February 20, 2025 - This post provides an overview of the Governor’s proposed budget for the Department of Health Care Access and Information, analyzes a proposed diaper access initiative, and provides an implementation update on the CalRx program.
April 5, 2019 - This report analyzes one of the two initiatives included in the Governor's executive order: to transition the pharmacy services benefit in Medi‑Cal, the state’s largest low‑income health care program, from managed care to entirely a fee‑for‑service (FFS) benefit directly paid for and administered by the state.
February 17, 2005 - State agencies purchase about $4.2 billion annually in prescription and nonprescription drugs as part of their responsibilities to deliver health care services to their program recipients. Our review—which focused on 10 percent of these purchases—found several deficiencies in the state's procurement of drugs which lead to it paying higher costs than necessary. We make a number of recommendations to correct these procurement and administrative deficiencies which would, if implemented, generate savings totaling tens of millions of dollars annually.
February 10, 2005 -
Our analysis indicates that the Governor's California Rx plan for drug discounts for the uninsured provides a reasonable starting point for the development of such a program. However, we propose, among other changes, that in the event that drug makers fail to make good on their promises for significant price concessions, an automatic trigger would phase-out the proposed voluntary approach to obtaining rebates from drug manufacturers, and be replaced by an alternative strategy likely to result in greater discounts on more drugs for consumers.
A related report—Lowering the State's Costs For Prescription Drugs—which addresses the state's purchasing of drugs for its own programs, will be released shortly.
March 21, 2018 - This budget brief analyzes the Governor’s 2018-19 budget proposal to eliminate the use of the 340B Drug Pricing Program in Medi-Cal. The Governor’s proposed statutory changes are intended to generate state savings and reduce the administrative complexity of complying with federal law on duplicate discounts when 340B prescriptions drugs are dispensed to Medi-Cal enrollees. We find that the Governor’s proposal merits serious consideration from the Legislature since, among other benefits, it would likely result in state savings that the Legislature could, in turn, use to fund its priorities. We note, however, that these savings would be in place of savings currently enjoyed by eligible healthcare providers. Before making a decision on the Governor’s proposal, we recommend that the Legislature ask the administration to provide the following key information on the Governor’s proposal: (1) the amount of Medi-Cal savings that would be generated, (2) the impact on healthcare providers currently participating in the 340B Program, and (3) the trade-offs of alternative policy approaches to addressing the challenges that are present due to the use of the 340B Program in Medi-Cal.
October 15, 2020 - From the General Fund, the 2020-21 spending plan provides $26.7 billion for health programs—an increase of 3 percent over estimated 2019-20 General Fund spending for these programs. The year-over-year net increase in General Fund spending is largely due to the projected COVID-19-related increase in the Medi-Cal caseload. The post describes major health-related actions (both policy actions and various budget adjustments) adopted by the Legislature as part of its 2020-21 spending plan. These actions include the offsetting of what would otherwise be General Fund costs with (1) revenues from the federally approved reauthorized tax on managed care organizations and (2) federal Medicaid funds that are being provided to the state at an enhanced level during the term of the public health emergency.
February 20, 2008 - Analysis of the 2008-09 Budget Bill, Health and Social Services Chapter
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.