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.
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.
February 5, 2018 - Assembly Select Committee on Health Care Delivery Systems and Universal Coverage.
2/5/18: Correction to Figure 3.
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).
March 22, 2017 - Presented to Assembly Budget Subcommittee No. 1 On Health and Human Services and Assembly Health Committee
October 31, 2007 - Presented to Assembly Health Committee, Mervyn M. Dymally, Chair
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.
March 18, 2013 - Letter to the Honorable Bill Emmerson Regarding Bridge Plan.
March 22, 2017 - Presented to: Assembly Budget Subcommittee No. 1 on Health and Human Services and Assembly Health Committee
February 22, 2017 - Assembly Budget Subcommittee No. 1 on Health and Human Services
December 7, 2005 - Chapter 794, Statutes of 2002 (AB 1401, Thomson), directed the Legislative Analyst’s Office (LAO) to evaluate the effectiveness of the measure in providing heath care coverage to individuals who are otherwise unable to obtain health benefits (the "hard-to-insure"). While we found there is now only limited information available to assess the outcome of various aspects of AB 1401, we concluded the measure has increased the state’s capacity to help hard-to-insure individuals access health coverage using the same level of state resources. Based upon our evaluation, we present several recommendations to improve the program by potentially reducing its costs to enrollees and the state.
February 20, 2014 - The report analyzes the Governor's 2014-15 health budget proposals. In it, we (1) provide an analysis of the impact the implementation of the Patient Protection and Affordable Care Act (ACA)--known as federal health care reform--is having on the Medi-Cal program; (2) analyze the Governor's budget proposal to exempt certain, but not all, classes of Medi-Cal providers and services from retroactive recoupments of payment reductions; and (3) assess the fiscal outlook for the California Health Benefit Exchange, also known as Covered California.