How to end health care insecurity in California

New Year prediction: In 2022 out-of-pocket health care costs will continue to rise, prompting more California families to avoid medical care. The still virulent COVID-19 will add to health care insecurity, and more insurers will pass treatment charges on to patients.

Those trends are well underway, but California legislators have an opportunity to protect our families and communities with a universal health care program called CalCare. The Assembly must act on the Guaranteed Health Care for All Act –   Assembly Bill 1400 – in January.

This year we can meet the promise many of our elected leaders proclaim – that health care is a human right. We’re already guaranteed that costs will continue to skyrocket, let’s instead guarantee all Californians will be able to get the medical treatment they need without worrying how to pay for it.

Under AB 1400, there are no more premiums, no deductibles – how much you must pay out of pocket before the insurer covers any cost – no co-pays, no co-insurance. No soaring levels of medical debt, no bankruptcies caused by medical bills, no GoFundMe campaigns by parents desperate to assure their children can get life-saving care.

For years, California legislators have studied proposals for single-payer health coverage at length. Now it’s time to move beyond commissions and studies to caring for our people and end the health care crisis and insecurity so many California families face every day.

Heading into the 2022 midterm elections, nearly half of U.S. adults list out-of-pocket costs for medical care as their top economic worry, according to a December survey by the Kaiser Family Foundation.

One in seven Californians skipped, delayed or cut back on care in 2020, 60% of them because of cost.    

More Black and Latino Californians self-rationed needed care due to cost or insurance barriers than for whites, according to a September UCLA Health Policy Brief. Among Latinos, 40% postponed or skipped care due to high costs, with another 15% citing system barriers. Many of them are among the 3.2 million Californians who remain uninsured despite gains in coverage through the Affordable Care Act.

Employer-paid insurance isn’t protection enough. The California Health Care Foundation reported in August that 45% of Californians pay more than 25% of the premium for single coverage.

Seventy-two percent of workers in companies employing 199 workers or less face annual deductibles of at least $1,000 for single coverage. A fourth of insurance plans require a deductible of $2,000 or more, an amount that has more than doubled since 2012.

In the past year, 14% of California firms reported that they increased cost-sharing for their workers. And they’re not done. Nearly 40% of California firms say they are likely to demand premium increases this year; 28% expect to raise deductibles in 2022.

On the eve of another pandemic surge, 70% of the nation’s largest insurers had ended waiving COVID-19 treatment costs, the Kaiser Family Foundation reported. Those surviving hospitalization face huge bills and other daunting costs, including the threat of persistent symptoms, known as Long Covid, for six months or longer.

Nurses see the patients who have delayed the care they need, often worsening their health. We see the strain on families unable to afford medical bills and who are left wondering where else to slash their family budget for basics such as food, housing or heating bills.

AB 1400, introduced by Assemblymember Ash Kalra, a Democrat from San Jose, with 19 co-authors, and sponsored by the California Nurses Association/National Nurses United, is a humane, caring response to a growing crisis we must confront. Urge your legislator to join with nurses and support AB 1400.