In summary
California’s health system changed in 2024 but lawmakers face a busy future with bird flu, vaccines, and abortion access all on the docket.
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California voters made several major health care decisions at the ballot box in 2024.
By a narrow margin in March voters approved Proposition 1, one of Gov. Gavin Newsom’s marquee efforts to expand and change the state’s behavioral health system. This ballot measure included a $6.4 billion bond to build more treatment beds and permanent housing for people with mental health and addiction disorders. Additionally, it required counties to redirect some of their existing mental health funding from community services to housing homeless people. The idea is that creating more treatment facilities and housing will keep people with serious mental illness off the streets and out of jails. The governor’s office has already released some funding from the measure and it has promised transparency and progress reports to the public.
Then in November, voters passed Proposition 35, which required that revenue generated from an existing tax on health insurance plans be reserved specifically for health care purposes rather than to offset the state’s general fund spending. The tax revenue — an estimated $35 billion over the next four years — is in part to be used to increase what Medi-Cal reimburses doctors, who for years have protested that the pay they receive to see low-income patients is not sustainable.
Meanwhile lawmakers pushed through some new protections and benefits for Californians, including an incoming law that prohibits medical debt from showing up on people’s credit reports. This should make it easier for people with a medical balance to rent a home or buy a car starting next year. A second law will require certain health insurance plans to cover in vitro fertilization for the first time, providing some financial relief to families looking to start a family with the help of this treatment. In response to a growing number of California hospitals shutting down their maternity wards lawmakers also passed a law that requires hospitals to increase their public notice window to 120 days before shutting down perinatal services.
The Newsom administration saw a significant departure from its health team this year. Dr. Mark Ghaly, who was instrumental in California’s COVID-19 pandemic response as the state’s Health and Human Services secretary, stepped down in September. Kim Johnson, who formerly led the California Department of Social Services, is the new secretary. Johnson steps into this role at a critical time. Health officials are currently monitoring the H5N1 bird flu virus that some experts say is one mutation away from spreading to humans and creating perhaps yet another pandemic.
2025 outlook
California is already in defense mode as it prepares for a second Trump administration. Democrats are developing new plans to strengthen the state’s abortion protections, and public health experts are warning about a potential wave of vaccine and medical disinformation if Robert F. Kennedy Jr. is confirmed as secretary of the U.S. Department of Health and Human Services. Some experts worry that key insurance programs such as the Affordable Care Act and Medicaid, also known as Medi-Cal in California, could come under attack. Federal actions this coming year are almost certainly to result in litigation and pushback from the Golden State.
