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The 2025-26 Budget: Understanding Recent Increases in the Medi-Cal Senior Caseload


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Model for Health Coverage of Low-Income Families

June 2, 1999 - Roughly two million low-income children and their parents, primarily in working families, do not have health coverage in California. We have developed a “Family Coverage Model” which would result in an additional 0.9 million to 1.4 million persons obtaining health coverage at an annual cost of $188 million to $385 million annually when fully implemented.

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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.

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The 2025-26 Budget: Medi-Cal Fiscal Outlook

November 20, 2024 - 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.

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[PDF] 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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The 2024-25 Budget: Medi-Cal Fiscal Outlook

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.

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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.

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The 2023-24 Budget: Medi-Cal Fiscal Outlook

November 16, 2022 - This brief 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 several uncertainties.

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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).

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[PDF] The 2016-17 Budget: Analysis of the Medi-Cal Budget

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.

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The 2025-26 Budget: In-Home Supportive Services

March 6, 2025 - This post provides an overview of the Governor’s proposed 2025-26 budget for In-Home Supportive Services, provides updates on some of the most recent prior-year policy changes, and raises questions and issues for the Legislature to consider.

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[PDF] The 2014-15 Budget: Analysis of the Health Budget

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.

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The 2024-25 Budget: In-Home Supportive Services

February 29, 2024 - In this post, we provide some background on the In-Home Supportive Services (IHSS) program, an overview of the Governor's 2024-25 budget proposals and assumptions for IHSS, and offer relevant issues for legislative consideration.