The Secretary of the California Health and Human Services Agency shall research, develop, and pursue discussions of a waiver framework in consultation with the federal government with the objective of creating a health care system that incorporates the following features and objectives:
(a) A comprehensive package of medical, behavioral health, pharmaceutical, dental, and vision benefits, which includes primary, preventive, and wellness care services.
(b) A package of long-term care supports and services, including measures to support health and well-being while Californians age.
(c) Services that will not vary by age, employment status, disability status, income, immigration status, or other characteristics.
(d) The identification of disparities among Medicare, Medi-Cal, employer-sponsored insurance, and individual market coverage, with the goal to eliminate those disparities to the greatest extent possible in the new system.
(e) The elimination of the adverse impacts within the health care system of attempts to avoid covering the sick or providing the benefits patients need.
(f) The absence of cost sharing for essential services and treatments covered under the program, including primary, preventive, and wellness care services.
(g) The establishment of sufficient reserves to guarantee solvency during public health emergencies and times of economic disruption.
(h) A program to implement a just transition for members of the health industry workforce whose jobs may be disrupted.
(i) Assurances that no individual will pay more than a specified percentage of their income on a progressive sliding scale for the cost of financing the health system.
(j) Unified financing that delivers health care more effectively, efficiently, and equitably.
(k) Cost-effectiveness by systemwide pooled purchasing to negotiate rates with providers.
(l) Freedom for patients to choose providers and for primary care providers to choose practice models.
(m) Greater investments in public health, primary care, and health equity efforts to address the social determinants of health through an improved mix of health care and human services.
(n) Improvements in cost, quality, and health care system oversight and integration, which may include reducing overall administrative burdens on providers and improving connectivity and affordability of health care, built on the accomplishments of the Office of Healthcare Affordability and other current initiatives, including the Data Exchange Framework and California Advancing and Innovating Medi-Cal.
(o) A ratesetting process that could use Medicare rates as the starting point for the development of final rates that avoid disruptions in the health care system and expand the availability of high quality vital services by sustaining a stable, experienced, and equitably compensated workforce. This process should address historic inequities in primary care physician reimbursements as compared to other specialty practices and include policies and payments to support those providers that serve a disproportionate percentage of low-income Californians and other disadvantaged communities.
(p) Promotion of a workforce that addresses geographies and specialties with the greatest shortages and is diverse and able to provide culturally and linguistically competent care to all Californians regardless of race, nationality, ethnicity, sexual identity, and socioeconomic status.
(q) Prohibition on the kinds of risk-bearing contractual arrangements that could incentivize providers to withhold needed care, while allowing for payment models that guarantee access, promote quality, ensure equity, and enable multidisciplinary teams.
(r) Specific details on how care would be coordinated and organized.
(s) Methods of payment, delivery, and oversight implemented under the unified health care financing system that will continue to allow California the ability to receive the full benefit of federal expenditures and tax credits that currently underwrite the full scope of health services.
(Added by Stats. 2023, Ch. 412, Sec. 1. (SB 770) Effective January 1, 2024.)