AB 9: California Bill Would End County Mandate for Last-Resort Care, Including Communicable Diseases

The California Assembly has passed a bill, AB 9 (Goldsmith, R-Poway), that would end the current requirement that counties provide General Assistance, and medical care of last resort for persons who do not have access to Medi-Cal, private insurance, or any other way of getting medical care. If this bill becomes law, counties could decide to have no such care at all; and if they did provide indigent medical care, it could only be for life-threatening or limb-threatening conditions. There is concern that all counties will close facilities and reduce or eliminate last-resort care, leaving people with no access to treatment when they become ill.

The effect on communicable disease control does not seem to have been thought through. Unless a loophole can be found, the bill prohibits counties from providing last-resort care for communicable diseases which are not life threatening. The law would allow counties to treat life-threatening diseases like tuberculosis if they wanted to; but how would these illnesses be diagnosed if indigent persons could not see a healthcare professional when they get sick?

AB 9 could pass without thought to the consequences, because of the extreme partisanship of the California legislature. Under the Democrats, the bill had no serious chance; under the Republicans -- who achieved control of the Assembly in January 1996, when Assemblyman Willie Brown was forced out by term limits and left to become Mayor of San Francisco -- passage was all but automatic. Since minds were already made up, the bill never needed to build support through the normal political processes of accommodation and improvement.

The bill is now in the California State Senate. AIDS organizations are urging Californians to call their state senator immediately and tell him or her to oppose AB 9, then to follow up the call with a letter.

For more information, contact:

AIDS Project Los Angeles Sacramento office, Sophia Kwong, 916/443-9055;

LIFE AIDS Lobby, 916/444-0424;

ACT UP/Golden Gate, 415/252-9200.