An act to add Section 127406 to the Health and Safety Code, relating to health care.
Summary
AB 1312 adds Section 127406 to the Health and Safety Code to require hospitals, beginning July 1, 2027, to proactively screen patients for eligibility for hospital charity care and discount payment programs. The bill creates a presumptive eligibility pathway for patients who are enrolled in specified public assistance or utility/housing programs, have recently been found eligible for hospital financial assistance, or are experiencing homelessness. It also requires screening of uninsured patients and certain Medi-Cal and Covered California enrollees, while allowing patients to opt out of screening through a written form.
The bill prohibits hospitals from requiring patients to apply for Medicare, Medi-Cal, or other coverage before screening for or receiving discounted payment, and it allows hospitals to use existing patient information, intake data, and third-party software or services to conduct screening, subject to limits. Hospitals must adopt a public written screening process, document methods used, provide written notice before sending billing statements, and ensure bills reflect any charity care or discount adjustments. Notices must be provided in English and the patient’s spoken language, and screening itself cannot be treated as a charity care application or used to disqualify future requests.
Impact
AB 1312 expands hospital obligations under California’s charity care and discount payment laws by shifting from a largely application-based process to an affirmative screening model. It amends hospital billing and financial-assistance practices by requiring presumptive eligibility determinations for certain low-income or vulnerable patients, limiting when billing statements may be sent, and requiring hospitals to disclose their screening procedures and any third-party tools used. The bill also preserves rural hospitals’ ability to set lower eligibility thresholds when needed to maintain financial and operational integrity.
Sentiment
The voting history suggests generally favorable support for the bill, with multiple committee and floor votes passing by clear margins in both houses. The bill advanced through the legislative process and was ultimately chaptered, indicating it had sufficient bipartisan or cross-faction support to become law. The absence of committee transcript material limits insight into detailed debate, but the recorded votes show the measure was broadly accepted despite some opposition.
Contention
The main points of contention likely centered on the administrative and operational burden placed on hospitals, especially around mandatory screening, verification, multilingual notices, and the use of third-party software or data tools. Another likely concern was the potential for increased charity care obligations and the need to protect hospital finances, which is reflected in the rural hospital carve-out. On the patient side, supporters would have emphasized easier access to financial assistance, while critics may have focused on privacy, workflow complexity, and the risk of inaccurate or overbroad presumptive eligibility determinations.
An act to amend Sections 103825, 103835, 103840, 103845, 103850, 103855, 124977, 124991, and 125002 of, and to add Sections 103827 and 103832 to, the Health and Safety Code, relating to public health.
Requiring economic development electric rate discounts offered by public utilities to cover the incremental and variable costs to serve customers that receive such a discount.