IN THE LOOP

It’s time to vote. The General Election takes place on Tuesday, Nov. 3, and as you have likely heard, this may be the most important election in your lifetime.

Below is some information that will help you to prepare for the election: how and when to register to vote, when mail-in ballots will be sent out, how to track your ballot, and more.

The deadline for registering to vote is October 19, 2020. You can register to vote using any of the links below, or by calling the Los Angeles County Registrar’s office, or by mail. However, if you miss the October 19 deadline, then you will have to go in person to the county registrar’s office or a polling place to register.

If you have missed all the deadlines, you can still register to vote at any polling center up to and including on Election Day, but your vote will be conditional until your information is verified.

For more information, you can call the Los Angeles County Registrar at 1-800-815-2666. Staffers will answer your questions but wait times to talk to a live person will likely get longer as we get closer to the election. So if you want to speak to a live person about voting, call soon.

California Will Send Mail-In Ballots to All Voters This Year

• Sample voter ballots will be sent out around Sept. 24
• Mail-in ballots will be sent out Oct. 4
• Contact the Registrar if you don’t get yours
• Polling sites will be open for ten days, including Election Day
  • Sites will be open 10 am – 8 pm for nine days before Election Day
  • Sites will be open 7 am – 8 pm Election Day
• If you’re in line when polls close, you will get to vote
• If you arrive after closing you won’t get to vote
• Polling sites will be listed on the websites, below

If you are concerned about mailing in your ballot, the best advice is to mail it in as soon as possible. Once mailed, you can sign up to track your ballot at: california.ballottrax.net/voter/

If you prefer, you can drop off your mail-in ballot at any polling station up to and including Election Day. Otherwise, mail-in ballots must be post-marked no later than Election Day in order to be counted.

This election includes the all-important presidential election. Congressional seats will be on the ballot, along with State Assembly and Senate offices, Boards of County Supervisors, and more. There are 13 ballot initiatives up for a vote as well. These range from an initiative that would classify Uber and Lyft drivers as independent contractors to changes to Prop 13 (property taxes) and rent control. Ballot initiatives are often complicated. You can review them before you get your ballot at: ballotpedia.org/California_2020_ballot_propositions

The California Ending the Epidemics Coalition will also be circulating ballot initiative recommendations within the next few weeks.

Websites for Registration and Voter Information

To register to vote, or get information on how and where to vote, the California Secretary of State’s website can help: www.sos.ca.gov/elections/

Rock the Vote can also help (and has a snazzier name): www.rockthevote.org/

The League of Women Voters of California is an established and reliable site for anyone: lwvc.org/

The Los Angeles County Registrar’s office has an excellent site, can be reached by phone, and their website readily translates into Spanish and many other languages: www.lavote.net/home/voting-elections/voter-registration/register-to-vote/register

All elections are important and so is your vote. This time around you might want to:

Vote As if Your Life Depends on It!

Most health plans now required to cover PrEP without cost sharing, but some plans exempted

In June 2019, the U.S. Preventive Services Task Force (USPSTF) issued a grade A recommendation for PrEP, urging healthcare providers to offer PrEP to everyone who is at high risk of acquiring HIV. This is important because the Affordable Care Act (ACA) requires private insurers to cover preventive services recommended by the USPSTF with an “A” or “B” rating without patient cost sharing.

However, full implementation of the USPSTF recommendation is dependent on guidance from state and federal regulators. This week we are breaking down the latest developments on implementation of the USPSTF guidance in California.

Most California Health Plans Now Required to Cover PrEP Without Cost Sharing

In California, the large majority of health plans are regulated by two state departments — the California Department of Insurance (CDI) and Department of Managed Healthcare (DMHC). On June 10, 2020, CDI issued a notice to health insurers informing them of their obligation to cover PrEP without patient cost sharing. CDI’s notice explains that, under California law:

• All PrEP drugs approved by the FDA and recommended by the CDC must be covered in-network without a deductible, copayment, or coinsurance;
• Insurance companies generally cannot require prior authorization or step therapy for patients to access PrEP drugs;
• Health plans are required to cover all medical services necessary for PrEP initiation and follow-up care without cost sharing.

Insurance companies were encouraged to begin covering PrEP without cost sharing for all their policyholders beginning on June 11, 2020 rather than waiting until policies renew. DMHC issued similar guidance on July 8, 2020. Comprehensive guidance from both CDI and DMHC mean that the majority of Californians should now have access to PrEP drugs and related medical services without cost sharing.

Some Health Plans Exempted From State Insurance Laws

Some health plans in California are not regulated by CDI and DMHC. These plans, known as self-insured employee health benefit plans, are exempted from state insurance laws. These plans are regulated by the federal Department of Labor. In 2018, approximately 5.5 million Californians were enrolled in self-insured employee health benefit plans.

Individuals enrolled in these health plans do not have the same protections as those enrolled in health plans regulated by CDI and DMHC. However, these plans are still subject to the ACA requirement to cover recommended preventive services without cost sharing. At the very least, these plans should be required to cover PrEP medication with no cost sharing.

The HIV Healthcare Access Working Group, a coalition of over 100 national and community-based HIV service organizations, is urging federal regulators to fully implement the USPSTF PrEP recommendation, including coverage of PrEP clinical visits and lab services with no cost sharing. We will keep you updated as things develop at the federal level.

United Healthcare Will Begin Limiting Access to Descovy

On June 30, 2020, United Healthcare (UHC) announced that it would begin requiring prior authorization for Descovy — Gilead’s latest PrEP drug — beginning September 1, 2020. However, because California law generally prohibits prior authorization for PrEP, this change will only apply to individuals enrolled in UHC self-insured employee health benefit plans. For these plans, all patients currently on Descovy will need to be approved through the clinical review process to continue coverage of Descovy.

The prior authorization criteria are posted on the UHC website. Approved authorizations for Descovy will be granted for a 12-month period and approved patients will not be subject to cost sharing. In addition, once a generic version of Truvada is launched on September 30, 2020, all patients currently on Truvada will be required to switch to the generic version. UHC also announced that it will cover PrEP-related medical services for all enrollees with no cost sharing.

File a Complaint if Your Plan is Not Following State Law

If your health plan currently has cost sharing or prior authorization requirements for PrEP and you are unsure whether your plan is subject to state or federal regulations, we strongly encourage you to file a complaint online with CDI or DMHC. Submitting a complaint is extremely important so that regulators can work with your health plan to come into compliance with state law. You should also file a complaint if you have any other problems accessing PrEP through your health plan.

Millions of people are still struggling to pay rent amid the COVID-19 pandemic. On August 31, Governor Newsom signed Assembly Bill 3088 into law to extend protections against eviction for renters until February 1, 2021.

The initial statewide eviction moratorium expired on midnight of September 1, but the new law protects tenants who declare an inability to pay all or part of their rent due to a COVID-19-related reason. Tenants are still responsible for paying unpaid rent, but the new law states that tenants cannot be evicted for rent owed due to a COVID-19-related hardship that occurred between March 4 – August 31, if the tenant provides a declaration of hardship as outlined in the law.

For hardship that occurs between August 31 – January 31, tenants must pay at least 25 percent of the rent due to avoid eviction. Landlords may begin to recover debt beginning March 1, 2021. The law also extends anti-foreclosure protections to small landlords and creates new accountability and transparency provisions. You can read a summary of the law here. In Los Angeles County, the Board of Supervisor’s eviction moratorium is still in place through September 30, but the County will likely issue new guidance to align with the State.

Coupled with the new law, Governor Newsom announced a new campaign and webpage called Housing is Key that aims at connecting renters and landlords experiencing economic hardship due to COVID-19 with helpful information and resources.

The Governor noted that the law is meant to be a bridge while the legislature works on a more permanent solution and that he hopes there will be federal assistance to stabilize the housing market. The National Low Income Housing Coalition (NLIHC) estimates that approximately 5.4 million Californians are at risk of eviction, with Black and Latinx communities disproportionately at risk, so whether federal assistance arrives or not, it is critical that the Governor and legislature find a solution to ensure that millions of people do not fall into homelessness in the coming year.

At the federal level, the Centers for Disease Control (CDC) recently issued an Agency Order to halt residential evictions through December 31, 2020. The Governor stated in his press conference this week that the CDC’s order does not impact California because our state-level protections are stronger and extend longer than the federal ones.

If you are in need of housing assistance, or are at risk of experiencing homelessness, please reach out to APLA Health for more information and to schedule an appointment with one of our housing specialists. Call 213-201-1637 or send an email to bbrown@apla.org.