The bill to protect recipients of gender-affirming care presents a legal quandary

Bill that aims to protect identities of patients who have had abortions or received gender-affirming care in California could lead to hot hospitals to violate federal law if passed.

As CalMatters’ Ryan Sabalow and Kristen Huang explain, the proposal would require medical providers or businesses to contact the California attorney general within seven days if they are served with any civil, criminal or regulatory investigation or subpoena seeking “lawfully protected health care activity.” It would also be necessary for the recipient to alert the patients whose records are sought.

The attorney general will then have an additional 30 days to review the request before the recipient can comply with the order. Those found violating the new rule could be fined up to $15,000.

The bill was introduced in part in response to the Trump administration last year issuing federal subpoenas to 20 medical providers in the U.S. The providers, which included Children’s Hospital Los Angelesoffered gender-affirming care to minors, and the subpoenas demanded patients’ medical records. California Attorney General Rob Bonta co-sponsored the measure.

Compliance with the proposed law could put providers at risk of violating federal law by delaying their response to federal subpoenas. Critics of the bill and some constitutional scholars also say the proposal could stand on shaky legal ground.

Bill Esailly, a former Republican member of the California Assembly who heads the U.S. Attorney’s Office in Los Angeles, said the bill would be unconstitutional and “unenforceable under the Supremacy Clause,” which declares that federal law trumps state law. Other legal experts agree.

• Leslie Gillow Jacobslaw professor at McGeorge Pacific University School of Law: “It looks like the federal government can say you’re obstructing their law enforcement.”

In a statement, Bonta’s office said the bills are subject to change as they move through the Legislature and that the office “will address concerns when appropriate and necessary” about the bill. Parliament’s Public Safety Committee is due to discuss the bill on April 21.

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A bill that supporters say would ensure children get the money they need in child support is raising concerns among critics who say the proposal rips off power away from familieswrites ChrisAnna Mink for CalMatters.

Currently, when parents divorce, the custodial parent can choose to register with the California Department of Child Support Services, which collects and distributes child support.

To ensure that child support measures are not neglected, which could put the child at risk of poverty, the account will automatically enroll families in the department (although they can still opt out).

But some families are already opting out of enrollment because they’ve made their own arrangements — a delicate scenario that critics of the bill are urging lawmakers to keep in mind.

• Rebecca Gonzalezpolicy advocate for the Western Center on Law and Poverty: “We think parents should be trusted to make a decision about what’s best for their family, not forced into the system … the system doesn’t work for everyone.”

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Federal Court of Appeals delivered a victory to dialysis providers last weekafter repealing parts of a 2019 state law that limited how much companies could earn from certain privately insured patients, CalMatters’ Ana B. Ibarra reports.

The law limits the percentage of reimbursement that dialysis providers can receive for those patients who receive assistance from nonprofit charities that help pay their insurance premiums. The law sets that cap on what Medicare pays, which is about three times lower than what private plans in the individual market currently pay.

Dialysis providers DaVita Inc. and Fresenius Medical Care donate to the American Kidney Foundation, a nonprofit organization that provides first-class care to approximately 3,000 patients in California. Supporters of the law accused those three entities of operating a “profit-maximizing scheme” through their ties to each other, which the law aims to curb.

Authorities filed a lawsuit to block the law immediately after it went into effect. The 9th Circuit ruled that parts of the law violated the First Amendment by impeding the American Kidney Foundation’s right to associate with the two providers.

For now, the ruling leaves things as they were before the law passed, and patients currently receiving help from the American Kidney Foundation won’t see any immediate changes.

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