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February 22, 2017 - Proposition 56 was approved by voters in November 2016 to increase taxes on cigarettes and other tobacco products. Questions have been raised as to whether the Governor’s proposals for allocating Proposition 56 revenues meet the initiative’s requirement to supplement—and not supplant—existing spending in several areas. To examine these questions, we begin by reviewing the provisions of Proposition 56 and the Governor’s budget proposals. We then discuss whether the Governor’s proposals for Medi‑Cal could be viewed as supplanting General Fund resources and identify the relevant case law. We conclude by describing some trade‑offs for the Legislature to consider in allocating the Proposition 56 revenues.
February 17, 2017 - Summarizes the major impacts that the ACA has had in California, explores what the ACA’s repeal could mean for the state, and assesses a collection of policy alternatives to the ACA that the new federal administration and Congress are currently considering.
Correction 3/6/17: Removed reference to Alpine County as having only one participating insurer.
November 28, 2016 - This report presents the results of our projections to inform the Legislature and stakeholders about levels of disability and the potential need for long–term supports and services (LTSS) among California’s seniors over the next several decades. These projections provide a useful starting point in understanding how California’s changing population demographics will impact the LTSS delivery system. The results presented in this report can also be built upon with further analysis focused on utilization and financing of LTSS over the long term.
June 14, 2016 - Presented to: Assembly Health Committee Assembly Revenue and Taxation Committee Senate Health Committee
May 25, 2016 - Presented to: Assembly Health Committee and Senate Health Committee
May 10, 2016 - Presented to: Assembly Health Committee and Senate Health Committee
March 4, 2016 - The Governor’s 2016-17 budget proposes $3.8 billion from the General Fund for Department of Developmental Services (DDS) programs—a 7.5 percent increase over 2015-16 estimated expenditures. This report focuses on the Governor's major policy-driven spending augmentations in the community services program. This report also summarizes legislation enacted as part of the recent special session that provides significant additional funding to the community services program and considers the Governor’s January proposals in this context.
February 18, 2016 - The 2016-17 Budget: Overview of Governor’s Proposals to Implement the Medical Marijuana Regulation and Safety Act
February 11, 2016 - In this report, we provide an analysis of the administration’s caseload projections, as well as a discussion of the impacts of the ACA on the ability to project caseload. We also provide an assessment of several General Fund cost pressures on the horizon in Medi–Cal, including the sunset of the hospital QAF.
December 17, 2015 - Presented to: Conference Committee on SBX2 2 and ABX2 1, Second Extraordinary Session
December 1, 2015 - Conference Committee on SB X2 2 and AB X2 1, Second Extraordinary Session
October 13, 2015 - Earlier this year, California submitted a proposal to renew its Section 1115 waiver, which is due to expire at the end of October. The state is currently negotiating with the federal government over the terms and conditions of this waiver renewal. In this post, we examine key issues and concerns related to the availability of federal funding for California’s proposal. The post provides a primer on how Section 1115 waivers are generally financed, an overview of California’s proposal, and a discussion of the challenges the proposal faces within that financing structure.
October 9, 2015 - This is the first in a series of policy posts on upcoming changes in Medi-Cal and the fiscal and policy uncertainty the changes create. In this post, we briefly highlight four upcoming major changes: (1) the renewal of the state’s Section 1115 waiver, (2) proposed modifications to the federal government’s regulations for Medicaid managed care plans, (3) the phase-in of state’s share of cost for the Affordable Care Act’s optional expansion population, and (4) the need to restructure the managed care organization tax to meet federal requirements. In the coming weeks and months, we will provide more detail and updates on these changes and their potential implications for the Medi-Cal program and the state’s budget in future policy posts similar to this one and in budget analyses.
August 18, 2015 - Presented to: Senate Committee on Public Health and Developmental Services.
July 20, 2015 - We compare two approaches to a restructured managed care organization (MCO) tax—the Governor’s tiered proposal versus a purely flat enrollment-based tax—in terms of their stability as a revenue source and overall financial burden placed on MCOs.