The glitz, glam and drama of federal policy often overshadows state policy. However, in many ways, state legislation is the catalyst for future national policy positioning. Over the past months, California and Colorado have passed new legislation that will significantly impact the operations of health systems. California has passed bills requiring a substantial bump in pay and sick leave for health care workers, while Colorado has new laws regarding the use of facility fees and transparency of services rendered by providers.

California: The Health Care Workforce

• Governor Gavin Newsom signed a new bill – B. 525– that raises the minimum wage for California health care workers from $15.50 to $25 per hour. A report found that the new law is set to raise wages for 455,000 employees. Supporters of the bill believe this legislation will help to alleviate staffing shortages in the state that have worsened during the COVID-19 pandemic.
• The Governor also approved B. 616, which will now extend up to five paid sick days a year to California workers. Advocates warned that many employees, especially in health care, often feel compelled to show up sick to work because they can’t afford to stay home. The California Chamber of Commerce, however, calls it a “job killer” and warns it could harm smaller businesses and physician practices.

Colorado: The Cost of Care

• The Limits on Hospital Facility Fees Act, B. 23-1215was signed into law by Governor Polis. Beginning on July 1, 2024, the Act prohibits a provider (defined as a corporation or organization that owns or operates three or more hospitals) from charging, billing or collecting a facility fee from a patient that is not covered by the patient’s insurance for mandatory coverage for preventive health-care services that are provided in an outpatient setting. Additionally, the law will:
  • Require a provider that charges a facility fee to notify a patient of the fee;
  • Require a standardized bill that includes itemized charges identifying the facility;
  • Require a health facility that is newly affiliated with or owned by a hospital or health system after July 1, 2024, to provide written notice to patients of the change in ownership and that the health facility may now charge a facility fee.
• The Patients’ Right to Know Act, H.B. 23-1218, was also signed into law by Governor Polis. The Act requires the Department of Public Health to identify reproductive health care, LGBTQ health care and end-of-life health care services that, for non-medical reasons, are not generally available at health care facilities or are subject to significant restrictions.
  • The Act also requires covered entities to submit a form to the Department and to update the form within 30 days after a change in the availability of the health care service. An entity that fails to comply with the Act is subject to monetary penalties.
  • The information will live on a public-facing website.