Healthcare in California
This article summarizes healthcare in California.
California State Department of Health Care Services
The California Department of Health manages state government projects in California.
As of 2018, most of the insured in California were in plans regulated by the California Department of Managed Health Care (DMHC) with about 60% regulated by either DMHC or the California Department of Insurance (CDI). This dual regulation arose due for historical reasons, and when the DMHC was created in 2000, the California legislature requested a report on merging the health insurer responsibilities with the CDI. Dual regulation has also raised questions around the applicability of premium tax to the DHMC-regulated entities, which have historically not paid premium taxes while CDI-regulated entities have. Value-based pay for performance managed care plans where providers take on risk have arisen, and in 2019 the DHMC announced plans to regulate these "risk-bearing entities".
As of 2018, about one-third of California was covered by Medi-Cal, which is California's Medicaid program. It is administered by the California Department of Health Care Services, which operates it in accordance with California's Medicaid State Plan and Title XIX of the Social Security Act.
As of 2015, about 14.1 million people were insured privately, including in self-funded plans; 1.3 million were in plans regulated by the CDI and 12.7 million were in plans regulated by the DHMC. Kaiser Permanente had about 50% of the market, followed by Blue Shield of California, Anthem Blue Cross, and Health Net (a subsidiary of Centene).
Healthcare by region
Los Angeles offers all available health care services. Notable health systems or hospitals in the region include Los Angeles County Department of Health Services, Kaiser Permanente, UCLA Health, Cedars-Sinai, Verity Health, Providence Health, UCI Medical Center, and Keck Hospital of USC.
San Francisco Bay Area
In 2018, a lawsuit was filed against Sutter Health for alleged antitrust.
Proposed single-payer healthcare
A single-payer health care system for California has been suggested multiple times. Two bills in the California State Legislature that would have implemented universal health coverage were vetoed by Governor Arnold Schwarzenegger in 2006 and 2008, respectively. A new 2021 proposal for single-payer healthcare, AB 1400, is being presented in the State Assembly, and has renewed discussion about unilateral state-wide universal healthcare.
Outbreaks, plagues, and epidemics
- California Medical Association
- California Health and Safety Code
- California Senate Bill 277 removed personal belief as exemption from vaccination requirements for entry to schools
- "Issue Brief: Estimates of Sources of Health Insurance in California for 2019" (PDF). California Health Benefits Review Program.
- "Making Sense of Managed Care Regulation in California" (PDF). California HealthCare Foundation. 2001.
- Kelso, J. Clark (2001). "Regulatory Jurisdiction Over Health Insurance Products: The Department of Managed Health Care & The Department of Insurance" (PDF). Archived (PDF) from the original on 2015-09-09. Retrieved 2019-10-12.
- "New California Court of Appeal Decision May Impose Premium Taxes on California Health Plans". C&M Health Law. 2015-10-12. Retrieved 2019-11-29.
- Oppenheim, Charles B.; Gross, Stephanie (16 May 2019). "Changes Ahead for California's Managed Care Regulatory Scheme".
- "California's Medicaid State Plan (Title XIX)". California Department of Health Care Services.
- "The Private Insurance Market in California, 2015". California Health Care Foundation. Retrieved 2019-06-13.
- "2019 Edition — California Health Insurers". California Health Care Foundation. Retrieved 2019-10-14.
- "Evolving Market Share Of Health Plans In Covered California". IMK. 2018-10-09. Retrieved 2019-06-13.
- Bartolone, Pauline; Gorman, Anna; Terhune, Chad. "Anthem's retreat leaves Californians with fewer choices, more worries". The Sacramento Bee.
- "Hospital consolidation in California linked to higher health prices". SFChronicle. 5 September 2018.
- "Suit against Sutter spawns fight with Bay Area hospitals over trade secrets". SFChronicle. 15 October 2018.
- Korcok, Milan (October 10, 2006). "Schwarzenegger vetoes single-payer bill". CMAJ : Canadian Medical Association Journal = Journal de l'Association Medicale Canadienne. 175 (8): 860. doi:10.1503/cmaj.061200. PMC 1586096. PMID 17030932.
- "SB-840 Single‑payer health care coverage".
- Rojas, Aurelio (September 30, 2008). "Gov. Schwarzenegger again vetoes single payer bill". Physicians for a National Health Program. Retrieved 2021-04-09.
- "Letter: Health care for all California". Davis Enterprise. April 7, 2021. Retrieved 2021-04-09.
- California Department of Health Care Services
- California Department of Public Health
- Hoffman, Beatrix (2003). "Health Care Reform and Social Movements in the United States". American Journal of Public Health. 93 (1): 75–85. doi:10.2105/ajph.93.1.75. PMC 1447696. PMID 12511390.