The Uncertain Affordable Care Act Landscape: What It Means for California

Feb 17, 2017 - Reconstitute High‑Risk Pools Federal Funding for High ‑Risk Pools to Help Individuals With Costly Preexisting Medical Conditions Obtain Health Coverage. Another potential policy change with support from members of the new Republican congressional majority is the reconstitution of high ‑risk pools.
https://lao.ca.gov/Publications/Report/3569

The 2020-21 Budget: Analysis of the Medi-Cal Budget

Feb 14, 2020 - Finally, the administration has not clearly laid out how it determined amounts related to the new quality pool. This includes how the portion of the aggregate rate increase that would be allocated to the quality pool was determined.
https://lao.ca.gov/Publications/Report/4161

The 2019-20 Budget: The Governor's Individual Health Insurance Market Affordability Proposals

Feb 7, 2019 - First, the goal of the individual mandate penalty as a deterrent against people foregoing health insurance coverage is at odds with the goal of generating funds for insurance subsidies. Prioritizing the goal of deterrence would mean maximizing compliance with the mandate and minimizing penalty revenues, which would have the effect of reducing funding available for subsidies.
https://lao.ca.gov/Publications/Report/3927

Enhancing Federal Financial Participation for Consumers Served by the Department of Developmental Services

Nov 9, 2021 - Based on these factors, as well as discussions with DDS, we estimate that about half, at most, of the potential pool of children, or about 7, 000 c hildren, could enroll in Medi ‑Cal via institutional deeming.
https://lao.ca.gov/Publications/Report/4471

Section 1115 Waiver Renewal: Key Medi-Cal Financing Issues Remain Outstanding

Oct 13, 2015 - Under the Bridge to Reform, the federal government provides additional uncompensated care funding through the Safety Net Care Pool (SNCP). This includes annual capped payments to DPHs for uninsured costs that are not covered by DSH funding.
https://lao.ca.gov/Publications/Report/3301

The 2023-24 Budget: Whole Child Model Expansion

May 5, 2023 - For example, the shift in services to managed care results in a shift in supplemental payments for hospital outpatient CCS services from fee-for-service to a broader pool of managed care payments. This shift on net yields financial reductions to children ’s hospitals, which disproportionately serve CCS beneficiaries.
https://lao.ca.gov/Publications/Report/4767

Issues That Could Impact Californians' Health Care Coverage in 2023 and Beyond

Dec 16, 2022 - Increased coverage of younger, healthier populations leads to a more balanced insurance risk pool and allows the costs of covering higher ‑risk populations to be spread more broadly. This in turn reduces the average cost of  coverage.
https://lao.ca.gov/Publications/Report/4654

The 2019-20 Budget: Undoing California’s Outstanding Budgetary Deferrals

Mar 26, 2019 - The State Treasurer ’s Office (STO) invests state funds, including reserves, in the Pooled Money Investment Account (PMIA), generating an investment return. STO invests these funds in safe, short-term assets, like U.S.
https://lao.ca.gov/Publications/Report/3988

The 2019-20 Budget: Using Proposition 56 Funding in Medi-Cal to Improve Access to Quality Care

Feb 22, 2019 - Medi ‑Cal managed care plans use the pooled funding from their capitated rates to pay for the Medi ‑Cal services utilized by their members, as well as to pay for their administrative expenses. The portion of capitated rate funding that is not ultimately used to pay for health care services or administration is generally retained by the plans as profits, reserves, or used for other purposes.
https://lao.ca.gov/Publications/Report/3949

The 2022-23 Budget: Health Care Access and Affordability

Feb 23, 2022 - Increased coverage of younger, healthier populations leads to a more balanced insurance risk pool and allows the costs of covering higher ‑risk populations to be spread more broadly. This, in turn, reduces the average cost of coverage and helps to offset the increased cost of making individual market coverage more comprehensive under the ACA.
https://lao.ca.gov/Publications/Report/4560