ITUP 2018 A Year-In-Review

January 9, 2019

by Elia Gallardo

ITUP 2018 A Year-In-Review

The past year began and ended with ongoing federal efforts to invalidate or dismantle the Affordable Care Act (ACA) through litigation, federal rulemaking, and the federal budget process contrasted with California’s continuing efforts to expand coverage and improve health care.

These starkly different approaches at the state and federal level, including proposed and final federal rules, are outlined in the ITUP 2018 Year-In Review and the accompanying Summary of 2018 Federal Rulemaking.


The annual ITUP Year-In-Review chronicles month-by-month important state and federal health policy milestones. In addition to federal rulemaking, the 2018 Year-In-Review highlights the still pending lawsuit brought by Republican state officials to overturn the ACA. In late December, a district court judge ruled the ACA unconstitutional, which was immediately followed by a California-led coalition of states challenging this ruling. California Attorney General Xavier Becerra spearheaded the effort to defend the law, securing a legal stay of the decision while the issues are on appeal.

During 2018, California continued to focus on making sure individuals and families are enrolled in available coverage options, including developing policies and strategies to preserve and protect advances made under the ACA. California lawmakers also explored state-based coverage expansions for the remaining uninsured and policies to improve affordability of coverage for low- and moderate- income families. Specifically, 2018 legislative proposals would expand Medi-Cal coverage to some or all undocumented adults and extend subsides beyond the federal ACA subsidies for coverage in Covered California, the state’s marketplace.

California will continue many of these efforts in 2019, with legislation introduced on the first day of the legislative session to cover undocumented adults. This week, on day one of the Newsom Administration, the new Governor offered a package of health care proposals to expand coverage, improve affordability and reduce health care costs.  

Note: To hear the latest on the fight to protect California coverage gains, attend the ITUP 23rd Annual Conference where Attorney General Xavier Becerra will give the opening keynote address.  The ITUP conference will also focus on what to expect over the next two years in California health reform, including the proposals from the Governor and legislators already in the mix.

ITUP 2018 Year-In-Review

ITUP Summary of 2018 Federal Rulemaking