The California Health Care Affordability Board convened on October 29, 2024, to discuss critical issues surrounding the definition of primary care, particularly the exclusion of obstetricians and gynecologists (OB GYNs) from this classification. The meeting highlighted significant concerns from various stakeholders regarding the implications of this exclusion on women's health care access.

Richard Pan, a board member, emphasized the importance of including OB GYNs in the primary care discussion, arguing that many women rely on these specialists for essential health services. He pointed out that the current health care system often presents barriers, such as long wait times and high deductibles, which disproportionately affect women's access to care. Pan urged the board to reconsider the exclusion, noting that it could lead to a loss of vital services for women and girls.

Ryan Spencer, representing the American College of OB GYNs, echoed these sentiments, expressing frustration over the lack of a clear recommendation for including OB GYNs in the primary care definition. He highlighted that excluding these providers could result in reduced support for the essential services they offer, particularly preventative care. Spencer argued that many women view OB GYNs as their primary care providers, especially during pregnancy, and that the current definition fails to recognize this reality.

Kate, a virtual participant, reinforced the argument by stating that ignoring the role of OB GYNs in women's health care perpetuates a long-standing trend of neglecting women's health needs in medical research and policy. She criticized the board for potentially continuing this trend by not adequately addressing the inclusion of OB GYNs in primary care discussions.

In contrast, Vanessa Kahina from the California Academy of Family Physicians supported the board's current definition, suggesting that while OB GYNs provide essential services, they do not coordinate comprehensive primary care across various health systems. She argued that the focus should be on measuring coordinated care rather than individual services.

Janice Rocco from the California Medical Association expressed opposition to the exclusion of OB GYNs, highlighting the philosophical and data-related challenges that have hindered progress on this issue. She pointed out the inconsistency in how similar services provided by different types of providers are treated under the proposed definition.

The meeting concluded with a clear call for further discussion and data collection to address the complexities surrounding the inclusion of OB GYNs in primary care definitions. The board's decisions in this area will have significant implications for women's health care access and the overall landscape of primary care in California.