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Monica Soni, Covered California’s chief medical officer, oversees an effort to hold health plans financially accountable for the quality of care they provide, including childhood vaccination rates, which have fallen in California and nationwide. She worries federal spending cuts could soon bring turbulence to the state’s Affordable Care Act marketplace.
The state has in recent years embraced several initiatives recommended in an influential health care workforce report, including alternative payment arrangements for primary care doctors to earn more. Despite increasing residency programs, student debt forgiveness, and tuition-free medical school, California is unlikely to meet patient demand, observers say.
Federal law requires states to offer health insurance to many people with low incomes or disabilities. But some states, including California, are far more generous than what’s required. Budget pressures may force lawmakers to cut benefits that have led to a historic low in the uninsured rate.
As House Republicans mull a massive $880 billion cut from federal programs likely including Medicaid, constituents, disability advocates, and health care providers are joining forces to lobby GOP members in California — including those who represent rural, deeply conservative pockets that stand to lose the most.
Medi-Cal, California’s Medicaid program, borrowed $3.4 billion from the state — and will likely need even more — due to higher prescription costs and increased eligibility for seniors and immigrants. The top Republican in the state Senate is demanding a hearing “so the public knows exactly where their tax dollars are going.”
At a town hall in Orange County, California, angry residents said Congress should keep its hands off Medicaid. The cuts contemplated in a House budget blueprint would bore a giant hole in California’s version of the safety net health insurance program, Medi-Cal, which covers nearly 15 million residents.
Enhanced federal subsidies and more state aid for out-of-pocket costs have made health insurance purchased through California’s marketplace more affordable. It's unclear if the incoming Republican Congress will extend the enhanced subsidies beyond 2025.
As Gov. Gavin Newsom enters the second half of his final term, health care stands out as his most ambitious but glaringly incomplete initiative for California residents. The issue will likely shape his national profile for better or worse. And now, Donald Trump brings a new wrinkle.
Donald Trump’s second term is reigniting mistrust in health services among California immigrants, making it harder for community health workers to get people enrolled in Medi-Cal. Yet the president-elect is also seen as someone who could improve their lives with a better economy, even if that means forgoing health care.
As Donald Trump prepares to reenter the White House with a Republican-controlled Congress, health officials and community advocates in California worry that large-scale Medicaid cuts could be enacted as soon as next year. More than 60% of California’s $161 billion Medi-Cal budget comes from Washington.
The state Office of Health Care Affordability has set a goal for insurers to direct 15% of their spending to primary care by 2034, part of a push to expand preventive care services. Health plans say it’s unclear how the policy will mesh with the state’s overarching goal to slow spending growth.
California this year completed its Medi-Cal expansion to include income-eligible residents regardless of their immigration status. This final installment of the “Faces of Medi-Cal” series profiles three of those newly eligible patients and how coverage has affected their health.
This legislative cycle, Gov. Gavin Newsom signed bills affirming reproductive rights and mandating insurance coverage of in vitro fertilization, but the Democrat was reluctant to impose new regulations and frequently cited costs for vetoing bills.
Proposition 35, which would use revenue from a tax on managed-care plans to raise the pay of health care providers who serve Medi-Cal patients, has united a broad swath of California’s health care, business, and political establishments. But a newly formed, smaller group of opponents says it will do more harm than good.
As California cities crack down on homeless encampments in the wake of a U.S. Supreme Court ruling authorizing fines and arrests, front-line workers say such sweeps are undercutting billions in state and federal Medicaid spending meant to stabilize people’s health and get them off the streets.
John Baackes, who steered Medi-Cal’s largest health plan following the Affordable Care Act expansion, and later prepared it for a state overhaul of Medi-Cal, will retire after this year. Baackes believes low payments to doctors and other providers, along with an acute labor shortage, hamper Medi-Cal’s success.
California is among a growing number of states that offer dental benefits to low-income residents, but some lawmakers want the state to go further by covering more cleanings and costlier implants. Dentists and health experts worry the approach doesn’t address the root of the problem: Many providers don’t accept Medicaid.
Gov. Gavin Newsom wants to pull funds earmarked for new investment in Medi-Cal to help plug California’s $45 billion deficit. A state budget passed June 13 by the legislature largely endorsed Newsom’s plan. Voters could settle the matter in an industry-backed initiative that has qualified for the November ballot.
Lawmakers passed a budget that rejected Gov. Gavin Newsom’s proposal to save nearly $95 million by eliminating in-home support services for qualifying older, blind, and disabled immigrants lacking legal residency. Advocates say Newsom’s plan would have cost more in the long run. Newsom has not indicated whether he’ll veto.
An Alameda County mother has spent 10 months seeking help for her 4-year-old son’s speech and behavior issues from his school district and her Medicaid health insurer. She still doesn’t have an answer.
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