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April 5, 2022 - This report contains four primary sections: (1) a description of the five key climate hazards affecting California, (2) the major ways those hazards impact sectors across the state, (3) significant existing state‑level efforts underway to address climate change impacts, and (4) key issues for the Legislature to consider in response to these impacts. This is one of a series of reports summarizing how climate change will impact different sectors across California.
March 29, 2022 - In this post, we provide an overview of the proposed 2022-23 Department of Developmental Services (DDS) budget and assess the three main new discretionary proposals. We then raise oversight issues for legislative consideration.
March 17, 2022 - This letter responds to the Assembly Rules Committee request for the LAO to analyze financing and other considerations related to AB 1400 (Kalra), which would create a single-payer health care delivery system known as “CalCare,” and ACA 11 (Kalra), which includes tax provisions related to the financing of CalCare.
March 10, 2022 - This post analyzes the Governor’s proposed Care Economy Workforce Development Package. We provide an assessment and recommendations for both the package as a whole and for two specific components of the package.
March 3, 2022 - This brief analyzes the Governor’s three major behavioral health budget proposals. We include analyses of the Governor’s proposals to (1) provide funding for behavioral health bridge housing, (2) provide funding to implement certain solutions developed by the felony incompetent to stand trial solutions workgroup, and (3) add mobile crisis intervention services as a new Medi-Cal benefit.
February 23, 2022 - This brief focuses on access to health insurance coverage and the affordability of health care costs. We (1) assess various Governor’s proposals intended to improve health care access and/or affordability—including expanding Medi-Cal eligibility to undocumented residents between ages 26, reducing Medi-Cal premiums to zero cost, establishing the Office of Health Care Affordability, and reducing the cost of insulin through a state partnership; (2) discuss options to improve affordability of health plans purchased through Covered California; and (3) highlight some key access and affordability challenges that remain to address.
Correction (2/24/22): Figure 2 - Number of undocumented residents has been corrected.
February 16, 2022 - This brief analyzes the Governor’s proposed spending plan for a $300 million ongoing General Fund augmentation for the California Department of Public Health, describes merits of the proposed plan and identifies ways it could be strengthened, and offers issues for legislative consideration.
February 10, 2022 - This post provides an update on the state's home- and community-based services spending plan, which was conditionally approved by the federal government in January 2022. We describe the quarterly updates the state will need to provide the federal government and ways to ensure legislative oversight over implementation of HCBS spending plan.
February 9, 2022 - This brief analyzes the Governor’s budget proposal for Medi-Cal. We include an analysis of the administration’s caseload projections, provide options for renewing the managed care organization tax (that the Governor proposes to let expire), and provide our assessment of the discretionary budget proposals to provide equity and practice transformation payments and eliminate certain existing provider payment reductions.
January 13, 2022 - On January 10, 2022, Governor Newsom presented his proposed state budget to the Legislature. In this report, we provide a brief summary of the proposed budget based on our initial review. In the coming weeks, we will analyze the plan in more detail and release several additional budget analyses.
Update (1/21/22): Includes a corrected estimate of Governor’s Budget proposals that are excludable under the State Appropriations Limit (SAL).
December 15, 2021 - Presented to: Assembly Committee on Judiciary Assembly Committee on Health
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 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