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Saturday, February 24, 2024

Well being care is entrance and middle as Desantis and Newsom go mano a mano

Republican presidential candidate Ron DeSantis and Democratic Gov. Gavin Newsom — political rivals from reverse coasts and proxies for crimson and blue America — are set to sq. off for a first-of-its-kind debate Nov. 30 in Georgia.

Newsom, a liberal firebrand in his second time period as governor of California, is not working for president in 2024. However he goaded DeSantis, in his second time period as governor of Florida, to go mano a mano. “I am going to convey my hair gel. You convey your hairspray,” he taunted on social media.

The matchup guarantees to be a heated brawl between rising political stars who lead two of the nation’s most populous and various states. And it’ll mark the primary time the politicians meet in particular person at the same time as they’ve very publicly traded barbs and insults, in current weeks attacking one another in fundraising movies and marketing campaign advertisements.

Entrance and middle shall be homelessness and well being care, prime priorities for voters — and points which have largely outlined the governors’ insurance policies and management kinds. From abortion to covid-19 vaccines, Newsom and DeSantis couldn’t be additional aside.

Earlier this yr, DeSantis blasted California for being too beneficiant with public profit packages, reminiscent of Medicaid, which the Golden State has expanded to all eligible residents no matter immigration standing. That sweeping coverage takes impact in January and goes effectively past the elective enlargement of Medicaid that the Reasonably priced Care Act supplied states. In Florida, one among 10 states which have refused to increase Medicaid beneath Obamacare, DeSantis wears the state’s 11% charge of uninsured residents as a badge of honor.

“We’re not going to be like California and have large numbers of individuals on authorities packages with out work necessities,” DeSantis stated at a presidential major debate in Southern California earlier this yr.

DeSantis has led his state to limit abortion and gender-affirming care and to ban covid-related masks and vaccine mandates.

Newsom, a slick and brash surrogate for Democratic President Joe Biden, has slammed DeSantis for placing Floridians at risk and stripping them of their rights.

“Be a part of us in California, the place we nonetheless imagine in freedom,” Newsom stated in a political advert earlier this yr.

Newsom has earned the moniker of “well being care governor” by catapulting the difficulty to the highest of his coverage priorities. He made California an abortion sanctuary and is dramatically increasing well being care advantages. He had promised to convey single-payer well being care to the nation’s most populous state whereas campaigning for his first time period, however that concept hit stiff political opposition early in his tenure. And now Newsom boasts about bringing the state’s uninsured charge to an all-time low of 6.5% by increasing protection in different methods.

These points are anticipated to take middle stage throughout the nationally televised 90-minute debate on Fox Information, which may have main reverberations for the presidential contest subsequent yr and will even assist form the 2028 subject of White Home contenders.

Prematurely of the showdown, KFF Well being Information analyzed 10 of the governors’ prime well being care positions and the way their insurance policies have improved — or hindered — the well being of the residents they signify.



DeSantis has refused to increase Medicaid eligibility to extra individuals beneath the Reasonably priced Care Act. Partly because of this, greater than 3 million Floridians had protection by means of the federal Obamacare trade as of February, greater than another state. Florida doesn’t have a state-based trade or supply state-sponsored subsidies.


The state has enthusiastically embraced the Reasonably priced Care Act, increasing Medicaid whereas establishing its personal insurance coverage trade, Coated California. Below Newsom, it has additionally gone effectively past the provisions of Obamacare and created a state requirement for Californians to have medical insurance after the federal mandate was eradicated.



DeSantis accredited laws in April banning abortions after six weeks of being pregnant. Nevertheless, the Florida Supreme Courtroom has taken up a problem to the 15-week ban launched in 2022, which is able to decide if the six-week ban can take impact.


Newsom spearheaded the hassle in 2022 to amend the state structure to enshrine the suitable to abortion and contraception. He additionally accredited $60 million to assist uninsured sufferers and folks from out of state pay for abortions in California, and signed reproductive well being care legal guidelines, together with one defending docs who mail abortion tablets to different states.

Transgender care


Below DeSantis, Florida handed a regulation this yr banning gender-affirming well being look after trans minors and mandating that grownup sufferers signal knowledgeable consent types earlier than beginning or persevering with hormone therapy. The regulation additionally restricts who can order hormone remedy to physicians and prohibits the usage of telehealth for brand spanking new prescriptions. A federal lawsuit difficult the regulation is ready to go to trial in mid-December.


Newsom and different state leaders have amended state regulation to make sure all California adults and youngsters are entitled to gender-affirming well being care providers. And insurance coverage corporations doing enterprise in California should embrace data on in-network suppliers for gender-affirming providers by 2025. State well being care businesses are designing “enforceable high quality requirements” to make sure trans sufferers have entry to complete care.



DeSantis has not declared homelessness a precedence. In a video filmed on the streets of San Francisco and posted to social media in June, DeSantis used the subject as a marketing campaign cudgel to criticize what he referred to as “leftist insurance policies” in California. Florida is experimenting with utilizing Medicaid funds to deal with homelessness, however this system is proscribed. Practically 26,000 persons are homeless in Florida, or 12 of each 10,000 residents.


Newsom has plowed greater than $20 billion into the homelessness disaster, with billions extra for well being and social providers. For instance, some homeless Californians can get social providers by means of the state’s Medicaid program, reminiscent of cash for rental safety deposits, utility funds, and first and final month’s hire. Newsom additionally led a brand new state initiative that would power some homeless individuals into psychological well being or habit therapy. Greater than 171,000 persons are homeless in California, or 44 of each 10,000 residents.

Psychological well being


DeSantis has stored his pledge to advocate for psychological well being therapy packages as governor, though Florida nonetheless ranks forty third nationally in entry to psychological well being care and has the fourth-highest charge of adults with psychological sickness who’re uninsured, based on the Miami Heart for Psychological Well being and Restoration. Below DeSantis, Florida has elevated state funding for psychological well being packages in faculties and peer-to-peer psychological well being providers for first responders, and directed funding to suicide prevention.


Newsom in 2020 signed one of many nation’s strongest psychological well being parity legal guidelines, which requires insurance coverage corporations to cowl psychological well being and substance use issues simply as they’d bodily well being situations. He’s funding a $4.7 billion initiative to offer psychological well being therapy in faculties. Newsom can be main the marketing campaign for a statewide, $6.4 billion bond measure in 2024 to revamp and increase community-based behavioral well being packages, together with hundreds of latest therapy beds.



Florida’s drug overdose dying charge was 37.5 per 100,000 individuals in 2021. In August, DeSantis introduced a brand new statewide habit restoration program billed as a “first of its sort” in america, utilizing peer counselors, medication-assisted therapy, and a coordinated community of help providers. DeSantis additionally approved Florida counties to undertake needle trade packages in 2019 to cut back the unfold of blood-borne illnesses and encourage habit therapy.


California’s drug overdose charge was 26.6 per 100,000 individuals in 2021. Newsom is sending the state Freeway Patrol and Nationwide Guard into San Francisco to fight the open-air fentanyl commerce and is boosting habit restoration packages statewide. However he vetoed laws final yr that will have allowed Los Angeles, San Francisco, and Oakland to ascertain secure injection websites.



A DeSantis proposal submitted to the FDA in 2020 consists of permitting imported drugs from Canada. A brand new state regulation additionally units value limits for pharmacy profit managers — intermediaries between insurers, pharmacies, and producers — and creates new guidelines for them round pricing transparency. The regulation additionally requires pharmaceutical corporations to reveal vital value hikes.


Newsom is spearheading a $100 million, first-in-the-nation initiative that places California within the generic drugmaking enterprise, starting with insulin and the opioid reversal drug naloxone. California already had a pricing transparency regulation when Newsom took workplace. This yr, he signed a regulation that tightens state rules for pharmacy profit managers.

Well being care affordability


In 2019, DeSantis signed the Affected person Financial savings Act, which permits well being insurers to share value financial savings with enrollees who store for well being care providers, reminiscent of imaging and diagnostic assessments. Below his management, Florida lawmakers have additionally allowed short-term well being plans lasting lower than a yr and direct well being care agreements between a affected person and a well being care supplier that aren’t thought-about insurance coverage and are usually not topic to Florida’s insurance coverage code.


Considered one of Newsom’s first well being care initiatives was to fund state-financed medical insurance subsidies for low- and middle-income residents who buy insurance coverage by means of Coated California. Newsom this yr additionally agreed to decrease copays and eliminate some deductibles for plans bought by means of the trade. California’s newly created Workplace of Well being Care Affordability is capping trade value will increase and will doubtlessly regulate well being trade consolidation. California bans short-term well being plans.

Public well being


DeSantis signed laws in 2021 banning authorities, faculties, and personal employers from requiring covid vaccinations. In 2023, he pushed legislators to undertake legal guidelines prohibiting sure vaccine and masks necessities. He additionally shaped a Public Well being Integrity Committee led by his hand-picked surgeon normal, Joseph Ladapo, whose official steering on covid vaccines contradicts the CDC’s suggestions. The Sunshine State’s covid-19 vaccine booster charge for residents age 5 and older is 12.4%.


Newsom grew to become the primary U.S. governor to difficulty a statewide stay-at-home order initially of the covid-19 pandemic. He pushed robust vaccination and masks mandates and accused DeSantis of being weak on public well being. Newsom has additionally signed legal guidelines strengthening childhood vaccination mandates, together with a measure that cracks down on bogus medical exemptions granted by docs. The Golden State’s covid-19 vaccine booster charge for residents ages 5 and older is 21.9%.

Immigrant well being care


With DeSantis making immigration a precedence, legislators handed a state regulation requiring all Florida hospitals to ask on their admission types whether or not a affected person is a U.S. citizen or lawfully current within the nation. Medical doctors, nurses, and well being coverage consultants say the regulation targets marginalized individuals who have already got problem navigating the well being care system and can additional deter them from in search of care.


Starting in January, all immigrants who meet earnings {qualifications} shall be eligible for the state’s Medicaid program. Earlier than Newsom took workplace, California had already expanded eligibility to unauthorized immigrant youngsters by means of age 18. Newsom then signed legal guidelines increasing this system to younger adults as much as age 26, adults 50 and older, and, later, immigrants of any age who in any other case meet eligibility necessities.

This text was produced by KFF Well being Information, which publishes California Healthline, an editorially impartial service of the California Well being Care Basis.

Kaiser Health NewsThis text was reprinted from khn.org, a nationwide newsroom that produces in-depth journalism about well being points and is likely one of the core working packages at KFF – the impartial supply for well being coverage analysis, polling, and journalism.

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