Health Care & Reproductive Rights

OAKLAND — California Attorney General Rob Bonta today issued a consumer alert warning Californians about deferred-interest medical credit cards. Frequently marketed as “zero interest” financing options for dental and medical care, deferred-interest medical credit cards allow consumers to delay interest charges for a limited promotional period, typically for 6 or 12 months. However, if a consumer misses a payment or does not repay the entire loan by the end of the promotional period, interest can be charged retroactively from the date of purchase, resulting in large and unexpected bills.

“Deferred-interest medical credit cards can sound like a good deal — service today, pay for it later with zero interest — but that’s not always how it plays out,” said Attorney General Bonta. “Even one missed payment or not fully paying off your bill on time can mean interest gets added from the very beginning. That can quickly drive up the cost of care and leave people with debt they didn’t see coming. These cards are not the only financing option available, and consumers should carefully consider alternatives before signing up.”

In the consumer alert, Attorney General Bonta cautions that consumers should not allow a dentist or doctor to pressure them into signing up for a medical credit card they do not fully understand. Specifically, consumers are encouraged to take the following steps:

• If an agreement is not in a language you understand, do not sign it. Ask a trusted interpreter to explain the terms of any medical credit product offered to you.
• Shop around for other lender options, including your local credit union.
• Do not apply for medical credit cards while you are undergoing treatment, and do not allow yourself to be rushed into a decision. 

Consumers are also advised to take the following steps:

• If you have insurance, ask for only services that your insurance will cover.
• Consult additional dental or medical providers to compare costs and treatment options.
• Ask for a payment plan directly with your dentist or doctor instead of a “third party” lender. With medical credit cards, you are borrowing money from a third party, usually a bank, not from your doctor or dentist.
• Before applying for a medical credit card or loan for hospital care, ask the hospital about its charity care and discounted payment policies, and whether you qualify. Charity care helps Californians who qualify and cannot afford to pay their hospital bills. 
• See if you qualify for the Medi-Cal Dental Program, which provides free or low-cost dental services to eligible California residents, including checkups, cleanings, x-rays, fillings, and dentures.
• Consider low-cost dental care programs at California dental schools.
• Before applying for a medical credit card, it may be a good idea to talk to your family, community, or faith leaders to see if they can help you pay for your care. 

Under California law, only the consumer may apply for a “deferred-interest” medical credit card, and the application must be completed directly with the lender. State law prohibits dentists, doctors, or their staff from filling out or submitting applications on a patient’s behalf. Consumers who believe they have been misled or improperly pressured can file a complaint with the California Department of Justice at oag.ca.gov/report.

Comment letter supports stronger disclosure requirements for PBMs, seeks clarity that proposed rule doesn’t preempt state PBM transparency laws 

OAKLAND — California Attorney General Rob Bonta today co-led a bipartisan coalition of 45 attorneys general in submitting a comment letter supporting a proposed U.S. Department of Labor (Department) rule that would require greater transparency from pharmacy benefit managers (PBMs) that service employer-funded health plans covered under the Employee Retirement Income Security Act of 1974 (ERISA). Created in the late 1960s to process prescription drug claims, PBMs now play a far broader and more powerful role in the health care system by managing prescription drug benefits for health insurers. This includes, among other things, negotiating rebates and reimbursements with drug manufacturers and determining which drugs are covered and at what cost. Approximately 136 million Americans receive health coverage through an employer — either their own job or a family member’s — and the proposed rule responds to concerns that employers often lack visibility into how PBMs are making money or why drug costs change. It would require PBMs to disclose twice a year how they generate revenue and would give employers the right to audit them. PBMs have also long sought to avoid state regulation by claiming federal preemption under ERISA. The attorneys general urge the Department to clarify that the proposed rule does not preempt state PBM transparency laws.

“PBMs have significant control over prescription drug pricing and coverage decisions, yet too often operate without transparency or accountability,” said Attorney General Bonta. “This proposed rule is an important step toward greater transparency in how PBMs operate across the country. In addition, my fellow attorneys general and I call on the Department of Labor to ensure that any final rule fully respects and preserves the ability of states to enforce their own laws designed to protect consumers from unfair and abusive PBM practices.”

Further, in the comment letter, the attorneys general ask the Department to clarify that it supports working with them to enforce the rule. According to the coalition, there should be mention that nothing in the rule is intended to prevent the Department from referring matters to state attorneys general, requesting their investigative or enforcement assistance, or coordinating with them when the Department discovers violations of state law.

Today, the top three PBMs manage approximately 80% of prescription drug claims. Due to the power imbalance held by PBMs and the negative effects of such power on drug pricing, all fifty states, the District of Columbia, and Puerto Rico have enacted laws to rein them in. Common provisions include limits on patient out-of-pocket costs, bans on “gag clauses” that prevent pharmacists from telling patients they could save money by paying for their prescription out of pocket instead of using insurance, and protections against unfair treatment of independent pharmacies. For example, California law requires PBMs, upon request, to disclose detailed financial information for each health plan or employer they serve, including drug costs, rebates, fees, and pharmacy payments. This helps clarify the true cost of prescription drugs and how money is distributed among PBMs, insurers, drug companies, and pharmacies.

Attorney General Bonta co-led today’s comment letter along with the attorneys general of Minnesota, Ohio, and Oklahoma. They are joined by the attorneys general of Alaska, American Samoa, Arizona, Arkansas, Colorado, Connecticut, Delaware, the District of Columbia, Georgia, Hawaii, Idaho, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, and Wyoming.

OAKLAND — California Attorney General Rob Bonta today announced that, after multistate negotiations, an agreement in principle has been reached on monetary terms that would require grocery chain Albertsons to pay up to $773,787,782.93 to address its role in the opioid epidemic. Albertsons operates in California through a number of subsidiaries, including Safeway and Vons. While the parties have reached agreement on the total potential payment that Albertsons would make to eligible state and local governments, important negotiations — including with respect to injunctive relief — remain.

“This agreement is part of our ongoing fight to bring help and healing to communities harmed by the opioid crisis,” said Attorney General Bonta. “The California Department of Justice has worked closely with our coalition partners to hold corporate actors accountable for fueling this public health crisis. We will continue to address the epidemic from all angles and support individuals and families affected by it.” 

The negotiations with Albertsons have been led by the attorneys general of California, Colorado, Illinois, and Oregon.

OAKLAND — California Attorney General Rob Bonta, alongside the attorneys general of Massachusetts and New York, today sent a letter to the Trump Administration expressing deep concern over its review of a federal rule that ensures unaccompanied minors have access to reproductive healthcare, including abortion care. Announced by the Biden Administration’s U.S. Department of Health and Human Services in 2024, the rule has helped provide this essential medical care to young people who have experienced sexual violence in their home countries or during the dangerous journey to the United States. Although the specific regulatory action under consideration is unclear, as no summary is available, recent reporting suggests the Trump Administration is taking action to limit abortion access. 

“Unaccompanied minors, who often face assault on their perilous journey to the United States, are among the most vulnerable and deserve access to reproductive healthcare,” said Attorney General Bonta. “Any rollback of the Biden-era rule could put them at risk of serious health complications and additional trauma. We are requesting a meeting with the Trump Administration to share more information about our position and the considerations we believe must guide any decision.”

Current regulations require that:

• Pregnant unaccompanied minors be provided with information about and access to reproductive healthcare, including pregnancy and abortion care. 
• The federal government prioritize placing minors in shelters where abortion is legal because any pregnant minor could experience miscarriage or complications that require life- or health-saving abortion care.  If a minor is in a shelter in a state with an abortion ban and she requests an abortion, the federal government must transfer her to a state where abortion is legal.

According to a recent NPR article, “The Trump administration is sending all pregnant unaccompanied minors apprehended by immigration enforcement to a single group shelter in South Texas. The decision was made over urgent objections from some of the administration's own health and child welfare officials, who say both the facility and the region lack the specialized care the girls need.” During the first Trump Administration, unaccompanied minors were prevented from accessing abortion care, and the attorneys general are concerned that similar restrictions could be officially reinstated.

OAKLAND — California Attorney General Rob Bonta today announced filing an amicus brief in Art Center Holdings, Inc., et al. v. WCE CA Art, et al., a case before the California Second District Court of Appeal involving a dispute between a physician who owned a medical practice and a private equity-backed management services organization (MSO). In California, only licensed medical professionals can practice medicine. For nearly a century, California has prohibited corporations and non-physicians from engaging — either directly or indirectly — in the practice of medicine. This ensures that medical judgment remains independent and focused on patient care. While medical professionals may contract with MSOs to assist with administrative, back-office support, MSOs are vendors and cannot own or operate medical practices, nor can they exert undue influence over licensed medical professionals. Increasingly, however, private equity-backed MSOs have expanded into healthcare, chasing profits at the expense of patient care. In the amicus brief, Attorney General Bonta argues that the trial court correctly held that contractual provisions giving the MSO excessive control over the medical practice — including the power to replace the physician-owner of the medical practice — violate California’s ban on the corporate practice of medicine. 

“State law is clear: medical decisions must be made by licensed physicians, not unduly influenced by corporate interests,” said Attorney General Bonta. “As private equity investment in healthcare grows, we must reaffirm our commitment to California’s prohibition on the corporate practice of medicine and ensure patients remain our top priority.”

In the amicus brief, which supports neither party since both parties seek to weaken the prohibition on the corporate practice of medicine, Attorney General Bonta argues that:

• Important public policy reasons underlie California’s ban on the corporate practice of medicine. Among other things, it protects patients from commercial exploitation, prevents profit-driven corporations from interfering in the doctor-patient relationship, and ensures that doctors' loyalties remain with patients. Medical professionals should be the ones making decisions that affect patient lives as they are trained and licensed to make decisions in patients’ best interests.
• When an agreement gives an unlicensed corporation the right to replace the physician-owner of a medical practice with a different physician of its choice, the corporation effectively owns the practice. Likewise, when the practice’s ostensible physician owner cannot replace the unlicensed MSO without fear of losing ownership over their practice, the MSO has undue control over that practice. 

In filing this amicus brief, Attorney General Bonta wrote only to support the trial court’s holding regarding the corporate practice of medicine.

OAKLAND — California Attorney General Rob Bonta, leading a multistate coalition, asked the U.S. District Court for the Northern District of California to enforce its preliminary injunction blocking U.S. Immigration and Customs Enforcement (ICE) from obtaining and using the data of Medicaid recipients who are lawfully residing in the United States. Attorney General Bonta and the coalition’s recent communications with the U.S. Department of Health and Human Services (HHS) indicate that HHS shared with ICE a “a large and complex data set” of Medicaid recipient data, even though the Court unambiguously held that much Medicaid data, including that of citizens and lawful permanent residents, is “off limits.” The exact contents of this data set are unclear. In filing its motion to enforce, the coalition also asks the court to confirm the scope of its original order includes all individuals lawfully residing in the U.S. and require the federal government to explain what data has been shared by HHS, and how ICE is using that data.

“The Trump Administration appears to be defying a direct court order blocking it from sharing the personal, sensitive data of individuals including U.S. citizens and lawful permanent residents. It’s invasive — and deeply troubling,” said Attorney General Bonta. “When Californians signed up for Medi-Cal, they did so with the understanding that their data would not be used for purposes unrelated to administering this program. I urge the court to enforce its earlier order and make clear that these guardrails exist for anyone who is lawfully residing in the United States.” 

BACKGROUND

Created in 1965, Medicaid is an essential source of health insurance for lower-income individuals and particular underserved population groups, including children, pregnant women, individuals with disabilities, and seniors. The Medicaid program allows each participating state to develop and administer its own unique health plans; states must meet threshold federal statutory criteria, but they can tailor their plans’ eligibility standards and coverage options to residents’ needs. As of January 2025, 78.4 million people were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) nationwide.  

California’s Medi-Cal program provides healthcare coverage for one out of every three Californians, including more than two million noncitizens. Noncitizens include green card holders, refugees, individuals who hold temporary protected status, Deferred Action for Childhood Arrival recipients, and others. Not all noncitizens are eligible for federally funded Medi-Cal services, and so California uses state-only funds to provide a version of the Medi-Cal program to all eligible state residents, regardless of their immigration status. 

On July 1, 2025, California led a multistate coalition in filing a lawsuit against the Trump Administration arguing that HHS's mass transfer of Medicaid data to ICE violates the law and asking the court to block any new transfer or use of this data for immigration enforcement purposes. The lawsuit highlighted that the Trump Administration’s illegal actions are creating fear and confusion leading noncitizens and their family members to disenroll, or refuse to enroll, in emergency Medicaid for which they are otherwise eligible, leaving states and their safety net hospitals to foot the bill for federally mandated emergency healthcare services. 

In a limited preliminary injunction order, the court allowed some data transfers, but enjoined ICE’s broader efforts to obtain sensitive health data; data of citizens, lawful permanent residents, and others residing lawfully in the U.S.; and data from other CMS administered health programs. 

In filing this motion, Attorney General Bonta leads the attorneys general of Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Massachusetts, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, Washington, Wisconsin, and the Governor of Kentucky.

OAKLAND — California Attorney General Rob Bonta today announced sponsoring three bills that strengthen protections for patient access to and provider delivery of reproductive health care and gender-affirming care in California. The bills — Assembly Bill (AB) 1854 by Assemblymember Maggy Krell (D-Sacramento), AB 1930 by Democratic Caucus Chair and Assemblymember Rick Chavez Zbur (D-Hollywood), and AB 2448 by Assemblymember Marc Berman (D-Menlo Park) and Assemblymember Rebecca Bauer-Kahan (D-Orinda) — are in response to continued attacks on these essential medical services by the Trump Administration and Republican officials nationwide. 

“California is a safe haven for reproductive rights and gender-affirming care. In the face of ongoing attacks by the Trump Administration, I’m proud to sponsor legislation that strengthens our role as a safe haven,” said California Attorney General Rob Bonta. “These medical decisions are deeply personal and should be made by patients with their providers, free from interference by politicians. California will not be intimidated into abandoning our values.”     

AB 1854 — Clarifying California Shield Laws

Authored by Assemblymember Krell, AB 1854 would add provisions to the Penal Code that prohibit a broader range of California businesses and individuals from complying with out-of-state legal demands for protected information. It also creates a notification process so the Attorney General can intervene and stop improper disclosures. 

In addition, this bill would clarify that law enforcement cannot arrest someone if the Governor refuses an extradition request. This is relevant because Louisiana recently sought to extradite a California abortion provider for allegedly sending abortion medication to a Louisiana resident. Governor Gavin Newsom promptly rejected this request.

“AB 1854 continues California’s long and proud history of defending reproductive health care freedoms by strengthening California’s shield laws to better stop out-of-state anti-abortion prosecutions and extradition attempts at our border,” said Assemblymember Maggy Krell. “At a time when anti-abortion states are stepping up efforts to target those who legally provide or receive reproductive health care in California, it’s vital we step up our protections.”

AB 1930 — Defending Protected Health Care in California

Authored by Assemblymember Zbur and co-sponsored by Equality California, AB 1930 would add provisions to the Civil Code requiring business entities in California to notify the Office of the Attorney General if they intend to respond to a subpoena or inquiry regarding legally protected health care activity and would authorize the Attorney General to intervene to prevent disclosure of legally protected health care activity. Thus, AB 1930 will help the Attorney General protect patients who receive, and providers of, legally protected health care in California.  

By strengthening California’s existing protections, this bill helps ensure that patients and providers can access and deliver medically necessary care without fear of harassment or retaliation from hostile jurisdictions. It will be heard in policy committee in the coming weeks.

“Patients seeking reproductive health care or gender-affirming care — including access to legal, safe abortion and care for transgender people — deserve the same fundamental protections as anyone else receiving medical treatment: privacy, dignity, and the freedom to make decisions about their health without fear,” said Assemblymember Rick Chavez Zbur. “California has made clear that this care is legal, medically necessary, and protected under our laws. AB 1930 strengthens those protections by ensuring that when individuals or entities attempt to obtain private medical information or intimidate providers, the State of California can step in to defend the patients, families, and health professionals who rely on or provide these services. No one should have to worry that seeking lawful medical care in California could put their safety or privacy at risk.”

“Across the country, we are seeing coordinated efforts to weaponize the legal system to target patients and providers for seeking or delivering lawful, medically necessary health care,” said Equality California Executive Director Tony Hoang. “AB 1930 builds on California’s existing protections for transgender people, those seeking reproductive health care, and the providers who serve them by establishing critical safeguards against out-of-state subpoenas and investigations that threaten privacy, safety, and access to care. At a time of escalating political attacks, this bill sends a clear message: California will continue to stand with transgender people and defend the providers who care for them.”

AB 2448 — Protecting Privacy of Abortion-Related Patient Data

Jointly authored by Assemblymembers Berman and Bauer-Kahan and co-sponsored by Planned Parenthood of California, AB 2448 would ensure that health care providers have the technological capabilities to segregate sensitive health data in electronic medical records. The bill advances California’s commitment to protecting the confidentiality of medical information by requiring entities that maintain electronic health records for sensitive services to implement meaningful, operational safeguards to secure that data. 

"In a post-Dobbs world, protecting the privacy of patients seeking reproductive care is not just good policy, but a moral imperative. I'm proud to partner with Attorney General Bonta, Assemblymember Berman, and Planned Parenthood to protect reproductive rights and gender equity by ensuring the sanctity of the patient/provider relationship,” said Assemblymember Rebecca Bauer-Kahan. “Women should be able to come here and know they are getting safe, effective, and confidential care.”

"In the years since Roe was overturned, attacks on reproductive and gender affirming care have steadily intensified, threatening access to healthcare services for millions of Californians," said Assemblymember Marc Berman. "In these dangerous times, it is critical that medical providers have access to technology to protect sensitive medical information so that patients who have received reproductive and gender affirming care cannot be identified and targeted. AB 2448 requires the implementation of this technology to protect the privacy and security of medical records, so all Californians can access critical healthcare services without fear."

“With our current federal government hell bent on attacking vulnerable communities, patient privacy, and access to essential health care, PPAC is proud to co-sponsor AB 2448 with Attorney General Bonta to ensure Californians’ sensitive health records are secure,” said President and CEO of Planned Parenthood Affiliates of California Jodi Hicks. “We are grateful to Assemblymembers Berman and Bauer-Kahan for authoring this bill and to Attorney General Bonta for his ongoing partnership and commitment to protecting patients’ rights and reproductive freedom.”

OAKLAND — As part of a coalition of 16 attorneys general, California Attorney General Rob Bonta filed a motion asking the U.S. District Court for the Western District of Washington to enforce its December 19, 2025 order, which required the U.S. Department of Education (Department) to set aside its unlawful discontinuation decisions on school mental health funding programs established by Congress and to issue new decisions in full compliance with the law. On March 2, 2026, the Department decided to only award grantees six months of funding instead of providing funding for the full year, as is standard practice. The Department’s decision to deny grantees’ access to a full year of funding violates the Court’s order because the decision will effectively end some grantee projects and severely burden many other grantees. Without the certainty of a full year of funding, some grantees will lose essential staff and will be unable to properly plan and budget for the fall semester.

“The Trump Administration’s noncompliance must come to an end. In California and nationwide, grantees have issued layoff notices, and even though they take effect months later, the ongoing uncertainty complicates planning and staffing for critical programs that support students’ mental health,” said Attorney General Bonta. “My fellow attorneys general and I will not give the Trump Administration a free pass. We urge the Court to hold the Administration fully accountable for failing to comply with its order.”

Spurred by episodes of devastating loss from school shootings, Congress established and funded the Mental Health Service Professional Demonstration Grant Program (MHSP) in 2018 and the School-Based Mental Health Services Grant Program (SBMH) in 2020 to increase students’ access to mental health services. On or about April 29, 2025, the Department notified grantees — including state education agencies, local education agencies, and institutes of higher education — that their grants would be canceled for allegedly conflicting with the Trump Administration’s priorities. In the press, the Trump Administration admitted that it targeted the States’ grants for their perceived diversity, equity, and inclusion (DEI) efforts. In July 2025, Attorney General Bonta and the coalition filed a lawsuit against the Department over the discontinuation of the grants, and in December 2025, the coalition secured a permanent decision declaring that the Department acted illegally and requiring the Department to make new continuation decisions.

In the motion to enforce, Attorney General Bonta and the coalition assert that:

• The Department is continuing to violate the Court’s order. In their most recent act of noncompliance, the Department put new, unnecessary rules in place that achieve the same result as canceling some grants and severely hinder other grantees’ ability to serve students.
• By claiming the grants “will continue under protest,” the Department is making grantees jump through unnecessary hoops — like filling out complicated reimbursement forms that historically have only been required for grantees who mismanaged funds and forcing grantees to submit a meaningless performance report before any new data is available.
• The Department has also threatened to withhold six months of funding that grantees would have normally received and need for the fall semester. 

MHSP addresses the shortage of school-based mental health service providers by awarding multi-year grants to projects that expand the pipeline for counselors, social workers, and psychologists through partnerships between institutes of higher education and local educational agencies. SBMH funds multi-year grants to increase the number of professionals that provide school-based mental health services to students through direct hiring and retention incentives. The ultimate goal of the programs is to permanently bring 14,000 additional mental health professionals into U.S. schools.

The programs have been an incredible success. In their first year, the programs provided mental and behavioral health services to nearly 775,000 elementary and secondary students nationwide. Sampled projects showed real results: a 50% reduction in suicide risk at high-need schools, decreases in absenteeism and behavioral issues, and increases in positive student-staff engagement. Data also showed recruitment and retention efforts are working — in the first year of the programs, nearly 1,300 school mental health professionals were hired and 95% of those hired were retained. Importantly, these newly hired school-based mental health providers were able to create an 80% reduction in student wait time for services. The grants have helped schools hire hundreds of psychologists, counselors, and social workers who have served thousands of students, including in the state’s most economically disadvantaged and rural communities. By all markers, these programs work. 

Joining Attorney General Bonta in filing the motion are the attorneys general of Washington, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, New Mexico, New York, Nevada, Oregon, Rhode Island, and Wisconsin.

Catastrophic plans offer minimal coverage and high deductibles, leaving consumers with greater financial risk 

OAKLAND — California Attorney General Rob Bonta today co-led a coalition of 19 attorneys general in submitting a comment letter responding to a proposed rule by the U.S. Department of Health and Human Services (HHS) and Centers for Medicare & Medicaid Services (CMS) that would lead to a massive expansion of catastrophic health insurance plans. Under these plans, which are currently allowed only in very limited situations, health insurance coverage largely does not begin until significant maximum out of pocket costs (MOOP) have already occurred. Right now, that is $10,600 for an individual or $21,200 for a family, which is already too costly. In the 2027 plan year, the proposed rule at issue — entitled the “Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027; and Basic Health Program” — would widen catastrophic plans beyond their original limited use and increase MOOP limits to an unaffordable $15,600 for an individual and $31,200 for a family. The comment letter explains that these changes, and numerous others, are arbitrary and capricious and are therefore unlawful if ultimately adopted. 

“The Trump Administration’s plans to expand catastrophic health plans would indeed be catastrophic for families across the country, leaving them with minimal coverage and huge out-of-pocket bills. After failing to extend ACA subsidies and letting premiums soar for millions of Americans at the beginning of the year, the Trump Administration is now trying to clean up its own mess by offering these policies as the answer to rising health care costs,” said Attorney General Bonta. “This proposed rule is a dangerous deception that uses affordability as a misnomer for plans that cover essentially nothing, and my fellow attorneys general and I insist that it should be withdrawn.”

The proposed rule introduces a broad array of substantial changes over its near 600 pages — including many that are identical or substantially similar to a 2025 Marketplace Integrity and Affordability rule that Attorney General Bonta and a multistate coalition challenged in court. That case is still in active litigation. The proposed rule also introduces a range of other changes that harm consumers. This includes increasing the out-of-pocket cost for catastrophic plans to 130% of the statutory limits while also allowing bronze plans to raise cost-sharing above the statutory maximum out-of-pocket limitations. Together, this would promote an increased use of catastrophic plans with the intent to make those plans cover even less than they already do, thereby driving down premiums at the expense of little to no coverage. The rule also creates uncertainty about defrayal determinations, while making all its changes with rushed or flawed data that is riddled with errors and inconsistencies.

The ACA was passed by Congress and signed into law by President Barack Obama in 2010 to increase the number of Americans with health insurance and decrease the cost of healthcare, but the proposed changes to the law at issue will have the opposite effect. Projections indicate that up to two million individuals will lose their health coverage because of the changes — leaving states and residents to bear the cost. Healthier enrollees may drop more extensive coverage. Others, who may enroll in a catastrophic plan and then face a severe medical crisis, might forego needed care until they can switch back to a more generous plan, thus harming their health and potentially increasing the cost of future care. The consequences of these changes will fall hardest on the consumers least able to absorb the surprise medical bills, but all consumers will be affected.

In the letter, Attorney General Bonta and the coalition argue that the proposed rule:

• Is replete with errors and provides insufficient time to implement its substantial changes.
• Reimposes provisions substantially similar to provisions of the 2025 rule — like income verification provisions and the failure-to-reconcile provision — that have been stayed as likely unlawful and arbitrary.
• Reimposes regulations requiring the Federal Exchange to verify 75% of special enrollment period enrollees, despite a court’s prior stay of that provision.
• Contains provisions relating to catastrophic plans, bronze plans, essential health benefits, and other provisions that would harm states and consumers by making healthcare more expensive and dramatically weakening coverage.

In sending this letter, California Attorney General Bonta, Massachusetts Attorney General Campbell, and New Jersey Attorney General Davenport, are joined by the attorneys general of Arizona, Colorado, Delaware, Hawaii, Illinois, Maine, Maryland, Michigan, Minnesota, Nevada, New Mexico, New York, Oregon, Rhode Island, Washington, and Wisconsin.

Multistate coalition pushes back on federal rules that allow employers to restrict access to birth control 

OAKLAND — California Attorney General Rob Bonta today joined a coalition of 22 attorneys general in filing an amicus brief with the U.S. Court of Appeals for the Third Circuit in support of a lawsuit filed by Pennsylvania and New Jersey concerning reproductive rights. Specifically, the brief backs the two states in opposing the first Trump Administration’s 2017 and 2018 regulations that undermine the Affordable Care Act’s (ACA) guarantee of no-cost contraception coverage by employer healthcare plans. The regulations expand religious exemptions and create moral exemptions that allow employers to strip workers of guaranteed, no-cost coverage for birth control and other contraceptive care and services. California led a parallel challenge to the first Trump Administration’s rollback of the contraceptive mandate and that case remains pending before the U.S. District Court for the Northern District of California. The regulations were stayed during the Biden Administration while the U.S. Department of Health and Human Services considered issuing new rulemaking, which Attorney General Bonta supported.

“Decisions about using birth control should be made by women and their doctors — not dictated by their bosses. California has long embraced that principle, and we have no intention of backing down,” said Attorney General Bonta. “My fellow attorneys general and I are urging the Third Circuit to affirm the lower court’s decision that struck down the Trump Administration’s unlawful regulations.” 

More than 80% of women ages 18 to 49 report having used some form of contraception in the past 12 months. With contraception costing an average of $584 per user per year, these unlawful regulations could shift an estimated $73.8 million in costs to individuals who rely on contraceptive care, creating significant barriers to accessing safe, effective healthcare.

In the brief, Attorney General Bonta and the coalition argue that:

• The regulations threaten contraceptive coverage for hundreds of thousands of women, putting at risk their health and the economic and public health of the states generally.
• States will face significant financial strain as they are forced to expend millions of dollars for replacement contraceptive care and services through state-funded programs.
• The regulations deepen already prevalent racial, gender, and income disparities. People of color and people with low incomes are disproportionately likely to live in “contraceptive deserts,” or areas that lack reasonable access to the full range of contraceptive care.
• Access to birth control and contraceptive care has been substantially reduced in the years since these regulations were first implemented, and this harm will be exacerbated if the regulations remain in place because of changes in the landscape for reproductive healthcare.

Joining Attorney General Bonta in filing this brief are the attorneys general of Arizona, Colorado, Connecticut, Delaware, the District of Columbia, Hawaiʻi, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Mexico, New York, North Carolina, Oregon, Rhode Island, Vermont, Virginia, and Washington.