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Health Financing

California’s health system is funded through several income streams, from individual premiums to federal tax income. ITUP focuses on financing for public health programs, the most relevant funder being the California State Budget.


On the Eve of Reform: Hospitals, Clinics and the Safety Net (2008-2011)

These reports are analyses of the Office of Statewide Health Planning & Development’s hospital and community clinic data that examines utilization and financing during the height of the Great Recession.  It looks into inpatient and outpatient care (hospitals), Medi-Cal utilization trends, county indigent care, as well as hospital utilization/financing trends […] more

Summary of California Assembly Bill 85

Summary of AB 85: The Budget Trailer Bill Governing County Health Realignment This bill transfers realignment  funds from county health to social services with a 5% CalWorks increase in aid payments on March 1, 2014. It reduces county health realignment funds by an average of 60% beginning in January 1, […] more

ITUP Analysis of OSHPD Data about Safety Net Hospital and Clinic Utilization and Revenue

This ITUP analysis uses data from the California Office of Statewide Health Planning and Development to asses safety net hospitals’ and clinics’ utilization and revenue. The charts and tables provide data by payer and display trends over the last several years. The data are available for hospitals (inpatient and outpatient […] more

Redefining the Relationship between California’s State and County Governments: Creating Healthier Communities through Innovative Collaboration and Financing

California is the most populous and perhaps the most diverse state in the nation. To accommodate the needs of its different communities, the state relies on its 58 counties to administer many public and social services. The State formally realigned responsibility for administering certain public programs from the state to […] more

Realignment Redistribution Formulas

The full report is also available for download: One of the great questions at the ITUP conference that went unanswered is “what formula could/should/might be used by the state and the counties in re-allocating the county health realignment savings from coverage expansion?” Background: Health realignment pays for indigent health and […] more

Republican Governor Rick Scott Announces Support for ACA Medicaid Expansion in Florida

Yesterday, Florida Republican Governor Rick Scott threw his support behind adopting the Affordable Care Act’s (ACA) Medicaid expansion in the state. The move would extend eligibility for the program to 138% of federal poverty, offering health coverage to an additional 1 million people in Florida. Scott’s decision is particularly noteworthy […] more

Continued Slower Growth in U.S. Health Costs Reduces Federal Budget Deficit Estimates

Last week, the Congressional Budget Office (CBO) reduced its estimates of federal spending on Medicare and Medicaid as a result of a marked slowdown of the rise in health care costs during the last few years. This pattern of deceleration has brought the rise in health care costs to its […] more

Republican Governors Kasich of Ohio and Snyder of Michigan Move Forward to Implement ACA Medicaid Expansion

The group of Republican governors signaling support for expanding Medicaid in their states has grown in recent days. The LA Times reports that Governors John Kasich of Ohio and Rick Snyder of Michigan intend to expand eligibility for the program to 138% of federal poverty in 2014, a central element […] more

Thinking Ahead – High Priorities for ACA Implementation in California

This report looks at California — where we are and where we need to go in implementing the Affordable Care Act. These materials reflect ITUP’s views on the challenges for California health reform and a status report for the progress we’ve made. We welcome your thoughts and feedback, and hope […] more

Arizona Republican Governor Jan Brewer Announces State Will Implement Medicaid Expansion

Arizona Republican Governor Jan Brewer has announced that she will move forward to implement the Affordable Care Act’s Medicaid expansion in her state. She made the decision public in her annual State of the State address. This expansion would extend coverage to 240,000 Arizonans and bring $1.6 billion in federal […] more