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Guest Post: SB 138 Keeps Young California’s Health Information Safe

By Vivian Nguyen

Even before the opening of state-based insurance marketplaces, like Covered California, on October 1, 2013, young adults in California were already benefiting from the federal health reform law. Thanks to a provision that requires insurers to cover dependents up to age 26, more than 435,000 young adults in California have been able to access care through their parent’s plan since 2011. California is also one of the few states expanding its Medicaid program, allowing thousands of previously uninsured young adults to gain coverage.

And young adults are making the most of their options — Covered California closed out its first week of business with a total of 987,440 unique visitors. The high volume of traffic signals an exceptionally strong demand for access to health care. But it’s not enough to simply meet this demand—we must also ensure that everyone with private health insurance feels safe enough to use it, especially for services that they need and use most. When young people don’t feel there are strong privacy protections in health care, they are less likely to seek care.

Prior to the passage of SB 138, there were real and frightening consequences for individuals who didn’t know that insurers could expose their sensitive health information. Another Young Invincible guest blogger shared her story of how she used her insurance for a pregnancy test. Luckily, it came back negative. However, her parents found out about the test from an Explanation of Benefits letter they received. Her relationship with her parents suffered as a result.

Stories like hers made it necessary for Governor Brown to sign SB 138 – The Confidential Health Information Act – into law last month. While California already has some of the nation’s strongest protections for sensitive medical information, loopholes allowed for confidentiality breaches in the form of routine health plan communications, like Explanation of Benefits letters that are sent to your policyholder (your parents if you’re under their plan) explaining what medical treatments and services were paid for under their insurance.

But now, with SB 138 signed into law:

  • Individuals insured under another person’s policy will have the option of submitting a confidential communications request to their health plan.
  • This means when receiving sensitive services like birth control, STD tests, and mental health care, health plans will have to send all routine communications regarding coverage of those services directly to you, the individual patient, not the policyholder.
  • Individuals who believe that disclosure of any information related to any health care service to the main policyholder could bring them harm are protected through confidential communications requests. This is particularly important for people who are experiencing or who have fled domestic violence.

Now that SB 138 is law, your health privacy is protected—in California. With SB 138, California has developed a model that other states can adopt in order to tackle a problem that advocates are trying to address nationwide. The law strikes a balance between protecting patient confidentiality and allowing health plans to send required communications to their enrollees.

The current and expected growth in the number of insured young adults under the Affordable Care Act is a momentous step forward. With SB 138, the promise of access to safe and quality health care can become a permanent reality for young adults in California and beyond.


Vivian Nguyen is the Strategic Communications Coordinator for California Family Health Council.  She is a graduate of UC Berkeley and is passionate about sexual and reproductive health access. Vivian enjoys café hopping, running and quoting “Arrested Development.”