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Reflecting on CCCC’s 2023 Legislative Activity

By Alex Khan

January 2, 2024

2023 proved to be a mixed year for California, marked by a financial rollercoaster and significant changes in the makeup of the State Legislature. Despite the challenging fiscal climate, political jockeying, and the uncertainty of so many new faces, CCCC continued its efforts towards advocating for key legislative priorities aimed at improving healthcare access and quality for Californians living with chronic conditions.

In May, CCCC held a successful advocacy day event at the State Capitol, as we welcomed keynote speakers Assemblymembers Dr. Akilah Weber and Marie Waldron. After a morning of education and networking, advocates meet with over 25 legislators and staff to discuss state policy priorities for Californians with chronic conditions.

Among the notable legislative pursuits were our support or sponsorship of several key bills.

AB 874 (Weber) – The “All Copays Count Act”

One of the cornerstone legislative efforts supported by the CCCC was AB 874, more commonly referred to as the “All Copays Count Act.” This initiative sought to improve access to essential medication for individuals managing chronic conditions by banning a harmful practice known as “copay accumulator policies,” whereby health plans and their pharmacy benefit manager (PBM) partners prohibit patient assistance funds from counting towards patients’ out-of-pocket spending requirements.

Unfortunately, AB 874 was not granted a hearing in the Assembly Health Committee, despite support from more than 80 patient advocacy groups. The All Copays Count Coalition continues to pursue this important patient protection policy, and we anticipate the introduction of a new bill in 2024.

SB 694 (Eggman) – Coverage of Self-Measured Blood Pressure Devices for Medi-Cal Beneficiaries

CCCC joined the American Heart Association to co-sponsor SB 694, a bill mandating coverage for self-measured blood pressure devices and associated services for Medi-Cal beneficiaries. This proactive step aimed to empower individuals with the tools necessary for better care and self-management of blood pressure, a pivotal factor in chronic disease management.

After passing out of the Legislature unanimously, SB 694 was vetoed based on cost concerns, along with nearly every other Medi-Cal mandate. The Governor’s veto message did not express any policy concerns with the proposal but indicated that it would be more appropriately addressed through the annual budget process. CCCC and the American Heart Association are currently exploring the feasibility of a 2024 budget request.

AB 913 (Petrie-Norris) – Regulation of Pharmacy Benefit Managers (PBMs)

Another priority for CCCC was AB 913, designed to address predatory and harmful practices within the healthcare system. CCCC sponsored AB 913 along with our partners at the California Pharmacists Association. This bill sought to regulate and license Pharmacy Benefit Managers (PBMs), aiming to, among other things, curtail practices detrimental to individuals reliant on medications for chronic conditions.

Due to the complexity and gravity of this proposal, it was not heard in the 2023 legislative year, giving proponents time to parse through important details. We intend to move forward with the proposal in 2024 and look forward to presenting the case for the need to reform the PBM industry.

In total, CCCC took positions on 20 bills, each aligning with our mission to advocate for improved care and accessibility for those grappling with chronic conditions. While celebrating some notable successes, we also know that the headwinds created by the difficult economic outlook and entrenched opposition mean our work is far from finished. Below is a summary of the CCCC bills that were successfully enacted into law:

AB 1341 (Berman) Public Health: Oral Therapeutics

Summary: Extends COVID-19-era flexibilities to authorize pharmacists to continue furnishing oral therapeutics for COVID patients until January 1, 2025. CCCC position: support.

SB 496 (Limón) Biomarker Testing

Summary: Requires coverage for medically necessary biomarker testing, subject to utilization management protocols. CCCC position: support.

AB 317 (Weber) Pharmacist Service Coverage

Summary: Requires that pharmacists be reimbursed by health plans and insurers for performed within pharmacists’ scope of practice. CCCC position: support.

AB 948 (Berman) Prescription Drugs

Summary: Makes permanent existing law provisions that prohibit the copayment, coinsurance, or any other form of cost sharing for a covered outpatient prescription drug for an individual prescription from exceeding $250 for a supply of up to 30 days or $500 for bronze products. CCCC position: support.

AB 1369 (Bauer-Kahan) Out-Of-State Physicians and Surgeons: Telehealth: License Exemption

Summary: Authorizes eligible out-of-state physicians and surgeons without a California license to provide telehealth services to California patients with an immediately life-threatening disease or condition. CCCC position: support.

As we bid farewell to 2023, we reflect on the strides made and the challenges encountered, persistently preparing ourselves for the opportunities that lie ahead. The commitment to advocating for improved chronic care policies in California remains resolute, fueled by the belief that everyone deserves equitable access to quality healthcare, irrespective of their health conditions.