May 30, 2023 - Presented to: Assembly Committee on Health Assembly Budget Subcommittee No. 1 on Health and Human Services
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.
February 9, 2022 - This brief analyzes the Governor’s budget proposal for Medi-Cal. We include an analysis of the administration’s caseload projections, provide options for renewing the managed care organization tax (that the Governor proposes to let expire), and provide our assessment of the discretionary budget proposals to provide equity and practice transformation payments and eliminate certain existing provider payment reductions.
May 14, 2019 - The Governor’s May Revision includes Medi-Cal spending of $19.7 billion from the General Fund ($93.4 billion total funds) in 2018-19 and $23 billion from the General Fund ($102.2 billion total funds) in 2019-20. As will be described in this post, about half of the reduction in estimated spending in 2018-19 reflects a shift of costs in Medi-Cal to a different budget item, rather than a true reduction in estimated program costs. After accounting for this shift, the May Revision is about $350 million below January estimates across 2018-19 and 2019-20.
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.
October 23, 2023 - This post summarizes overall spending in the 2023-24 budget package for health programs. It is part of our California Spending Plan series, which contains posts focused on each major sector of the state budget.
February 10, 2023 - This brief provides an overview of the Governor’s proposed budget for Medi-Cal, assesses the administration’s assumptions on caseload and COVID-19-related policies, and analyzes the Governor’s managed care organization tax proposal.
December 7, 2023 - This post provides our annual fiscal outlook for General Fund spending in Medi-Cal. It summarizes our projections, describes the major factors driving our projections, and highlights key uncertainties.
June 3, 2019 - Presented to: Budget Conference Committee
December 21, 2018 - This post describes recent national developments pertinent to the reauthorization of California’s managed care organization (MCO) tax. The state’s prospects for receiving federal approval—which initially were uncertain—appear to be improved following the recent federal approval of a health insurer tax in Michigan that is structured similarly to California’s MCO tax.
May 14, 2018 - In this post, we describe and provide our initial comments on adjustments to the Medi-Cal budget in the 2018-19 May Revision.
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.
October 16, 2023 - This publication provides a preliminary overview of the 2023-24 Budget Act, gives a brief description of how the budget process unfolded, and then highlights major features of the budget.
May 28, 2020 - Presented to the Senate Budget and Fiscal Review Committee
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.