Sometimes, patients who call an ambulance end up getting stuck with a big bill because the ambulance company does not have a contract with their health plan.

Assembly Bill 716 is designed to prevent surprise out-of-network bills. It passed the California State Assembly and is now making its way through the state Senate committees.

Katie Van Deynze, policy and legislative advocate for Health Access California, said people should not have to worry about the cost if they need to call an ambulance.

"Consumers have no control in whether the ambulance that shows up is in their network, resulting in many surprise bills," Van Deynze pointed out. "We hear from Californians across the state that they might not even call the ambulance out of legitimate fear of the bill, putting their health at risk."

The bill would guarantee patients with insurance would only have to pay the in-network cost-sharing amount. People without insurance would be charged the Medi-Cal or Medicare rate for that service. And if the ambulance provided does not have a contract with a health plan, the ambulance company would be paid a rate set by local authorities.

Jennifer Reisz, a mother from Fresno who testified in favor of the bill, said when her daughter was kicked by a horse, she needed an ambulance and spent three days in the hospital, only to be hit with a large out-of-network bill.

"A month later, she received a bill from the ambulance company totaling $4,600, but our insurance company paid less than half of the bill, leaving my daughter responsible for $2,400," Reisz recounted. "She was distraught because she didn't know how she was going to pay for this bill."

The legislation also includes consumer protections against debt collections, including wage garnishment. The last provision has drawn criticism from representatives of the state's debt collection industry.

November has been Diabetes Awareness Month - but heading into the holidays, people who are diabetic know they can't lose their focus on keeping it in check. And technology is making it easier to monitor the disease from home.

More than 520,000 Washingtonians have been diagnosed with diabetes.

Dr. Mamatha Palanati is the medical diabetes program director for Kaiser Permanente Washington. She said the disease needs to be managed closely, because it can lead to serious health complications.

Palanati noted that fortunately, people don't need to leave their homes to do this in some cases.

"In today's world, there's a much easier way to do it, like telehealth," said Palanati. "Telehealth provides multiple ways for the follow-up and connection to the health care for any individual."

Palanti said people managing diabetes still should plan to see their physician in person at least once a year. Management of other factors, like blood pressure and cholesterol, can also help reduce complications.

Palanati said monitoring technology can also assist people.

"The family members and caregivers, or anyone who can take care of that particular individual," said Palanati, "can do it remotely and manage their diabetes in a much better way."

Palanati stressed that diabetes is a chronic disease.

"Don't look at this as an additional chore or anything," said Palanati. "Make it as a part of your life. So, be active, making sure you adapt to the healthy lifestyles. It may not be perfect, but try your best to get what you can do."




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As World AIDS Day turns 35, the mother of an Indiana teen who became the public face of the disease is a reminder of the importance of never forgetting the hard work of medical researchers and the victims lost in the frenzy to find a cure.

More than 40 million people have died from AIDS, including Ryan White, who grew up in central Indiana at a time when not much was known about it and medicine offered few treatments. Ryan contracted the disease during a blood transfusion at age 13. He became a staunch advocate against discrimination and helped change how Americans view AIDS.

Jeanne White-Ginder, who eventually left Indiana for Florida, said it is imperative to remember all the lost lives.

"That is so important that we remember all the people who got us to where we are today, because they are no longer here," White-Ginder noted. "And I'm not just talking about Ryan, because Ryan was a face, but there are so many people that did all the work."

Just five weeks after Ryan's death in 1990, Congress overwhelmingly passed the Ryan White CARE Act with bipartisan support. The legislation helps more people get tested for HIV and offers assistance to patients in all stages of the disease.

Ryan's mom emphasized AIDS affects people across the spectrum, regardless of labels.

"A gay person has it, a straight person has it, a blood transfusion person has it; it was for everybody," White-Ginder explained. "Once you have AIDS, you're just like everybody else who has AIDS; you're fighting to stay alive. And people fought to stay alive, and people dedicated their lives to get us to where we are today."

She added Ryan would have turned 52 next week.

His mom plans to travel to Indiana University on his birthday, where the Rural Center for AIDS/STD Prevention will present the Ryan White Distinguished Leadership Award to Dr. Joe and Sarah Ellen Mamlin.


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Advocates for affordable health care are speaking out to remind people what is at stake if the Affordable Care Act is repealed in the wake of recent statements by former President Donald Trump.

Mr. Trump, who leads the polls for the 2024 Republican nomination, has recently said he is looking at alternatives to the Affordable Care Act, and criticized the GOP lawmakers who voted against his attempts to end the program in 2017.

Laura Packard, a Stage 4 cancer survivor, noted before the Affordable Care Act, insurance companies were allowed to deny coverage to people like her with pre-existing conditions.

"While I was on the couch, trying to survive, that's when Republicans in the U.S. House voted to repeal the Affordable Care Act that was keeping me alive," Packard recounted. "Then, they held a party to celebrate. We can't go back to that."

The Affordable Care Act created health exchanges -- like Covered California -- offering subsidized health insurance to millions of people. And it funded an expansion of MediCal, benefiting 5 million low-income Californians in the first six years after the law's passage.

Sen. Ron Wyden, D-Ore., who helped write the health care law, said the Affordable Care Act forces health insurance companies to cover basic services like maternity care, mental health services, cancer screenings and contraception. The idea of getting rid of the law has been largely unpopular, and Wyden knows why.

"It would mean higher premiums for families and health insurance," Wyden pointed out. "And it would also threaten Medicaid nursing home benefits, because Medicaid is paying much of the nursing home bill for this country."

The law also allows adult children to stay on their parents' health plans until age 26 and bans lifetime caps on coverage.


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