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The 2019-20 Budget: The Governor's Individual Health Insurance Market Affordability Proposals


Handout

[PDF] Funding and Implementing Individual Health Insurance Market Affordability Policies

February 12, 2019 - Presented to: Assembly Health Committee, Assembly Budget Subcommittee No. 1 on Health and Human Services, Senate Committee on Health, and Senate Budget and Fiscal Review Subcommittee No. 3 on Health and Human Services

Report

The 2022-23 Budget: Health Care Access and Affordability

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.

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Governor’s May Revision Update: Health Insurance Affordability Proposals

May 15, 2019 - With the May Revision (and prior to the May Revision with the release of proposed implementing legislation), the administration has provided additional details on its January proposal to impose a state individual mandate and use penalty revenues from the mandate to fund health insurance subsidies. In this post, we summarize key updates to the Governor’s proposals and raise some issues for the Legislature’s consideration.

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The 2019-20 Budget: California Spending Plan—Health and Human Services

October 17, 2019 - From the General Fund, the 2019-20 spending plan provides $26.4 billion for health programs and $15.5 billion for human services programs—an increase of 18 percent and 12.6 percent, respectively, over estimated 2018-19 General Fund spending in these two policy areas. Major health-related policy actions include the reauthorization of a tax on managed care organizations (which will reduce the above-noted General Fund health spending by $1 billion, pending federal approval) and over $400 million General Fund for state-funded subsidies for health insurance purchased on the individual market through Covered California. Major human services-related policy actions include General Fund support to increase CalWORKS cash grants and most developmental services provider rates, and to restore previously reduced service hours in the In-Home Supportive Services program. The spending plan also reflects the deposit of $700 million into a safety net reserve (bringing its balance to $900 million) that can be used for future CalWORKs and/or Medi-Cal expenditures.

Report

Issues That Could Impact Californians' Health Care Coverage in 2023 and Beyond

December 16, 2022 - This brief looks at health care coverage in California; provides background on the drivers of the significant decline in the percentage of Californians without health care coverage over the last ten years; and discusses various issues that could impact the number of Californians with coverage, and how the type of coverage they have may change, in calendar year 2023 and beyond.

Handout

[PDF] Financing Considerations for Potential State Healthcare Policy Changes

February 5, 2018 - Assembly Select Committee on Health Care Delivery Systems and Universal Coverage.

2/5/18: Correction to Figure 3.

Report

[PDF] The 2019-20 Budget: Overview of the Governor's Budget

January 14, 2019 - This report presents our office’s initial assessment of the Governor’s Budget. The budget’s position continues to be positive. With $20.6 billion in discretionary resources available, the Governor’s budget proposal reflects a budget situation that is even better than the one our office estimated in the November Fiscal Outlook. The Governor’s Budget allocates nearly half of these discretionary resources to repaying state liabilities. Then, the Governor allocates $5.1 billion to one-time programmatic spending, $3 billion to reserves, and $2.7 billion to ongoing spending. Although the Governor’s allocation to discretionary reserves represents a smaller share of resources than recent budgets, the Governor’s decision to use a significant share of resources to pay down state debts is prudent. The Governor’s ongoing spending proposal is roughly in line with our November estimate of the ongoing capacity of the budget under an economic growth scenario. This was just one scenario, however. Recent financial market volatility indicates revenues could be somewhat lower than either we or the administration estimated.

Report

[PDF] The Uncertain Affordable Care Act Landscape: What It Means for California

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.

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The 2023-24 Budget: Assessment of Covered California Budget Solution

February 13, 2023 - This post provides background on state and federal premium subsidies for Covered California before providing an overview and assessment of the Governor’s proposed budget solution regarding the California Premium Subsidy program.

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[PDF] The 2017-18 Budget: Analysis of the Medi-Cal Budget

March 9, 2017 - In California, the federal‑state Medicaid program is administered by the Department of Health Care Services (DHCS) as the California Medical Assistance Program (Medi‑Cal). Medi‑Cal is by far the largest state‑administered health services program in terms of annual caseload and expenditures. In this report, we provide an analysis of the administration’s caseload projections, including a discussion of the projected increases in ACA optional expansion caseload. We also provide an assessment of several aforementioned major factors affecting projected changes in Medi‑Cal spending in 2017‑18 and other policy changes proposed by the administration. These include the Governor’s proposed uses of Proposition 56 revenues, the proposal to shift additional New Qualified Immigrants (NQIs) to Covered California in 2017‑18, assumptions around federal CHIP funding, and the proposed abolition and transfer of the Major Risk Medical Insurance Fund (MRMIF).

Handout

[PDF] California Fiscal Impact of Overturning the ACA

October 21, 2020 - Senate Health Committee

Updated 11/13/2020.

Handout

[PDF] What the Patient Protection and Affordable Care Act (ACA) Means for California

March 22, 2017 - Presented to Assembly Budget Subcommittee No. 1 On Health and Human Services and Assembly Health Committee

Handout

[PDF] The Governor's Health Care Plan: State Fiscal Risks and Issues--October 2007

October 31, 2007 - Presented to Assembly Health Committee, Mervyn M. Dymally, Chair

Report

[PDF] The Patient Protection and Affordable Care Act: An Overview of Its Potential Impact on State Health Programs

May 13, 2010 - The Patient Protection and Affordable Care Act (PPACA), often referred to as federal health care reform, is far-reaching legislation that will change how millions of Californians access health care coverage. We provide an overview of the new law and describe its implications for state health programs in the near term and the long term. We also recommend the Legislature think broadly about implementing PPACA and identify key issues to address including: (1) future costs for health programs, (2) whether structural changes to health programs are warranted, (3) whether PPACA should prompt a reevaluation of the state-local relationship, (4) new strategies that could bolster health care quality and outcomes, and (5) how future workforce and health infrastructure needs should be addressed.

Letter

[PDF] Letter to the Honorable Bill Emmerson Regarding Bridge Plan

March 18, 2013 - Letter to the Honorable Bill Emmerson Regarding Bridge Plan.