Biden has also said he would work to restore women's access to abortion and other reproductive health services, reversing a four-year effort by the Trump administration to restrict abortion and shift federal money to organizations like so-called crisis pregnancy centers that don't offer a full range of family-planning services.
"If this administration has a second term, I'm afraid it will have grave impact on Californians' access to sexual and reproductive health," warned Julie Rabinovitz, president of Essential Access Health, a leading family-planning advocate.
The most visible sign of California's health care progress is the expansion of coverage fueled by the state's decision to expand Medicaid eligibility and build Covered California, the state's insurance marketplace.
Although insurance premiums have risen for some Californians as access has expanded, medical care has also become more affordable for many. Between 2013 and 2017, the share of Californians who skipped care in the previous year because of cost dropped by a quarter, according to data from the nonprofit Commonwealth Fund.
The insurance gains also translated into better care for many Californians, said Thomas Priselac, a leading hospital executive in the state who has headed the Cedars-Sinai Health System in Los Angeles for more than 25 years. "Quality medical care starts with having access to it," he said.
California's coverage expansion has had broader effects as well, driving profound changes in how patients — rich and poor — receive care.
At Northeast Valley Health Corp., a network of clinics serving low-income patients in the San Fernando and Santa Clarita valleys, doctors and nurses now work with clinical pharmacists to help diabetics better manage their blood sugar, a change the health care law helped bring about.
The clinics have also added care coordinators to keep track of patients with chronic diseases and prevent them from ending up in the hospital or emergency room.
"The Affordable Care Act was terrific in helping us serve more patients," said Kim Wyard, Northeast Valley Health's chief executive. "Also embedded in it was this sense of transforming the health care system."
At Mission Hospital, a community hospital off the San Diego Freeway in Mission Viejo, yet another transformation is underway, this one in how women give birth.