5 Things California: State budget, charity care, Jeffrey Lewis

DJ is taking a much needed vacation, so we’ll be bringing you the next two editions of 5 Things We’re Watching. We’re part of the team tracking health care and health policy in California and are excited to share what has caught our eyes in health care lately. DJ will be back in July, but until then, here’s what we’re watching in California health policy.


Kylie Walsh & Marjie High
State of Reform

1.  State budget compromise foregoes health coverage expansions

California legislators and Governor Jerry Brown reached a budget compromise last week. Gov. Brown is expected to sign the nearly $200 billion budget by the end of the month. The package includes almost $35 billion in health related spending, but what’s left out is just as noteworthy as what’s included.

Legislators did not include proposed health coverage expansions favored by universal coverage advocates. These proposals included the extension of Medi-Cal coverage to income eligible undocumented youth and seniors, establishing a “fast lane” approval procedure for WIC eligible families, and expanding Medicare premium subsidies.

The budget compromise does include a one-time $5 million allocation to create a universal health care task force to explore a unified publicly funded health care system. It also includes $60 million to establish an all payer claims database.

2.  California’s suicide rate increases but still among the lowest

recent report by the CDC shows that the national suicide rate increased by over 25 percent from 1999 to 2016. California was among the states with the lowest increases, with an increase of 14.8 percent. For comparison, North Dakota had the highest increase of 57.6 percent.

California’s suicide rate has remained below the national rate since 1999. In 2016, California had the seventh lowest suicide rate of 12.1 per 100,000, compared to the national rate of 15.4 and Montana’s rate of 29.2, the highest in the nation. But suicide rates varied by county, from 7 in Imperial and San Benito Counties to nearly double the national average with 30.4 in Trinity County.

3.  Hospital charity care drops while profits increase

A California Nurses Association analysis of hospital financial data shows a 33.88% drop in the overall amount of charity care provided by California non-profit hospitals from 2011 to 2016. The California Hospital Association suggests that the drop demonstrates that patients need less help covering medical bills due to increased insurance coverage under the ACA.

However the CNA report points out that despite lower uninsured rates, there are still 12 million Californians who struggle to pay medical bills. The analysis reveals that in the same time period, non-profit hospitals accumulated almost $37 billion in profits.

4.  Video: Jeffrey Lewis, Legacy Health Endowment

Jeffrey Lewis is the President and CEO of Legacy Health Endowment, which works to create sustainable health care solutions in Stanislaus and Merced Counties through philanthropy. He joins us in the episode of “What They’re Watching” to talk about how Legacy Health Endowment is addressing the provider shortage.

“We gave a $1.7 million grant to Livingston Community Health, an FQHC to partner with Cal State Stanislaus. A million dollars of the $1.7 million goes towards what’s called tuition relief. The catch is this: any student who wants tuition relief must agree to live and work in the bi-county area I represent, which is about 19 zip codes. Twenty-three students in the first class, 15 took tuition relief. So that means by December 2019, I’ll have 15 new nurse practitioners in the community.”

5.  Convening Panel shaping LA conference

The Convening Panel for our 2018 Los Angeles State of Reform Health Policy Conference met a few weeks ago. It was a great conversation of diverse voices who shared what topics in health care and health policy in LA are capturing their attention.

We’re taking their ideas and creating our Topical Agenda, which will be released next month. But in the meantime, if you want to join us on September 19th, register now to take advantage of our early bird rate!