California Attorney General Xavier Becerra has ordered three California hospitals to pay out millions of dollars to local nonprofits, declining their requests to be freedfrom charity obligations required under state law.

These days, when the federal government turns in one direction, California veers in the other — and in the case of health care, it’s a sharp swerve.

The fight over third-party premium assistance for dialysis patients is heating up this week in California and Washington, D.C. as employers and labor unions get involved.

A bill that would expand health care coverage to undocumented adults has moved forward in the California state Assembly, part of a push by Democratic lawmakers to create universal coverage, after a single-payer bill stalled last year.

There are already more than a dozen reasons people can use to avoid paying the penalty for not having health insurance. Now the federal government has added four more “hardship exemptions” that let people off the hook if they can’t find a marketplace plan that meets not only their coverage needs but also reflects their view if they are opposed to abortion.

California hospitals are on edge over a bill dropped late Monday that would mandate regulated rate-setting for providers. The measure would use Medicare rates as the benchmark to calculate commercial insurer payments, and would cost state hospitals $18 billion in the first year alone, according to preliminary projections.