Health Care Is Front and Center as DeSantis and Newsom Go Mano a Mano

Florida

DeSantis approved legislation in April banning abortions after six weeks of pregnancy. However, the Florida Supreme Court has taken up a challenge to the 15-week ban introduced in 2022, which will determine if the six-week ban can take effect.

California

Newsom spearheaded the effort in 2022 to amend the state constitution to enshrine the right to abortion and birth control. He also approved $60 million to help uninsured patients and people from out of state pay for abortions in California, and signed reproductive health care laws, including one protecting doctors who mail abortion pills to other states.

Florida

Under DeSantis, Florida passed a law this year banning gender-affirming health care for trans minors and mandating that adult patients sign informed consent forms before starting or continuing hormone treatment. The law also restricts who can order hormone therapy to physicians and prohibits the use of telehealth for new prescriptions. A federal lawsuit challenging the law is set to go to trial in mid-December.

California

Newsom and other state leaders have amended state law to ensure all California adults and children are entitled to gender-affirming health care services. And insurance companies doing business in California must include information on in-network providers for gender-affirming services by 2025. State health care agencies are designing “enforceable quality standards” to ensure trans patients have access to comprehensive care.

Florida

DeSantis has not declared homelessness a priority. In a video filmed on the streets of San Francisco and posted to social media in June, DeSantis used the topic as a campaign cudgel to criticize what he called “leftist policies” in California. Florida is experimenting with using Medicaid funds to address homelessness, but the program is limited. Nearly 26,000 people are homeless in Florida, or 12 of every 10,000 residents.

California

Newsom has plowed more than $20 billion into the homelessness crisis, with billions more for health and social services. For example, some homeless Californians can get social services through the state’s Medicaid program, such as money for rental security deposits, utility payments, and first and last month’s rent. Newsom also led a new state initiative that could force some homeless people into mental health or addiction treatment. More than 171,000 people are homeless in California, or 44 of every 10,000 residents.

Florida

DeSantis has kept his pledge to advocate for mental health treatment programs as governor, although Florida still ranks 43rd nationally in access to mental health care and has the fourth-highest rate of adults with mental illness who are uninsured, according to the Miami Center for Mental Health and Recovery. Under DeSantis, Florida has increased state funding for mental health programs in schools and peer-to-peer mental health services for first responders, and directed funding to suicide prevention.

California

Newsom in 2020 signed one of the nation’s strongest mental health parity laws, which requires insurance companies to cover mental health and substance use disorders just as they would physical health conditions. He is funding a $4.7 billion initiative to provide mental health treatment in schools. Newsom is also leading the campaign for a statewide, $6.4 billion bond measure in 2024 to revamp and expand community-based behavioral health programs, including thousands of new treatment beds.

Florida

Florida’s drug overdose death rate was 37.5 per 100,000 people in 2021. In August, DeSantis announced a new statewide addiction recovery program billed as a “first of its kind” in the United States, using peer counselors, medication-assisted treatment, and a coordinated network of support services. DeSantis also authorized Florida counties to adopt needle exchange programs in 2019 to reduce the spread of blood-borne diseases and encourage addiction treatment.

California

California’s drug overdose rate was 26.6 per 100,000 people in 2021. Newsom is sending the state Highway Patrol and National Guard into San Francisco to combat the open-air fentanyl trade and is boosting addiction recovery programs statewide. But he vetoed legislation last year that would have allowed Los Angeles, San Francisco, and Oakland to establish safe injection sites.

Florida

A DeSantis proposal submitted to the FDA in 2020 includes allowing imported medications from Canada. A new state law also sets price limits for pharmacy benefit managers — intermediaries between insurers, pharmacies, and manufacturers — and creates new rules for them around pricing transparency. The law also requires pharmaceutical companies to disclose significant price hikes.

California

Newsom is spearheading a $100 million, first-in-the-nation initiative that puts California in the generic drugmaking business, beginning with insulin and the opioid reversal drug naloxone. California already had a pricing transparency law when Newsom took office. This year, he signed a law that tightens state regulations for pharmacy benefit managers.

Florida

In 2019, DeSantis signed the Patient Savings Act, which allows health insurers to share cost savings with enrollees who shop for health care services, such as imaging and diagnostic tests. Under his leadership, Florida lawmakers have also allowed short-term health plans lasting less than a year and direct health care agreements between a patient and a health care provider that are not considered insurance and are not subject to Florida’s insurance code.

California

One of Newsom’s first health care initiatives was to fund state-financed health insurance subsidies for low- and middle-income residents who purchase insurance through Covered California. Newsom this year also agreed to lower copays and get rid of some deductibles for plans sold through the exchange. California’s newly created Office of Health Care Affordability is capping industry cost increases and could potentially regulate health industry consolidation. California bans short-term health plans.

Florida

DeSantis signed legislation in 2021 banning government, schools, and private employers from requiring covid vaccinations. In 2023, he pushed legislators to adopt laws prohibiting certain vaccine and mask requirements. He also formed a Public Health Integrity Committee led by his hand-picked surgeon general, Joseph Ladapo, whose official guidance on covid vaccines contradicts the CDC’s recommendations. The Sunshine State’s covid-19 vaccine booster rate for residents age 5 and older is 12.4%.

California

Newsom became the first U.S. governor to issue a statewide stay-at-home order at the start of the covid-19 pandemic. He pushed strong vaccination and mask mandates and accused DeSantis of being weak on public health. Newsom has also signed laws strengthening childhood vaccination mandates, including a measure that cracks down on bogus medical exemptions granted by doctors. The Golden State’s covid-19 vaccine booster rate for residents ages 5 and older is 21.9%.

Florida

With DeSantis making immigration a priority, legislators passed a state law requiring all Florida hospitals to ask on their admission forms whether a patient is a U.S. citizen or lawfully present in the country. Doctors, nurses, and health policy experts say the law targets marginalized people who already have difficulty navigating the health care system and will further deter them from seeking care.

California

Beginning in January, all immigrants who meet income qualifications will be eligible for the state’s Medicaid program. Before Newsom took office, California had already expanded eligibility to immigrant children through age 18 living in the state without authorization. Newsom then signed laws expanding the program to young adults up to age 26, adults 50 and older, and, later, immigrants of any age who otherwise meet eligibility requirements.