New CHPR Issue Brief (PDF) to Inform Medi-Cal Budget-related Decision-making
Karen Shore, Ph.D., and Patricia Powers, M.P.A., with the Center for Healthcare Policy and Research’s Center for Health Decisions, analyzed the impacts on the state’s Medi-Cal program budget of various revenue-generating and expenditure-reducing policies enacted in California over the course of the last decade. Their analysis of this 10-year period, encompassing a major economic downturn as well as more prosperous years, provides valuable lessons in how to maintain this core public program that provides health insurance coverage to 13.5 million people, nearly one of every three Californians. The report describes five major types of policy changes California deployed during this period to manage Medi-Cal program costs and provides examples of each with magnitude estimates:
(1) Changes in benefits
(2) Eligibility changes
(3) Changes to provider/health plan payments
(4) Delivery system changes
(5) Other revenue augmentations
One of the major findings is that the proportion of the Medi-Cal budget funded by California’s General Fund declined dramatically, from a high of 39% in fiscal year (FY) 2007-08 to 18% in FY 2017-18. Other, likely less volatile, revenue sources helped to sustain and grow the Medi-Cal program during this period.
Medi-Cal Budget: Lessons Learned from a Review of Policy Changes with Significant Budgetary Impact, 2007-2017 (PDF), seeks to inform a variety of audiences including state and federal policymakers and staff, state agency staff, health policy analysts and researchers, health care advocates, and beneficiary representatives. To ensure the usefulness of the report to these audiences, a committee composed of current and former budget staff experts from the state legislature, the Legislative Analyst’s Office, the Department of Finance, and the California Budget & Policy Center advised the authors as they designed and conducted the analysis. The committee recommended, for example, that the analysis emphasize long-term structural changes rather than policies that generate one-time savings to achieve a balanced budget in a given year. The final list of major budget policies analyzed includes some that were state-initiated, some that were implemented in response to opportunities made available by the federal government, and others that resulted from ballot initiatives.
The California Health Care Foundation provided funding for this project.
For questions about or comments on the Issue Brief (PDF), please contact Patricia Powers at email@example.com.