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Federal Spending in California


[PDF] Financing Considerations for Potential State Healthcare Policy Changes

February 5, 2018 - Assembly Select Committee on Health Care Delivery Systems and Universal Coverage.

2/5/18: Correction to Figure 3.


[PDF] Single-Payer Health Care Proposal

June 16, 2008 - We analyzed SB 840 (Kuehl), which would establish in California a single-payer health care system and its companion financing mechanism.


COVID-19: American Rescue Plan’s Major Health-Related Funding Provisions

May 6, 2021 - On March 11, 2021, the President signed into law the American Rescue Plan Act of 2021 (ARP Act)—a $1.9 trillion coronavirus disease 2019 relief package. This post highlights the health-related provisions of the ARP Act that provide significant funding directly to state/local health care and public health agencies, rural hospitals, home- and community-based services programs, subsidized individual market health coverage programs, and public behavioral health services. Where possible, based on currently available information, we provide an estimate of the funding allocations to California governments and other entities in the state. While this post reflects our best understanding of the high-level content and implications of this legislation as of late April, we will update the post as new information and clarifications become available.


COVID-19: Federal Health-Related Response

March 23, 2020 - This initial post highlights key federal actions in response to the coronavirus disease 2019 (COVID-19)—through March 19, 2020—relating to public health broadly and individual health care. We discuss three sets of federal actions—(1) a federal legislative package focused on public health infrastructure, (2) a declaration of national emergency that opened the door for the state to apply for increased flexibility in the delivery of Medicaid services, and (3) a federal legislative package that provides for increased federal Medicaid funding and universal coverage of COVID-19 testing without cost sharing.


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

October 13, 2015 - Earlier this year, California submitted a proposal to renew its Section 1115 waiver, which is due to expire at the end of October. The state is currently negotiating with the federal government over the terms and conditions of this waiver renewal. In this post, we examine key issues and concerns related to the availability of federal funding for California’s proposal. The post provides a primer on how Section 1115 waivers are generally financed, an overview of California’s proposal, and a discussion of the challenges the proposal faces within that financing structure.


[PDF] The 1997-98 Budget Act and Related Legislation

October 8, 1997 - The 1997-98 budget, signed into law by Governor Wilson on August 18, 1997, authorizes total state spending of $67.2 billion, including $52.8 billion from the General Fund and $14.4 billion from special funds.


Major Expenditure Proposals in the 2005-06 Budget

February 22, 2005 - We discuss several of the most significant spending proposals in the budget.


Hospitals Face Financial Headaches

February 20, 2002 - California hospitals face significant financial pressures in the next several years, particularly from recent federal regulations limiting the amount the state can pay public hospitals participating in Medi-Cal. We recommend steps the Legislature could take even in difficult fiscal times to deal with problems faced by hospitals.


Federal Expansion of Children's Health Coverage Potential Savings That Could Provide Sources of State and Local Matching Funds

July 17, 1997 - The House and Senate budget reconciliation bills currently pending in Congress both provide additional funds for the states to expand health care coverage for low-income children. The Senate bill authorizes expansion to cover children in families with incomes up to 200 percent of the federal poverty level, while the House bill allows coverage in families with incomes up to 300 percent of the poverty level. Both bills require a state match, but at a lower matching rate than under the Medi-Cal Program.