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February 17, 2021 - This post analyzes the Governor’s proposal in the Department of Health Care Services to provide $200 million General Fund ($400 million total funds) one time to provide incentive payments to Medi-Cal managed care plans to increase the number of students receiving behavioral health services.
February 17, 2021 - This post analyzes, and provides recommendations to the Legislature on, the 2021-22 Governor’s Budget proposal for the Department of Health Care Services to continue the replacement of several Medi-Cal information technology systems and to plan the modernization of the remaining systems under a new effort called the Medi-Cal Enterprise System Modernization.
February 16, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the second in a series assessing different aspects of the Governor’s proposal—analyzes CalAIM financing issues, including both the Governor’s funding plan for CalAIM as well as CalAIM’s policy changes related to Medi-Cal financing.
February 16, 2021 - This post analyzes the major adjustments to the Medi-Cal budget in 2020-21 and 2021-22, with a focus on the technical adjustments such as the administration’s caseload estimates. We will further analyze the major discretionary Medi-Cal proposals in separate publications and communications to the Legislature.
February 9, 2021 - The California Advancing and Innovating Medi-Cal (CalAIM) proposal is a set of reforms to expand, transform, and streamline Medi-Cal service delivery and financing. This post—the first in a series assessing different aspects of the Governor’s proposal—provides a brief overview of CalAIM, summarizes key changes from last year’s withdrawn proposal, and analyzes overarching issues related to CalAIM.
February 8, 2021 - Presented to: Assembly Budget Subcommittee No.1 On Health and Human Services Hon. Dr. Joaquin Arambula, Chair
February 5, 2021 - This publication describes how coronavirus disease 2019 (COVID-19) spending is reflected in the California Department of Public Health’s budget. It offers options for how the Legislature can express its COVID-19-related goals and priorities in light of the administration’s reliance on midyear budget adjustments, provides an evaluative framework for assessing the administration’s proposals, and recommends an after-action review of the state’s public health response.
November 18, 2020 - Medi‑Cal, the state’s Medicaid program, provides health care coverage to about 13 million of the state’s low‑income residents. Medi‑Cal costs generally are shared between the federal and state governments. In a typical year, the General Fund covers a little more than 20 percent of total Medi‑Cal costs, with federal funds and other state and local funds respectively covering the remaining 65 percent and 15 percent of total costs. In this web post, we describe the major factors that we expect to drive changes in General Fund spending in Medi‑Cal over the near term—in 2020‑21 and 2021‑22—and over the longer term through 2024‑25. We also describe a number of key assumptions that we made in our spending projections.
November 5, 2020 - This post provides a high-level summary of state and federal funds provided to date to respond to the coronavirus disease 2019 (COVID-19). In this post we discuss: (1) the authorities, at both the state and federal levels, for COVID-19 spending; (2) the state, federal, and other funding sources for COVID-19 spending; and (3) the amounts of COVID-19 spending authorized so far, organized by different purposes and program areas.
Updated 11/12/20: State and federal government spending on certain activities to control the spread of COVID-19 revised upward to $8.6 billion.
October 21, 2020 - Senate Health Committee
Updated 11/13/2020.
October 15, 2020 - From the General Fund, the 2020-21 spending plan provides $26.7 billion for health programs—an increase of 3 percent over estimated 2019-20 General Fund spending for these programs. The year-over-year net increase in General Fund spending is largely due to the projected COVID-19-related increase in the Medi-Cal caseload. The post describes major health-related actions (both policy actions and various budget adjustments) adopted by the Legislature as part of its 2020-21 spending plan. These actions include the offsetting of what would otherwise be General Fund costs with (1) revenues from the federally approved reauthorized tax on managed care organizations and (2) federal Medicaid funds that are being provided to the state at an enhanced level during the term of the public health emergency.
September 21, 2020 - This Budget and Policy post is intended to notify the Legislature of the federal government’s recent decision to withdraw the proposed Medicaid Fiscal Accountability Regulation (MFAR), proposed in 2019. If finalized as proposed, MFAR could have resulted in the loss of billions of dollars in non-General Fund funding for Medi-Cal on annual basis. Withdrawal of the regulation means that a major, near-term state fiscal risk has been averted.
May 22, 2020 - This post provides our analysis of the Governor’s May Revision projections related to Medi-Cal caseload. The May Revision assumes significant General Fund cost increases related to projected increases in Medi-Cal caseload due to the deteriorating economic environment caused by the coronavirus disease of 2019 (COVID-19). As we describe below, we find that the administration’s assumed caseload costs in Medi-Cal are likely significantly overstated and recommend a downward reduction to the Medi-Cal budget of $750 million General Fund across 2019-20 and 2020-21.
May 19, 2020 - Assembly Budget Subcommittee No. 1 on Health and Human Services