To browse all LAO publications, visit our Publications page.
November 17, 2021 - This post describes our fiscal outlook for Medi‑Cal, the major factors that we expect to drive changes in General Fund spending in Medi Cal, and a number of our key underlying assumptions. (Specifically, this post concerns projections of Medi‑Cal local assistance spending within the Department of Health Care Services [DHCS].)
November 9, 2021 - Examines Medi-Cal enrollment of Department of Developmental Services (DDS) consumers and the fiscal effect that additional Medi-Cal enrollment would have on the DDS budget and on state costs overall.
Correction 11/19/21: Corrected average annual per person fee-for-service cost in Medi-Cal.
October 27, 2021 - As part of the 2021‑22 spending plan, the administration and the Legislature agreed to spend $6 billion ($1.7 billion General Fund) over three fiscal years (starting in 2021‑22) on broadband infrastructure. Of the $6 billion, $4.372 billion is appropriated in 2021‑22—$4.322 billion in federal American Rescue Plan (ARP) fiscal relief funds and $50 million General Fund. This post details the key actions and events that preceded the 2021‑22 budget agreement, outlines the agreement (including a breakdown of the 2021‑22 appropriations), and describes key components of accompanying changes in state law—Chapter 112 of 2021 (SB 156, Committee on Budget and Fiscal Review). We note that while the administration and the Legislature are considering other broadband-related changes through administrative action and the legislative policy process, this post focuses on broadband infrastructure funding in the spending plan.
October 22, 2021 - The spending plan provides $33.7 billion General Fund for health programs. This is an increase of $6.7 billion, or 25 percent, compared to the revised 2020‑21 spending level. This year-over-year increase primarily is due to significant growth in projected General Fund spending in Medi-Cal. About two-thirds of the increase in General Fund Medi-Cal spending reflects technical budget adjustments (for example, adjustments due to projected caseload increases), while the remaining one-third reflects a large number of discretionary policy augmentations.
October 5, 2021 - Assembly Committee on Health
June 11, 2021 - The Governor’s May Revision includes several proposals related to child welfare, including some updates to proposals included in the January Governor’s budget as well as some new proposals. This post provides an overview of the major May Revision proposals for child welfare in addition to our initial analysis and comments on these proposals. We note that these comments reflect our understanding of the May Revision proposals as of June 1, 2021.
May 24, 2021 - The administration’s 2021-22 May Revision proposes up to $7 billion (federal and state funds) over two fiscal years to fund state broadband infrastructure projects and programs. In this post, we provide our preliminary comments on this proposal, reflecting our understanding of the proposal as of Sunday, May 23, and provide options for legislative consideration.
May 24, 2021 - In this post, we provide our preliminary comments on the Governor’s 2021-22 May Revision behavioral health proposals. We first provide an overview of the Children and Youth Behavioral Health Initiative proposal. We then provide some overarching comments on both (1) the initiative overall and (2) specific proposals within the initiative. We then provide an overview of the May Revision updates to the Behavioral Health Continuum Infrastructure proposal, our comments on the adjustments made to this proposal, and remaining outstanding questions we have on this proposal.
May 24, 2021 - The revised 2021-22 Department of Developmental Services budget at May Revision includes $6.6 billion General Fund ($10.7 billion total funds), a 1.6 percent increase in General Fund spending from the budget proposed in January. This increase is driven in large part by a number of new policy proposals totaling approximately $80 million General Fund. In this post, we provide comments on one of the key policy proposals.
May 21, 2021 - In this post, we provide our preliminary comments on the Governor’s 2021‑22 May Revision proposal for Medi‑Cal. We first provide an overview of the proposal, noting the major changes made relative to the Governor’s January budget, as well as changes made to estimated 2020‑21 spending relative to the January estimates. We then describe, and provide our comments on, the Governor’s proposal to augment the January proposal for the California Advancing and Innovating Medi‑Cal (CalAIM) package. We follow with descriptions of, and comments on, the Governor’s modified telehealth policy proposal, the proposal to extend full‑scope Medi‑Cal coverage to older undocumented immigrants, and the proposal to use American Rescue Plan Act funding to provide financial relief for designated public hospitals.
May 17, 2021 - On May 14, 2021, Governor Newsom presented a revised state budget proposal to the Legislature. (This annual proposed revised budget is called the “May Revision.”) In this post, we provide a summary of the Governor’s revised budget, focusing on the overall condition and structure of the state General Fund—the budget’s main operating account. In the coming days, we will analyze the plan in more detail and provide additional comments in hearing testimony and online.
May 13, 2021 - This budget series post provides an overview of the Governor’s January budget proposal for an ongoing, post-pandemic Medi-Cal telehealth policy; an assessment of the Governor’s proposal; and issues for legislative consideration.
May 7, 2021 - This post describes how coronavirus disease 2019 has affected access to health care in California through the earliest months of 2021. Contrary to expectations in light of the high level of pandemic-induced job losses, we find that health care coverage has either remained steady or potentially increased during the pandemic. We explore reasons why health care coverage trends have defied expectations. However, health care employment and utilization both declined significantly, particularly in the early months of the pandemic. Although access to care is trending toward pre-pandemic levels, continued monitoring of these trends is warranted. We provide several policy options that the Legislature could consider for sustaining and improving access to care, such as funding or making policy changes to address a deficit in children’s preventive services that has arisen among Medi-Cal-enrolled children during the pandemic.
May 6, 2021 - On March 11, 2021, the President signed into law the American Rescue Plan Act of 2021 (ARP Act)—a $1.9 trillion coronavirus disease 2019 relief package. This post highlights the health-related provisions of the ARP Act that provide significant funding directly to state/local health care and public health agencies, rural hospitals, home- and community-based services programs, subsidized individual market health coverage programs, and public behavioral health services. Where possible, based on currently available information, we provide an estimate of the funding allocations to California governments and other entities in the state. While this post reflects our best understanding of the high-level content and implications of this legislation as of late April, we will update the post as new information and clarifications become available.
May 5, 2021 - This budget and policy post responds to legislative requests for our office to estimate the costs of expanding comprehensive Medi-Cal coverage to all otherwise eligible Californians regardless of their immigration status. We estimate that nearly one million undocumented immigrants would gain full coverage under this expansion. Assuming a January 1, 2022 implementation, we estimate that the additional cost of expansion would be $790 million General Fund ($870 million total funds) in 2021-22. On an ongoing basis, we estimate the additional cost of the expansion would be $2.1 billion General Fund (nearly $2.4 billion total funds). Both our caseload and cost estimates are subject to significant uncertainty and rest on a number of key assumptions. Moreover, our ongoing estimates would be expected to change over time with medical inflation and changes in caseload and utilization.