Cal. Health & Safety Code § 1002
Unified Health Care Financing System
Redline — January 1, 2019 → current.View current text →
Current — January 1, 2023
As of January 1, 2019
(a) On or before July 1, 2020, the commission shall submit a report to the Legislature and the Governor with options that include all of the following:
(1) An analysis of California’s existing health care delivery system, including cost, quality, workforce, and provider consolidation trends and how they impact the state’s ability to provide all Californians with timely access to high-quality, affordable health care.
(2) Options for additional steps California can take to prepare for transition to a unified financing system, including, but not limited to, a single-payer financing system, including, but not limited to, administrative changes, reorganization of state programs, federal waivers, and statutory and constitutional changes.
(3) Options for coverage expansions, including potential funding sources. Options shall include expansion for full-scope Medi-Cal to individuals over 64 years of age, regardless of immigration status.
(b) On or before February 1, 2021, the commission shall submit a report to the Legislature and the Governor that includes options for key design considerations for a unified financing system, including, but not limited to, a single-payer financing system, including all of the following:
(1) Eligibility and enrollment.
(2) Covered benefits and services.
(3) Provider participation.
(4) Purchasing arrangements.
(5) Provider payments, including consideration of global budgets.
(6) Cost containment.
(7) Quality improvement.
(8) Participant cost sharing.
(9) Quality monitoring and disparities reduction.
(10) Information technology systems and financial management systems.
(11) Data sharing and transparency.
(12) Governance and administration, including integration of federal funding sources.
(a) In developing the waiver framework, the Secretary of the Health and Human Services Agency shall engage stakeholders to provide input on topics related to discussions with the federal government and key system design issues identified by the Healthy California for All Commission for further analysis.
(1) Stakeholder engagement shall include representatives of consumers, patients, and community-based health care service providers, community organizations, health care professionals, labor unions, employers, and health policy experts, as well as representatives of government agencies and philanthropic organizations focused on health care.
(2) Key system design issues include health care delivery, finance, operations, public administration, the specifics of the transition to a unified health care financing system from the current system, adapting existing consumer protections to the new system, applying reforms to move toward systems that reward and prioritize improvements in health outcomes, health care quality, and health care equity, and how to reduce costs and improve the experience of health care consumers.
(b) The secretary shall, no later than January 1, 2025, provide an interim report to the chairs of the Assembly and Senate Budget and Health Committees that details the agency’s policy priorities and preliminary analysis of issues related to the federal discussions, as well as a summary of the input received to date through the stakeholder engagement process. The secretary shall, no later than January 1, 2025, also propose statutory language to the chairs of these committees authorizing the development and submission of applications to the federal government for waivers necessary to implement the unified health care financing system.
(c) The secretary shall, no later than June 1, 2025, complete the drafting of the waiver framework, inclusive of input gathered through the stakeholder engagement process, make the draft available to the public on the agency’s internet website, and shall hold a 45-day public comment period thereafter.
(d) The secretary shall, no later than November 1, 2025, provide the Legislature and the Governor with a report that communicates the finalized waiver framework, informed by public comment received, and sets forth the specific elements to be included in a formal waiver application to establish a unified financing system consistent with the outcomes of the agency’s discussions with the federal government.
(e) The requirement for submitting the reports specified in this subdivision is inoperative on June 1, 2028, pursuant to Section 10231.5 of the Government Code.
(f) A report submitted pursuant to this subdivision shall be submitted in compliance with Section 9795 of the Government Code.
(d) The commission shall provide an update detailing its progress in developing the reports required by subdivisions (a) and (b) to the Governor and the health committees of the Senate and the Assembly on or before January 1, 2020, and shall update those committees every six months thereafter.
Official source: California Legislative Information. Reproduced from public-domain California statutes; confirm against the official source for the current text. Not legal advice.