increasing our health care workforce, bed capacity, and treatment options, and protecting these dollars from unauthorized uses, this chapter will improve our overall health care system by providing all patients with greater access to quality health care and affordable drugs.
(Added November 5, 2024, by initiative Proposition 35, Sec. 1. Effective December 18, 2024. Approved in Proposition 35 at the November 5, 2024, election. Operative January 1, 2025, pursuant to Section 14199.135.)
Statement of Purpose
In enacting this chapter, the purpose and intent of the people of the State of California is to do all of the following:
(a) Increase access to quality health care by establishing a permanent, dedicated funding stream to be used for increasing reimbursement rates and other supports to health care providers that treat Medi-Cal patients and investments in building an adequate health care workforce, bed capacity, and treatment options.
(b) Increase access to affordable prescription drugs by establishing a permanent, dedicated funding stream to be used to produce and distribute generic prescription drugs through the California Affordable Drug Manufacturing Act of 2020.
(c) Prevent the revenue stream permanently continued by this chapter from ever being used to fund unauthorized or unrelated programs or from being used to supplant or replace existing sources of moneys that currently fund health care access and affordable prescription drug programs in this state.
(d) Continue a dedicated funding stream that is fully permitted by federal law, while also ensuring that taxpayers and employers do not bear the financial burden for the implementation of this chapter.
(Added November 5, 2024, by initiative Proposition 35, Sec. 1. Effective December 18, 2024. Approved in Proposition 35 at the November 5, 2024, election. Operative January 1, 2025, pursuant to Section 14199.135.)