February 7, 2019 - This report provides our assessment of the Governor's proposals to (1) create a state requirement that most Californians purchase health insurance coverage (referred to as an "individual mandate") or pay a financial penalty and (2) use the revenues from this penalty to fund additional health insurance subsidies for households purchasing coverage through Covered California.
March 18, 2013 - Letter to the Honorable Bill Emmerson Regarding Bridge Plan.
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.
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.
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.
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
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).
February 5, 2018 - Assembly Select Committee on Health Care Delivery Systems and Universal Coverage.
2/5/18: Correction to Figure 3.
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
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.
February 17, 2012 - As part of the 2012-13 budget, the Governor proposes to reduce the negotiated rates paid to Healthy Families Program (HFP) managed care plans and shift the children enrolled in HFP to Medi-Cal over a nine-month period. In this report, we provide background information on HFP and Medi-Cal and how they will be affected by implementation of federal health care reform. We discuss the potential merits of the Governor’s proposal, but raise several implementation issues and concerns. Specifically, the savings in the budget year may be less than the administration’s estimates, and the proposal will disrupt healthcare services for some HFP enrollees and may impact access to providers. Finally, we make recommendations that encourage the consideration of alternatives to the Governor’s plan.
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.
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.