Political Pulse It's the Final Countdown Jeff Luther, MD, FAAFP

political pulse

Jeff Luther, MD, FAAFP Chair, Legislative Affairs Committee

It’s the Final Countdown

California’s legislative session concluded September 1st with lawmakers rushing to pass hundreds of remaining bills before the clock struck midnight on August 31st. After both houses approve a bill, it goes to the Governor. The Governor has three choices - sign the bill into law, allow it to become law without his or her signature, or veto it. Most bills go into effect on the first day of January the following year. Urgency measures take effect immediately after they are signed or allowed to become law without signature. At the time of drafting this article, the Governor had already signed into law the following CAFP-supported bills. All bills on which CAFP has taken a position fit under one of CAFP’s strategic goals – advance payment reform and system transformation; raise the profile of family medicine; prioritize justice through diversity, equity, and inclusion; and alleviate burnout and support member wellness and joy in medicine. • AB 35 (Reyes D) Civil damages: medical malpractice. AB 35 keeps California’s Medical

Injury Compensation Reform Act’s (MICRA) essential guardrails solidly in place for patients and providers alike while implementing a predictable increase to limits on non-economic damages in medical negligence cases starting January 1, 2023, with gradual increases thereafter. AB 35 also establishes new protections for all pre-litigation expressions of sympathy, regret, or benevolence, including statements of fault. AB 35 precluded a costly ballot initiative – the so-called “Fairness for Injured Patients

Act” – which would have effectively eliminated

MICRA’s cap on non-economic damages and at least doubled malpractice premiums overnight. • AB 2176 (Wood D) Live birth registration. This bill relates to CAFP’s strategic goal of justice, equity, diversity, and inclusion. Many Native tribes hold a sacred ceremony to name a child on the tenth day of life, and some Rancherias and tribes hold the naming ceremony later than that, but current law requires a hospital to submit a baby’s birth certificate to the local registrar/health department within ten days, which places undue pressure on Native families to provide

information to the hospital on the very day they are holding a naming ceremony for their new child. This bill addresses this issue by extending the time, from ten days to 21 days, by which live births are required to be registered with the local registrar. • AB 2585 (McCarty D) Health care coverage: nonpharmacological pain management treatment.

This bill encourages the use of evidence-based nonpharmacological therapies for pain management. • SB 245 (Gonzalez D) Health care coverage: abortion services: cost sharing. This bill prohibits cost-sharing, restrictions, delays, prior authorization, and annual or lifetime limits on all abortion services, including follow-up services. • SB 872 (Dodd D) Pharmacies: mobile units. This bill authorizes a county, city and county, or special hospital authority to operate a licensed mobile unit to provide prescription medication to individuals, including those individuals without fixed addresses, within the county’s jurisdiction and specifies certain criteria that a mobile unit must meet.

We are still awaiting action on several more CAFPsupported bills listed below.

Access and Equity • AB 32 (Aguiar-Curry D) Telehealth. • AB 498 (Quirk-Silva D) Medi-Cal: county organized health system: Orange County Health Authority. • AB 2352 (Nazarian D) Prescription drug coverage. • AB 1930 (Arambula D) Medi-Cal: comprehensive perinatal services. • SB 838 (Pan D) Insulin Manufacturing. • SB 944 (Pan D) California Health Benefit Exchange: affordability assistance. • SB 974 (Portantino D) Health Care Coverage:

Diagnostic Imaging • SB 1234 (Pan D) Family Planning, Access, Care, and

Treatment Program.

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continued from page 10 Justice, Equity, Diversity, Inclusion • AB 2761 (McCarty D) Death certificates: death while in law enforcement custody. Reproductive Health • AB 2091 (Bonta, Mia D) Reproductive health and privacy. • AB 2134 (Weber, Akilah D) Reproductive health care.

• AB 2320 (Garcia, Cristina D) Reproductive health care pilot program. • AB 2626 (Calderon D) Medical Board of California: licensee discipline: abortion. • SB 523 (Leyva D) Health care coverage: contraceptives. • SB 1245 (Kamlager D) Los Angeles County

Abortion Access Safe Haven Pilot Program.

Behavioral Health • SB 1238 (Eggman D) Behavioral health services: existing and projected needs.

COVID-19 and Vaccines • AB 1797 (Weber, Akilah D) Immunization registry. • SB 1296 (Pan D) Viral surveillance program. • SB 1479 (Pan D) COVID-19 testing in schools:

COVID-19 testing plans.

Administrative Burdens • AB 1880 (Arambula D) Prior authorization and step therapy.

Licensing • AB 1636 (Weber, Akilah D) Physician’s and surgeon’s certificate: registered sex offenders.

Workforce • AB 1918 (Petrie-Norris D) California Reproductive

Health Service Corps. For links to the bill language and an up-todate status of these bills, scan the following QR code:

Aside from legislation, CAFP may also take positions on ballot propositions, however, there is a higher threshold for taking positions on propositions. Generally, the initiative should clearly be within CAFP’s strategic goals and policies, have a direct impact on family medicine, and/or is an issue we have engaged Proposition 1 SCA 10 (Resolution Chapter 97, Statutes of 2022) Atkins. Reproductive Freedom. The California Constitution declares that defending life and liberty, acquiring, possessing, and protecting property, and pursuing and obtaining safety, happiness, and privacy are inalienable rights, and that a person may not be deprived of life, liberty, or property without due process of law or equal protection of the laws. Existing law, the Reproductive Privacy Act, declares that every individual possesses a fundamental right of privacy with respect to personal reproductive decisions and prohibits the state from denying or interfering with a person’s right to choose or obtain an abortion before viability of the fetus, or when the abortion is necessary to protect the life or health of the person. This measure would amend the California Constitution to prohibit the state from denying or interfering with an individual's reproductive freedom in their most intimate decisions, which includes their fundamental right to choose to have an abortion and their fundamental right to choose or refuse contraceptives. A “YES” vote on this measure means: The California Constitution would be changed to expressly include existing rights to reproductive freedom—such as the right to choose whether or not to have an abortion and use contraceptives. A “NO” vote on this measure means: The California Constitution would not be changed to expressly include existing rights to reproductive freedom. Proposition 31 Referendum on a 2020 Law Prohibiting Retail Sale of Certain Flavored Tobacco Products.

This referendum challenges a 2020 law that prohibits the retail sale of certain flavored tobacco products and tobacco flavor enhancers. The referendum would require a majority of voters to approve the 2020 state law before it can take effect. CAFP supported the passage of SB 793 (Hill-D), the legislation prohibiting the sale of flavored tobacco products in California and signed onto an amicus brief opposing tobacco company efforts to prevent enforcement of SB 793. A “YES” vote on this measure means: SB 793 goes into effect so in-person stores and vending machines could NOT sell most flavored tobacco products and tobacco product flavor enhancers.

A “NO” vote on this measure means: In-person stores and vending machines could continue to sell flavored tobacco products and tobacco product flavor enhancers. https://elections.cdn.sos.ca.gov/ballot-measures/pdf/sca-10.pdf https://oag.ca.gov/system/files/initiatives/pdfs/20-0003 %28Tobacco Products %29.pdf

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