Well being Care Is Entrance and Middle as DeSantis and Newsom Go Mano a Mano

Daniel Chang and Angela Hart

Florida

Gov. Ron DeSantisAge: 45Florida inhabitants: 22.2 million

California

Gov. Gavin NewsomAge: 56California inhabitants: 39 million

Republican presidential candidate Ron DeSantis and Democratic Gov. Gavin Newsom — political rivals from reverse coasts and proxies for pink 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, isn’t operating for president in 2024. However he goaded DeSantis, in his second time period as governor of Florida, to go mano a mano. “I’ll 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 individual whilst they’ve very publicly traded barbs and insults, in current weeks attacking one another in fundraising movies and marketing campaign adverts.

Entrance and middle can 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 12 months, DeSantis blasted California for being too beneficiant with public profit packages, similar to Medicaid, which the Golden State has expanded to all eligible residents no matter immigration standing. That sweeping coverage takes impact in January and goes properly past the elective growth of Medicaid that the Inexpensive Care Act provided states. In Florida, one in every of 10 states which have refused to develop Medicaid underneath Obamacare, DeSantis wears the state’s 11% fee 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 12 months.

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 part of us in California, the place we nonetheless imagine in freedom,” Newsom stated in a political advert earlier this 12 months.

Newsom has earned the moniker of “well being care governor” by catapulting the problem 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 fee to an all-time low of 6.5% by increasing protection in different methods.

These points are anticipated to take middle stage in the course of the nationally televised 90-minute debate on Fox Information, which may have main reverberations for the presidential contest subsequent 12 months and will even assist form the 2028 discipline of White Home contenders.

Upfront 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 characterize.

Obamacare

Florida

DeSantis has refused to develop Medicaid eligibility to extra folks underneath the Inexpensive Care Act. Partly in consequence, greater than 3 million Floridians had protection via the federal Obamacare change as of February, greater than some other state. Florida doesn’t have a state-based change or provide state-sponsored subsidies.

California

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

Abortion

Florida

DeSantis authorised 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.

California

Newsom spearheaded the hassle in 2022 to amend the state structure to enshrine the precise to abortion and contraception. He additionally authorised $60 million to assist uninsured sufferers and other people 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

Florida

Below DeSantis, Florida handed a legislation this 12 months banning gender-affirming well being care for trans minors and mandating that grownup sufferers signal knowledgeable consent varieties earlier than beginning or persevering with hormone therapy. The legislation additionally restricts who can order hormone remedy to physicians and prohibits using telehealth for brand new prescriptions. A federal lawsuit difficult the legislation is ready to go to trial in mid-December.

California

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

Homelessness

Florida

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 known as “leftist insurance policies” in California. Florida is experimenting with utilizing Medicaid funds to handle homelessness, however this system is restricted. Practically 26,000 folks are homeless in Florida, or 12 of each 10,000 residents.

California

Newsom has plowed greater than $20 billion into the homelessness disaster, with billions extra for well being and social companies. For instance, some homeless Californians can get social companies via the state’s Medicaid program, similar to cash for rental safety deposits, utility funds, and first and final month’s lease. Newsom additionally led a brand new state initiative that might pressure some homeless folks into psychological well being or habit therapy. Greater than 171,000 folks are homeless in California, or 44 of each 10,000 residents.

Psychological Well being

Florida

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 fee of adults with psychological sickness who’re uninsured, in line with the Miami Middle for Psychological Well being and Restoration. Below DeSantis, Florida has elevated state funding for psychological well being packages in colleges and peer-to-peer psychological well being companies for first responders, and directed funding to suicide prevention.

California

Newsom in 2020 signed one of many nation’s strongest psychological well being parity legal guidelines, which requires insurance coverage firms 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 supply psychological well being therapy in colleges. Newsom can also be main the marketing campaign for a statewide, $6.4 billion bond measure in 2024 to revamp and develop community-based behavioral well being packages, together with hundreds of recent therapy beds.

Habit

Florida

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

California

California’s drug overdose fee was 26.6 per 100,000 folks 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 12 months that might have allowed Los Angeles, San Francisco, and Oakland to determine protected injection websites.

Prescription Medication

Florida

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

California

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 legislation when Newsom took workplace. This 12 months, he signed a legislation that tightens state laws for pharmacy profit managers.

Well being Care Affordability

Florida

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 companies, similar to imaging and diagnostic assessments. Below his management, Florida lawmakers have additionally allowed short-term well being plans lasting lower than a 12 months and direct well being care agreements between a affected person and a well being care supplier that aren’t thought of insurance coverage and will not be topic to Florida’s insurance coverage code.

California

One in all Newsom’s first well being care initiatives was to fund state-financed medical health insurance subsidies for low- and middle-income residents who buy insurance coverage via Coated California. Newsom this 12 months additionally agreed to decrease copays and eliminate some deductibles for plans bought via the change. 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

Florida

DeSantis signed laws in 2021 banning authorities, colleges, and personal employers from requiring covid vaccinations. In 2023, he pushed legislators to undertake legal guidelines prohibiting sure vaccine and masks necessities. He additionally fashioned 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 fee for residents age 5 and older is 12.4%.

California

Newsom turned the primary U.S. governor to concern a statewide stay-at-home order initially of the covid-19 pandemic. He pushed sturdy 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 fee for residents ages 5 and older is 21.9%.

Immigrant Well being Care

Florida

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

California

Starting in January, all immigrants who meet revenue {qualifications} can be eligible for the state’s Medicaid program. Earlier than Newsom took workplace, California had already expanded eligibility to unauthorized immigrant kids via 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.