February 22, 2005 - We discuss several of the most significant spending proposals in the budget.
February 11, 2004 - California's program for substance abuse treatment services to Medi-Cal beneficiaries, known as Drug Medi-Cal, provides a patchwork of services with an inconsistent level of support for different modes of treatment and for different treatment populations. In this report, we recommend an approach for addressing these concerns which would provide greater authority and resources for community-based services, contain the fast-growing costs of methadone treatment, and integrate a new and potentially more cost-effective mode of treatment into Drug Medi-Cal that does not require a net increase in state General Fund resources.
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 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.
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.
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 6, 2009 - The Governor's budget for 2008‑09 proposes to hold General Fund spending on health programs virtually flat compared to the current-year spending level. However, based on our review of the available draft legislation, it appears that the federal stimulus package will provide substantial fiscal relief to California in the form of enhanced contributions to the state’s Medi-Cal Program. At the time this analysis was prepared, Congress also appeared to be close to agreement on federal legislation that would reauthorize the State Children’s Health Insurance Program (SCHIP). We recommend that the state forego at this time an option available under the new federal legislation to expand children’s coverage up to 300 percent of the federal poverty level because of the state’s current fiscal condition. We also propose seeking voter approval for modifications to Proposition 99, a 1988 initiative approved by voters, to “unlock” spending now earmarked for certain Proposition 99 programs, a step that could allow the Legislature to achieve substantial General Fund savings in the budget year.
February 14, 2024 - This brief provides an overview of the Governor’s proposed budget for Medi-Cal; describes key trends in Medi-Cal caseload; and analyzes proposals around the managed care organization tax, provider payment increases, and other budget solutions.
February 24, 2005 - Analysis of the 2005-06 Budget Bill, Health and Social Services Chapter
November 20, 2019 - This web post provides detail on our projections and assumptions related to General Fund spending in Medi-Cal for the years 2019-20 through 2023-24. In the near term, we project Medi-Cal spending to grow to $23.5 billion in 2020-21. Over the long term, we project General Fund spending in Medi-Cal to grow to up to $27.6 billion.
In addition to this report, you can find the main California's Fiscal Outlook report along with a collection of other fiscal outlook material on our fiscal outlook budget page.
February 20, 2002 - California hospitals face significant financial pressures in the next several years, particularly from recent federal regulations limiting the amount the state can pay public hospitals participating in Medi-Cal. We recommend steps the Legislature could take even in difficult fiscal times to deal with problems faced by hospitals.
February 13, 2019 - In this report, we describe the major changes and proposals in the Governor's proposed $100.7 billion (all funds) Medi-Cal budget. Specifically, we advise the Legislature to seriously consider renewing the managed care organization tax, despite the Governor not proposing to do so; present issues for consideration related to the Governor's proposed expansion of comprehensive Medi-Cal coverage for young adults regardless of immigration status; and provide an initial assessment of the Governor's proposals to use Proposition 56 funding in Medi-Cal to extend and expand provider payment increases. We recommend approval of the Governor's proposals to improve fiscal oversight of the Medi-Cal budget, and also recommend that the Legislature require the administration provide additional information to the Legislature in an effort to improve fiscal oversight and transparency of this very large, complex budget going forward.
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.
August 8, 2002 - We discuss the reasons for the recent withdrawals of health coverage by health maintenance organizations (HMOs) from rural areas and recommend a number of steps that we believe will create a more attractive health care marketplace for HMOs. In those rural areas where these steps are not enough to attract HMOs, we identify ways communities can develop their own health care systems.
February 18, 1997 - Analysis of the 1997-98 Budget Bill, Health and Social Services Chapter