Health and Human Services Publications

The 2022-23 Budget: Health Care Access and Affordability

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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.

The 2022-23 Budget: Public Health Foundational Support

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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.

The 2022-23 Budget: Update on Home- and Community- Based Services Spending Plan

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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.

The 2022-23 Budget: Analysis of the Medi-Cal Budget

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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.

The 2022-23 Budget: Overview of the Governor's Budget

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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).

Overview of Funding for the Lanterman-Petris-Short Act

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December 15, 2021 - Presented to: Assembly Committee on Judiciary Assembly Committee on Health

The 2022-23 Budget: Medi-Cal Fiscal Outlook

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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].)

Enhancing Federal Financial Participation for Consumers Served by the Department of Developmental Services

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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.

The 2021-22 Spending Plan: Health

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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.

CDPH’s Licensing and Certification of SNFs

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October 5, 2021 - Assembly Committee on Health

The 2021-22 Budget: LAO Preliminary Comments on the Governor’s Major May Revision Behavioral Health Proposals

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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.

The 2021-22 Budget: Department of Developmental Services (DDS) May Revision Budget Proposal

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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.

The 2021-22 Budget: LAO Preliminary Comments on the May Revision Medi-Cal Budget

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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.

The 2021-22 Budget: Initial Comments on the Governor’s May Revision

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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.

The 2021-22 Budget: Analysis of the Governor’s Medi-Cal Telehealth Proposal

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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.