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Centering Equity in Maternal Care: Unpacking California’s Medi-Cal Doula Services Implementation

July 21, 2025

The last ITUP publication, Centering Equity in Maternal Care: Unpacking California’s Medi-Cal Doula Services Implementation, explores the promise and challenges of the Medi-Cal doula benefit through a health equity lens.

Centering Equity in Maternal Care: Unpacking California’s Medi-Cal Doula Services Implementation

July 21, 2025

Insights Revealed: Older Adult Behavioral Health Survey Results

July 21, 2025

The survey aimed to assess the behavioral health needs of older adults, identify gaps in services, and help inform future policies and programs that advance equity, access, and culturally competent care.

The Role of Nurse Practitioner Diversity in Expanding Care Access in California Fact Sheet

July 7, 2025

California is facing a critical health care workforce crisis. Nurse Practitioners (NPs) are uniquely positioned to help close these gaps in primary care access—especially in underserved and historically marginalized communities.

Examining Incarceration Drivers and Promising Solutions Issue Brief

June 18, 2025

This ITUP Fact Sheet highlights insights from Shasta, San Joaquin, and Stanislaus counties, rural communities navigating service gaps, social drivers of incarceration, and community-led solutions to support justice-involved populations.

Strengthening Personal Care Aide Workforce Fact Sheet

June 17, 2025

Discover how the latest ITUP fact sheet highlights the vital role of Personal Care Aides (PCAs) and addresses key challenges like inconsistent training, lack of national standards, job instability, and low wages.

ITUP Mini Blog: Progress or Setbacks? Weighing Policies That Impact Undocumented Communities

April 10, 2025

ITUP is monitoring immigration-related bills that could impact California’s health coverage expansion. Read more!

ITUP Legislative Toolkit: Advancing Health Coverage in California

March 26, 2025

This toolkit provides a deep dive into the state of health coverage in California, equipping policymakers with the knowledge and strategies needed to reduce uninsured rates and expand access to care.

ITUP Mini Blog: Advancing Women’s Health in California

March 25, 2025

What’s Happening in Women’s Health Legislation? Read about new bills tackling health care disparities in women’s health.

Key Insights: 2025 ITUP Pre-Conference Workshop

March 5, 2025

The report captures actionable strategies and advocacy messages identified during the 2025 ITUP Pre-Conference workshop, offering a roadmap for stakeholders committed to advancing health equity.

ITUP Legislative Toolkit: Understanding Essential Health Benefits

February 26, 2025

EHBs ensure that all Covered California health plans provide a standardized level of care, protecting individuals and families from gaps in coverage.

ITUP Blog: Governor’s Fiscal Year 2025-26 Budget Proposal

January 31, 2025

By Sumaira Akbarzada and Jana Wright Governor’s Fiscal Year 2025-26 Budget Proposal On January 10, 2025, Governor Gavin Newsom released his Fiscal Year (FY) 2025-26 Budget proposal of $322 billion total funds (TF) (). Health and Human Services makes up a large portion of the budget with proposed expenditures of $296.1 billion ($83.7 billion General […]

Shaping the Future of Health Equity – ITUP Impact Report 2024

January 8, 2025

Explore the key milestones, impactful collaborations, and the measurable progress we’ve made in addressing health disparities.

California Health Care Specialty Workforce Shortages Fact Sheet

January 3, 2025

This ITUP fact sheet explores the current state of California’s specialty health care workforce, highlighting critical gaps and opportunities within the system.

Mobilizing Doulas: Advancing Equitable Maternal Health Outcomes in California

December 5, 2024

This ITUP Fact Sheet highlights investments in California’s birthing workforce and explores how doulas bridge gaps in maternal health access for marginalized communities.

California Health Care Workforce Shortage: ITUP Convenes Regional Equity Collaboratives to Address Solutions

October 14, 2024

Discover key insights into California’s statewide health workforce shortage and explore local perspectives from across the state.

Key Takeaways: 2024 ITUP Regional Equity Collaboratives

October 14, 2024

This report highlights the valuable insights and community-driven solutions shared during the 2024 ITUP Regional Equity Collaboratives.

Transforming Behavioral Health Services in California Jail Systems

September 24, 2024

This ITUP Fact Sheet underscores the urgent need for equitable access to behavioral health services for California’s justice-involved population.

Behavioral Health in California -ITUP Policy Toolkit

September 4, 2024

This curated ITUP policy toolkit brings together essential initiatives and resources supporting emotional and behavioral well-being across the state.

Health Coverage at a Glance In California 2024

August 26, 2024

This ITUP Fact Sheet includes data on the race/ethnicity breakdown of employer-sponsored coverage, Covered California, and Medi-Cal, including enrollment by health plan in California.

Catalyzing AI to Advance Health Equity in California Communities

August 14, 2024

This ITUP Fact Sheet explores the concept of Artificial Intelligence (AI) and its critical role in shaping the future of health care.

The Emergence of Artificial Intelligence and It’s Application in Health -ITUP Policy Toolkit

August 14, 2024

This ITUP Policy Toolkit combines the wide array of U.S. Federal and California state agencies that are and can support the advancement of equitable artificial intelligence usage for Californians.

ITUP Blog: Key Highlights in California’s Final FY 2024 – 25 Budget Act

July 12, 2024

This ITUP blog summarizes the final FY 2024-25 Budget Act and is the third in ITUP’s Budget Blog series in addition to Governor’s Fiscal Year 2023-24 Budget Proposal and Governor’s FY 2024-25 Budget: Key Highlights in the May Revision

2024 Regional Health Coverage Fact Sheets

July 9, 2024

The “Coverage at a Glance” fact sheets include health coverage data with race/ethnicity breakdown of counties and among the uninsured.

ITUP Legislative Toolkit -In Home Supportive Services (IHSS)

June 21, 2024

Shirley Lam, MPH, ITUP’s Assistant Director of Policy, delivered a comprehensive overview of the IHSS program. Find her presentation here!

ITUP Legislative Toolkit: State Government 101

May 24, 2024

ITUP provides technical assistance, such as legislative training and policy toolkits, to help anyone engage with the California legislature.

Leveraging Data to Advance Health Equity and Success in CalAIM

April 4, 2024

This ITUP issue brief highlights the critical role of accessible and equitable data policy and infrastructure in the success of California’s CalAIM Initiative.

ITUP Convenes Medi-Cal Redetermination Listening Sessions – Final Takeaways

March 28, 2024

Learn more about the Medi-Cal redetermination process and read local insights and additional opportunities to support Medi-Cal redetermination across the state.

ITUP Blog: 2024 Introduced Legislation

March 14, 2024

This blog summarizes introduced legislation that proposes solutions relating to ITUP’s three priority policy issues: health care coverage and access, delivery system transformation, and the future of health.

Making Medi-Cal Work for California Farmworkers

December 7, 2023

This issue brief spotlights three actionable ways, identified from work with farmworker advocates and stakeholders, policymakers can use to make the Medi-Cal system work for California farmworkers.

ITUP Blog: 2023 Legislation Round Up

November 27, 2023

The 2023 round-up of some significant health and health-related bills that were signed into law and some that were vetoed (shown in italics).

Health Coverage at a Glance In California

October 23, 2023

This Health Coverage at a Glance in California includes data on the race/ethnicity breakdown of employer-sponsored coverage, Covered California, and Medi-Cal, including enrollment by health plan.

Snapshot: Addressing Digital Equity for Equitable and Accessible Health Care

October 2, 2023

This ITUP fact sheet provides a brief overview of the opportunity to close the digital divide and provide a more equitable and accessible future of health care

California Data Exchange Framework 101 – Policy Toolkit

September 19, 2023

This policy toolkit highlights resources to inform and support stakeholders through the implementation of the California Health and Human Services Data Exchange Framework (DxF).

California Data Exchange Framework 101

September 18, 2023

The latest ITUP fact sheet explores the interconnected elements of the California Health and Human Services Data Exchange Framework (DxF).

Expanding Health Coverage for California Farmworkers

July 27, 2023

This issue brief emphasizes three actionable ways policymakers can expand access to coverage for farmworkers.

2023 Regional Health Coverage Fact Sheets

July 6, 2023

Each year ITUP releases Regional Health Coverage fact sheets highlighting key health coverage facts county-by-county in California. Find your local 2023 regional health coverage fact sheet here.

ITUP Presentation: Ensuring Equitable Health Coverage and Access in Pandemic Recovery

June 21, 2023

ITUP Presents at the Central Valley Health Network (CVHN) Quarterly Roundtable

ITUP Blog: Governor’s FY 2023-24 Budget: Key Highlights in the May Revision

June 7, 2023

This publication highlights key health and human services proposals in the FY 2023-24 May Revision.

Addressing Digital Equity for Equitable, Accessible Health Care

June 1, 2023

The latest ITUP issue brief emphasizes the pivotal moment California is in to advance digital equity and broadband and connectivity.

ITUP Broadband Bootcamp Report

May 15, 2023

This ITUP bootcamp report highlights findings from ITUP’s broadband bootcamp that will be used to inform the State’s Digital Equity Plan.

ITUP Blog: Governor’s Fiscal Year 2023-24 Budget Proposal

March 28, 2023

This blog highlights key health and human services proposals in the FY 2023-24 proposed budget as well as proposals that improve health equity and address the social determinants of health.

Engaging with CalAIM: Quick Links for Community-Based Organizations

January 17, 2023

This ITUP One-Page Resource features essential information and links to key sources to help community-based organizations (CBOs) engage with CalAIM.

2022 ITUP Year-in-Review

November 17, 2022

Read the ITUP Year in Review to see more of the rigorous work ITUP did in 2022 to discuss and develop health policy options that preserve and expand health care coverage in California.

Healthy Aging in California -ITUP Policy Toolkit

October 20, 2022

This toolkit helps seamlessly navigate between the state agencies, programs and initiatives, policy plans, engagement opportunities, and additional resources that create California’s healthy aging policy landscape.

ITUP Convenes CalAIM Listening Sessions – Final Takeaways

October 20, 2022

Read FINAL key takeaways of ITUP listening sessions on CalAIM implementation.

Transformation and Innovation: Advancing Health for California’s Older Adults

October 14, 2022

The latest ITUP fact sheet explains how California is transforming the services and supports for older adults through CalAIM and how these new services are incorporated and aligned with California’s Master Plan for Aging.

ITUP Blog: 2022 Legislative Round Up

October 14, 2022

This blog is a round-up of some significant health and health-related bills that were signed into law and some that were vetoed.

Partnering with Community Based Organizations for Better Health

September 15, 2022

ITUP fact sheet explains the role of Community Based Organizations (CBOs) and describes three service models for CBOs to partner with the health care system.

Broadband and Connectivity for Better Health Care -ITUP Policy Toolkit

August 23, 2022

New ITUP Broadband Policy Toolkit that provides hyperlinks to resources to help understand more about the need to expand broadband and connectivity to ensure a better future of health care for California communities.

ITUP Blog: Key Highlights in the Governor’s FY 2022-23 May Revise

June 2, 2022

This ITUP publication highlights key health and human services proposals in the FY 2022-23 May Revision as well as proposals that improve health equity and address the social determinants of health.

CalAIM Quick Links

April 14, 2022

In this resource, ITUP categorized informational web pages and provided direct links for information on CalAIM.

CalAIM Summary and Timeline (2022 Update)

April 12, 2022

Learn about CalAIM and its focus populations, primary goals, and major elements in the latest ITUP fact sheet.

ITUP Blog: 2022 Introduced Legislation

March 14, 2022

This ITUP blog summarizes introduced legislation that proposes solutions relating to ITUP’s three priority policy issues: health care coverage and access, delivery system transformation, and the future of health.

ITUP Blog: Governor’s FY 2022-23 Budget Proposal: Key Highlights

January 20, 2022

This blog highlights key health and human services proposals in the FY 2022-23 proposed budget as well as proposals that improve health equity and address the social determinants of health.

The Intersection and Coordination of Public Health & Health Care in California

January 18, 2022

This ITUP fact sheet purposefully brings the public health and health care systems together in one publication to explore their differences and more!

2021 ITUP Year-in-Review

January 11, 2022

The annual ITUP Year-in-Review highlights the rigorous work ITUP has accomplished over the last year.

Snapshot: Remaining Uninsured in California (2021 Update)

December 16, 2021

This ITUP Snapshot updates the profile of the state’s uninsured using 2020 data from the California Health Interview Survey (CHIS), and projections for 2022 from the California Simulation of Insurance Markets (CalSIM).

Community Health Workers and the Health Care Delivery System

December 10, 2021

In this ITUP Fact Sheet, readers will learn about community health workers, California communities where CHWs are valuable in closing equity gaps, and key policy considerations and decision points.

ITUP Presents at CHCF Community Health Worker State Plan Amendment Webinar

December 10, 2021

ITUP Presents at CHCF Community Health Worker State Plan Amendment Webinar.

Health Information Exchange

June 3, 2021

In this ITUP Fact Sheet readers will learn about the goal of health information exchange (HIE), types of HIE models, policy considerations for HIE, and more!

Broadband for Health Basics

May 21, 2021

In this ITUP Fact Sheet, readers will learn about the digital divide and its impact on health care. This latest fact sheet also covers types of wired broadband network technologies, key broadband definitions, and more!

Medicare and Health for Aging Californians Fact Sheet

April 22, 2021

In this easy-to-digest ITUP Fact Sheet, readers will learn about Medicare eligibility, benefits, and enrollment in California. This latest fact sheet also covers the California Master Plan for Aging and how COVID-19 has impacted Medicare beneficiaries.

2021 Regional Coverage Fact Sheets

April 15, 2021

Each year ITUP releases “Coverage at a Glance” regional health coverage fact sheets highlighting key coverage facts county-by-county in California. Find your local 2021 regional health coverage fact sheet here.

2020 Year-In-Review

January 29, 2021

The annual ITUP Year-in-Review highlights the many accomplishments ITUP has accomplished over the last year. View Document

Public Option in California (Winter 2020)

December 16, 2020

The latest ITUP Public Option ESSENTIALS refreshes past ITUP publications from 2018 and early 2020 to update and better inform policy discussions on what a public option might look like in California.

Telehealth and COVID-19

December 10, 2020

In this easy to digest ITUP Fact Sheet, readers will learn more about the telehealth policies put into place during the public health emergency and what considerations stakeholders should contemplate as we move into a post-pandemic environment.

Presentation: ITUP DHCS Request For Information (RFI) Responses

October 2, 2020

On September 1, the Department of Health Care Services (DHCS) put out a Request for Information (RFI) regarding their Medi-Cal Managed Care Plan Procurement efforts. Comments were due on October 1. The following are ITUP DHCS RFI responses.

Resources: The Historical Journey of the ACA

October 2, 2020

ITUP has compiled the following resources on what’s at stake for Californians and the nation if the ACA is overturned in California v. Texas on November 10, 2020.

ITUP Blog: California’s Final 2020-21 Budget

August 6, 2020

This ITUP blog summarizes the final 2020-2021 California State Budget and is the third in our Budget Blog series.

Press Release: New Fact Sheet & Webinar Explore the Basics of Health Insurance in California

July 14, 2020

Insure the Uninsured Project (ITUP) released a new fact sheet and announced a webinar for July 21, 2020, 2:00 – 3:00 PM, describing the various sources of health insurance in California and how each program operates.

Health Insurance Basics

July 14, 2020

This ITUP Fact Sheet provides an overview of common sources of health insurance in California. Learn more about who qualifies for, pays for, and regulates these sources of health care coverage in the state.

Health Care Coverage Options During COVID-19

May 19, 2020

This ITUP Fact Sheet provides an overview of what the health coverage landscape looked like before COVID-19 and how the pandemic has impacted coverage access in California.

Legislative Update: 2020 Introduced Legislation

March 13, 2020

This ITUP Legislative Update offers a preliminary review of newly introduced legislation, as well as two-year bills eligible for consideration that affect health care and coverage. ITUP will be monitoring the progress of these and other health care bills in the coming months.

Public Option in California

March 12, 2020

This issue of ITUP ESSENTIALS reviews through a California lens issues and concepts related to a state-level public option for individual coverage.

California Advancing and Innovating Medi-Cal (CalAIM)

February 21, 2020

California Advancing and Innovating Medi-Cal (CalAIM) is the newest ITUP Health Policy Essentials. This issue brief provides an overview of CalAIM, the related proposals in the Governor’s 2020-21 budget, and highlights potential issues and questions to inform the analysis and review of CalAIM currently underway.

Notes From the Field: Care Coordination in California

February 18, 2020

This report highlights key findings from the 2019 ITUP regional workgroup discussions on care coordination in Medi-Cal, California’s Medicaid program. The discussions were timely and informative and reflect the complexity of the care coordination challenges in California.

ITUP Overview of the Governor’s Proposed 2020-21 Budget

January 18, 2020

On January 10, 2020, Governor Newsom introduced his proposed budget for fiscal year 2020-21, including multiple programs and new initiatives aimed at improving health care and coverage in California.

2019 Year-In-Review

December 18, 2019

The annual ITUP Year-In-Review chronicles month-by-month important state and federal health policy milestones.

Covering Undocumented Young Adults in Medi-Cal

December 13, 2019

On January 1, 2020, California will extend Medi-Cal eligibility to low-income undocumented young adults.

Snapshot: Remaining Uninsured in California (Updated)

December 3, 2019

This ITUP Snapshot updates the profile of the state’s uninsured using 2018 data from the California Health Interview Survey (CHIS), and projections for 2022 from the California Simulation of Insurance Markets (CalSIM).

Legislative Update: Final Results of the 2019-20 Legislative Session

October 21, 2019

Governor Newsom signed most of the health care bills sent to him by the Legislature this year. This ITUP Legislative Update reviews the bills passed by the Legislature in 2019, and the governor’s actions to sign (shown as chaptered) or veto the bills. View Document

Newsom Administration Moves to Launch New Health Reform Commission

October 9, 2019

On September 26, 2019 the California Health and Human Services Agency (CHHS) released a Request-for-Proposal (RFP) for a vendor to provide project management services in support of the new Healthy California for All (HCFA) Commission. Pursuant to the 2019-20 state budget, the Commission is charged with developing options for a health care delivery system that “provides coverage and access through a unified financing system, including, but not limited to, a single-payer financing system, for all Californians.”

Medi-Cal Waivers Discussion Guide

October 3, 2019

This discussion guide is a companion document to the Mapping the Future issue brief, and focuses on the waivers, and the state process for addressing the issues presented by the 2020 deadline, as policymakers and stakeholders consider the implications and next steps for Medi-Cal.

2019 ITUP Regional Profiles

September 1, 2019

The 2019 ITUP “At-a-Glance” series profiling statewide and regional coverage, and enrollment by program, is now available!

My Intern Experience at ITUP

August 27, 2019

My summer at ITUP provided me with new skills in health policy analysis and research, increased my understanding of state and federal health care programs and legislative processes, and gave me the experience of working in a nonprofit organization that engages with state health care leaders as well as local health care stakeholders.

Bills Pending as Legislature Winds Down

August 16, 2019

This ITUP Legislative Update highlights the remaining deadlines in the legislative session that ends September 13 and the bills still moving through the process.

Final Federal Rule on Immigrants and Public Charge Fact Sheet

August 14, 2019

The latest ITUP Fact Sheet review and summarize the final rule, existing federal law related to public charge and health care programs, and assess the potential impacts on immigrant access to health care programs in California.

Public Charge & Health Care in California

August 14, 2019

On August 12, 2019, the U.S. Department of Homeland Security (USDHS) released the final rule on “public charge.” The latest ITUP Blog and Fact Sheet provide additional background on the final rule.

ITUP Analysis: Covered CA 2020 Rates

August 8, 2019

This new issue of ITUP Tracking reviews the rate changes and health plan choices available to consumers for 2020.

Health Care Programs for California Immigrants (Updated)

July 19, 2019

This ITUP fact sheet reviews existing health care programs for immigrants in California. California generally provides better access to health care coverage for immigrants than most other states, including covering all children in Medi-Cal regardless of immigration status.

Discussion Guide for the 2019 Regional Workgroups: Care Coordination

July 16, 2019

This discussion guide provides general background to support the 2019 regional workgroup conversations around care coordination challenges, best practices and policy recommendations.

Final 2019-20 State Budget Continues the Move Toward Universal Coverage

June 28, 2019

The final 2019-20 state budget (and related legislation) just signed by Governor Newsom moves California steps closer to universal coverage, improves coverage affordability in the individual market, and invests in system improvements in Medi-Cal, mental health services and services for homeless individuals.

Mapping the Future of Individual Health Insurance

May 19, 2019

Mapping the Future of Individual Health Insurance and the companion publication, Mapping the Future of Medi-Cal, following up on the 2019 ITUP conference, take an in-depth look at the issues for these two coverage options likely to engage policymakers and stakeholders.

Snapshot: Remaining Uninsured in California (Updated)

May 15, 2019

According to the California Health Interview Survey (CHIS), in the years leading up to the Affordable Care Act (ACA), the
uninsured rate among Californians under the age of 65 was approximately 16 percent.1 Implementation of the ACA
dramatically reduced the rate of uninsured to 8.4 percent, with approximately 3 million remaining uninsured in the state.2
This snapshot provides a quick overview of California’s remaining uninsured.

ITUP Review of the 2019-20 Budget May Revision

May 14, 2019

This ITUP Legislative Update provides an overview of the May Revise and health and health-related proposals.

2019 County Medically Indigent Care Programs

March 21, 2019

This version of ITUP Tracking provides an update to the ITUP 2017 Review of Medically Indigent Adult (MIA) programs administered by counties for low-income uninsured adults.

Mapping the Future of Medi-Cal

March 12, 2019

Mapping the Future of Medi-Cal and the companion publication, Mapping the Future of Individual Health Insurance, following up on the 2019 ITUP conference, take an in-depth look at the issues for these two coverage options likely to engage policymakers and stakeholders in the near future.

Covered California and Individual Health Insurance

March 12, 2019

Covered California and Individual Health Insurance is the newest ITUP Health Policy Essentials. Get the basics on California’s state-based exchange and the market for individual coverage.

2019-20 Introduced Legislation

March 4, 2019

The deadline for bill introduction in California’s 2019-20 legislative session was February 22, 2019. Before the deadline, the Legislature introduced 2,687 bills and resolutions including almost 1,000 health-related bills. This fact sheet offers a preliminary review of various bills affecting health care and coverage. View Document

Notes from the Field: Behavioral Health in California

February 2, 2019

This report outlines background on Medi-Cal mental health and substance use disorder treatment in California, and highlights key findings from 2018 ITUP regional workgroup discussions.

Covered California Announces 2019 Enrollment

February 1, 2019

This week, Covered California, California’s Affordable Care Act (ACA) marketplace, announced the results of the 2019 open enrollment season. Early analysis shows strong renewal rates but a significant drop in new enrollment. This blog highlights potential causes of the drop and its implications.

Covered California Announces 2019 Enrollment

February 1, 2019

This week, Covered California, California’s Affordable Care Act (ACA) marketplace, announced the results of the 2019 open enrollment season which ended on January 15, 2019. Data results show strong renewal rates but a significant drop in new enrollment. This blog potential causes of the drop and its implications.

Governor Newsom’s First Budget: Health Care Highlights

January 11, 2019

In his first act as Governor of California, Gavin Newsom announced executive actions and budget proposals to expand health coverage and improve affordability, signaling health care as one of his top priorities. This blog highlights health care items in the Governor’s proposed budget.

Governor Newsom’s First Budget: Health Care Highlights

January 11, 2019

Summary of 2018 Federal Rulemaking

January 10, 2019

This summary briefly describes key 2018 federal final rules, proposed rules and policy guidance.

2018 Year-In-Review

January 10, 2019

The annual ITUP Year-In-Review chronicles month-by-month important state and federal health policy milestones.

ITUP 2018 A Year-In-Review

January 9, 2019

The past year began and ended with ongoing federal efforts to invalidate or dismantle the Affordable Care Act contrasted with California’s continuing efforts to expand coverage and improve health care. These starkly different approaches at the state and federal level are outlined in the ITUP 2018 Year-In Review and the accompanying Summary of 2018 Federal Rulemaking.

ITUP Issues Comments on Public Charge

December 4, 2018

In comments addressed to the Department of Homeland Security (DHS), Insure the Uninsured Project (ITUP) expressed deep concern with the proposed rule on public charge and urged DHS to withdraw the proposal.

New Projections Estimate the Uninsured will Rise in California

November 28, 2018

In the years since implementation of the Affordable Care Act California made steady progress in reducing the number of uninsured in the state. According to newly released projections, this pattern is unlikely to continue without state policy intervention.

New Data Reveals that Racial/Ethnic Disparities in Health Coverage are Narrowing Under the Affordable Care Act

October 31, 2018

According to newly released California Health Interview Survey (CHIS) 2017 data, disparities in health care coverage across race and ethnic subgroups have narrowed with the implementation of the Affordable Care Act (ACA).

Final Results of the 2017-18 Legislative Session

October 23, 2018

Governor Brown signed into law most of the health bills sent to him by the Legislature this year. This blog summarizes legislation by topic and actions taken by the Governor, Chaptered (signed) or Vetoed.

UPDATE: California Strategies: Covering California’s Remaining Uninsured and Improving Affordability

October 8, 2018

This updated issue brief analyzes policy proposals advanced in 2018 to move the state closer to universal coverage by focusing on the challenges many Californians face.

Proposed Federal Rule on Immigrants and Public Charge Fact Sheet

October 3, 2018

The ITUP fact sheet briefly describes existing federal law on public charge and health care programs, the proposed changes, and the impact on immigrants’ access to health care programs in California.

Final Results of the 2017-18 Legislative Session

October 1, 2018

Governor Brown signed into law most of the health bills sent to him by the Legislature this year. This blog summarizes legislation by topics and actions taken by the Governor, Chaptered (signed) or Vetoed.

Proposed Federal Rule on Immigrants and Public Charge

September 28, 2018

In late September 2018, the U.S. Department of Homeland Security released a proposed rule to change the factors affecting a “public charge” determination for immigrants to the U.S. The proposed rule represents a dramatic shift in immigration policy and could prevent many low-income immigrants from reuniting with their families in the U.S.

California’s Uninsured Rate is 7.2 Percent, According to New Census Data

September 13, 2018

A new report from the U.S. Census Bureau shows California continued to make progress in reducing the number of uninsured in 2017. Census Bureau figures show that between 2016 and 2017, the number dropped by 47,000, leaving 2.8 million uninsured, or 7.2 percent of the population.

Health Bills Advance to the Governor’s Desk

September 4, 2018

Friday was the deadline for the California Legislature to pass legislation for the 2017-18 legislative cycle. The Assembly and Senate passed the following health bills; the Governor has until September 30 to act on the bills.

New Report Highlights Continued Strength of Community Health Centers Under the Affordable Care Act

September 4, 2018

More than four years into implementation of the Affordable Care Act (ACA), community health centers continue to play a prominent role in connecting consumers with health coverage despite recent federal reductions in ACA advertising funding, diminishing support for navigators, and a shortened open enrollment period.

The Legislature Fails to Advance Coverage for California’s Remaining Uninsured

August 17, 2018

On August 16, 2018, the California Legislature ended 2018 legislative efforts to expand coverage and increase affordability with multiple bills stalling in the Senate and Assembly fiscal committees.

Covered California Premiums for 2019 Increase Amid Concerns that Federal Efforts to Weaken the Affordable Care Act Are Having an Impact

July 25, 2018

Last week, Covered California announced preliminary health plan premium rates for the 2019 coverage year and suggested that federal action to weaken the Affordable Care Act (ACA) may have yielded higher rates than might have otherwise been expected. Subject to approval by state regulators, Covered California 2019 individual market rates will increase on average 8.7 percent.

California’s Health Care Safety Net

June 26, 2018

ITUP is pleased to release a new report, California’s Health Care Safety Net, the first in a new ITUP series, Health Policy Essentials, highlighting the basics on California health care programs and policy issues. This first issue brief focuses on the programs, providers and populations that make-up the state’s health care safety net for low-income and underserved communities.

2018 California At-A-Glance

June 22, 2018

The California At-A-Glance provides information on the remaining uninsured and coverage in California.

California Strategies: Covering California’s Remaining Uninsured and Improving Affordability

June 7, 2018

This issue brief analyzes policy proposals advanced this year to move the state closer to universal coverage by focusing on the challenges many Californians face.

Remaining Uninsured in California (Revised and Updated, April 2018)

April 27, 2018

California fully embraced the federal Affordable Care Act (ACA) with dramatic results. California’s uninsured rate is
currently at just 7 percent overall and 8.1 percent among those under 65 years old. In the years prior to the ACA,
California’s uninsured rate hovered between 16 and 19 percent.

Exploring Public Options in California

March 20, 2018

This ITUP report looks at public plan choice, the “public option,” through a California lens. ITUP identifies the unique circumstances in California relevant for the discussion about public options and outlines how a California public option might be structured.

2017-18 Legislative Session Bills in California

March 12, 2018

The deadline for introducing legislation in the second year of the 2017-18 legislative session was last month. Health Committees in both houses begin bill hearings this week on 2018 bills and on two-year bills that remain eligible for action.

Notes from the Field: Immigrant Communities in California Under the Cloud of Immigration Enforcement

February 14, 2018

In 2017, ITUP hosted annual workgroups throughout California, 10 regional workgroups and two collaboratives in Los Angeles. This report includes background on the legal complexities at the intersection of immigration policy and health access, and highlights key themes from the workgroup discussions.

Snapshot: Remaining Uninsured in California (Revised and Updated, April 2018)

January 10, 2018

Prior to the ACA, the uninsured rate for nonelderly Californians persisted around 20 percent. Although California’s implementation of the ACA dramatically reduced the number of uninsured, nearly three million uninsured Californians remain. This snapshot provides a quick profile of California’s remaining uninsured.

Health Care Reform: 2017 Year-In-Review

January 7, 2018

Because California embraced the opportunities available under the Affordable Care Act (ACA), 2017 began and ended with California reaching historic low rates of uninsured. The timeline below reviews notable health reform events for 2017 and includes links to source documents and related ITUP publications.

California Department of Health Care Services Confirms Graham-Cassidy Legislation Would Be Devastating for Health Care in California

September 25, 2017

On September 22, 2017, the California Department of Health Care Services (DHCS) released a fiscal analysis of pending Affordable Care Act (ACA) repeal legislation authored by U.S. Senators Graham, Cassidy, Heller and Johnson (Graham-Cassidy).

The U.S. Senate is contemplating ACA repeal legislation that could lead to 6.7 million Californians losing coverage

September 21, 2017

Under the latest Republican ACA “repeal and replace” bill, 6.7 million Californians could lose coverage and California could lose in one year an amount in federal funding equivalent to more than one-third of all General Fund spending in California’s budget, $57.5 billion, according to the U.C. Berkeley Labor Center (Labor Center) blog post.

Fact Sheet November 2017 – Remaining Uninsured in California

September 13, 2017

California benefited more than most states from the Affordable Care Act (ACA) because California fully embraced the ACA opportunities to expand coverage and streamline enrollment and retention processes. This also means that California has the most at stake in federal efforts to repeal or rollback the ACA coverage expansions. In the years preceding the ACA, […]

Framework for Designing a Health Coverage Proposal

August 27, 2017

On August 25, 2017, Speaker of the California Assembly, Anthony Rendon (D-Lakewood), announced the formation of the new Select Committee on Health Care Delivery Systems and Universal Coverage.

Covered California 2018 Rates Complicated By Federal Uncertainty and Rural Challenges

August 24, 2017

This week, Covered California, California’s Affordable Care Act (ACA) exchange, announced preliminary 2018 premium rates for exchange health plan offerings. Health plan proposed rates are still subject to regulatory review by the state Department of Managed Health Care (DMHC) and the California Department of Insurance (CDI). Covered California announced an average rate increase of 12.5 […]

Senate BCRA Incorporating the Graham-Cassidy-Heller Amendment

August 20, 2017

Near the end of July 2017, as the U.S. Senate began voting on various Republican‐sponsored initiatives to rollback the Affordable Care Act (ACA), Senators Graham (R‐South Carolina) and Cassidy (R‐Louisiana) offered an amendment to the Better Care Reconciliation Act (BCRA), which Senator Heller (R‐Nevada) later co-sponsored.

ACA Stands (for Now): Takeaways from the Repeal and Replace Roller Coaster

July 28, 2017

For now, the ACA remains. Credit goes to all the community voices, advocates, and experts who kept the pressure on elected officials and continued to call out the very real threats the proposals represented. Here for consideration are some takeaways from the admittedly chaotic “repeal and replace” process.

Fact Sheet, July 2017 – Summary of the Better Care Reconciliation Act

July 25, 2017

On July 13, 2017 Senate Republican leaders released a revised discussion draft of the Better Care Reconciliation Act (BCRA). The changes made in this version of the Senate proposal do not substantively change the basic features of the original BCRA proposal. The discussion draft leaves in place the dramatic restructuring of the federal Medicaid program. […]

The Common Theme of Pending Senate Health Reform Bills? Dramatic Increases in the Number of Uninsured

July 23, 2017

As of this writing, multiple discussion drafts of potential legislation to repeal or rollback the federal Affordable Care Act (ACA) are pending in the U.S. Senate. All the bills result in dramatic increases in the number of uninsured over the next ten years.

Revised Senate Health Reform Continues to Threaten Coverage for Millions

July 14, 2017

On July 13, 2017 Senate Republican leaders released a revised discussion draft of the Better Care Reconciliation Act (BCRA). The Congressional Budget Office (CBO) concluded the original BCRA ultimately strips coverage from more than 22 million Americans.

State Medicaid Agency Finds Staggering Losses for California Under U.S. Senate Bill

June 29, 2017

The magnitude of the state funding gap created by the BCRA threatens every part of the Medi-Cal program – provider payments, eligibility and benefits. The bill threatens California’s progress in reducing the uninsured and improving the health of Californians.

Fact Sheet, June 2017 – Year-by-Year Impacts of the Senate Better Care Reconciliation Act

June 27, 2017

According to the Congressional Budget Office (CBO), the Senate Better Care Reconciliation Act (BCRA) of 2017 strips insurance coverage from 22 million Americans by 2026, a similar result as the House-passed American Health Care Act (AHCA). This ITUP Fact Sheet shows the year-by-year policy changes that eventually lead to dramatic waive of uninsured Americans. Download […]

U.S. Senate Discussion Draft Continues Path to Increasing the Uninsured

June 23, 2017

On June 22, 2017, Senate Republicans released a discussion draft of legislation that would undo key provisions of the ACA. The BCRA would slow the timeline for some changes to ACA, but includes deeper cuts to Medicaid.

Meeting the Health Needs of the Immigrant Community In Uncertain Times

June 14, 2017

This fact sheet provides information on California’s immigrant community, the barriers they face to access health care, and California policies promoting access and/or coverage for all residents, regardless of immigration status.

California Budget Conference Committee Considers Coverage Expansion for Young Adults

June 5, 2017

While federal policymakers consider legislation that would eliminate coverage for 23 million Americans, California considers expanding Medi-Cal to all low-income California residents up to age 26 Late last week, the two-house budget conference committee of the California Legislature began deliberations on the 2017-2018 state budget. The conference committee will take up multiple budget items […]

CBO Confirms Devastating Consequences of the House-passed American Health Care Act

May 25, 2017

On May 24, 2017, the Congressional Budget Office (CBO) released an updated cost estimate for the American Health Care Act passed by the U.S. House of Representatives on May 4, 2017, adjusting their analysis for last minute amendments to H.R. 1628. (See ITUP summary of AHCA here.) The March 23, 2017 CBO analysis of a previous […]

ITUP ACA Watch, Issue 4 — The ACA and Medi-Cal: What’s at Stake?

May 25, 2017

This issue of ACA Watch highlights program and population changes that re-shaped Medi-Cal under ACA. In addition to expanding coverage for some of the state’s most disenfranchised residents, the ACA dramatically altered the demographic profile and scope of the Medi-Cal program.

ITUP ACA Watch, Issue 4 — The ACA and Medi-Cal: What’s at Stake?

May 25, 2017

Summary of President Trump’s Proposed Fiscal Year 2018 Budget Plan

May 24, 2017

On May 23, 2017, the Trump Administration released its proposed federal fiscal year (FFY) 2018 budget plan which relies on draconian cuts to the safety-net to increase spending for the military, border security, tax reform and infrastructure.

California Moves to Protect ACA Consumer Cost-sharing Reductions (CSRs)

May 23, 2017

On May 18, 2017, California and New York led 13 other states and the District of Columbia in filing a motion to intervene in the federal lawsuit affecting payments that reduce out-of-pocket costs for low income individuals enrolled in Affordable Care Act (ACA) marketplaces. Under ACA, individuals and families with incomes below 250 percent of […]

Fact Sheet, May 2017 – Summary of The American Health Care Act

May 5, 2017

On May 4, 2017, the United States House of Representatives passed the American Health Care Act (AHCA), H.R. 1628, as amended, as a budget reconciliation bill, on a party line vote, 217-213. The AHCA is intended to deliver on the Republican pledge to “repeal and replace” the ACA. Read more about the AHCA by downloading […]

U.S. House of Representatives Passes Bill that Will Lead to Millions of Uninsured

May 5, 2017

On May 4, 2017, the United States (U.S.) House of Representatives passed a budget resolution, the American Health Care Act (AHCA) (H.R. 1628), as amended. AHCA passed on a party line vote, 217-213. The AHCA is intended to deliver on the Republican pledge to “repeal and replace” the ACA. Last minute amendments added funding for […]

ITUP ACA Watch, Issue 3 — The False Equivalency of High-Risk Pools to Replace the ACA

April 25, 2017

This issue of ACA Watch highlights why high-risk pools would also likely not preserve the ACA’s promise to cover everyone regardless of pre-existing conditions. Ultimately, high-risk pools are a false equivalency to the ACA’s comprehensive coverage framework.

ITUP ACA Watch, Issue 3 — The False Equivalency of High-Risk Pools to Replace the ACA

April 25, 2017

Many Republican proposals to repeal, replace or rollback the federal Affordable Care Act (ACA) reintroduce state-based high-risk pools for individuals with pre-existing and high-cost health conditions. California’s pre-ACA experience with a state high-risk pool, discussed in this issue of ACA Watch, demonstrates that high-risk pools leave individuals who, by definition, most need access to comprehensive […]

Notes from the Field: California Legislative Hearings Put a Spotlight on the Impact of the ACA

April 3, 2017

Insure the Uninsured Project (ITUP) recently had the honor of participating in several health reform public hearings held around California. At the invitation of state elected officials, ITUP’s executive director, Deborah Kelch, testified as an independent expert on California’s success in implementing the Affordable Care Act (ACA) and the emerging threats from federal “repeal and replace” efforts.

Notes from the Field: Resources

April 3, 2017

PowerPoint Presentations ITUP Testimony Senate Health Committee 3-23-17 ITUP Testimony Assembly Health Committee 3-22-17 ITUP Testimony Senate Health Bakersfield 1-19-17 Senate Hearing Videos Bakersfield Fresno San Diego

ITUP ACA Watch, Issue 2 — Congressional Budget Office Scores the American Health Care Act

March 16, 2017

The second Issue in the series provides information and analyses on the independent, nonpartisan Congressional Budget Office (CBO) review of the American Health Care Act (AHCA). The GOP proposed AHCA would dismantle significant portions of the federal Affordable Care Act. This ACA Watch describes key provisions of the AHCA and highlights the CBO’s most significant […]

ITUP ACA Watch, Issue 2 – Congressional Budget Office Scores the American Health Care Act

March 16, 2017

The second issue in the series provides information and analyses on the independent, nonpartisan Congressional Budget Office (CBO) review of the American Health Care Act (AHCA). The GOP proposed AHCA would dismantle significant portions of the federal Affordable Care Act. This ACA Watch describes key provisions of the AHCA and highlights the CBO’s most significant […]

ITUP ACA Watch, Issue 1 – FAQs on ACA Repeal and Replace

December 12, 2016

Insure the Uninsured Project (ITUP) today launched a new publication series to be known as ACA Watch. In the wake of the 2016 Presidential election, California’s reform progress, and progress around the country, is at risk. President-Elect Trump, and Republican members of Congress now in the majority in both houses, campaigned on a platform of […]

ITUP ACA Watch — FAQs on ACA Repeal and Replace

December 12, 2016

Hospital Data – OSHPD 2014

April 6, 2016

Below are detailed excel sheets of the 2014 Office of Statewide Health Planning and Development (OSHPD) hospital utilization and financial data. As 2014 marks the start of ACA implementation, the data is a good measure of the changes that took place as a result of the law. Hospitals were analyzed by region, as well as by type. […]

Reflections on the 6th Anniversary of the Affordable Care Act

March 23, 2016

Today we mark six years since passage of the landmark federal Affordable Care Act (ACA). This is an important opportunity to take time and acknowledge our collective efforts to embrace and fully implement the ACA and its coverage expansions. ACA implementation has essentially cut in half the number of uninsured Californians. More than 13 million […]

2015 Workgroup Summaries

March 8, 2016

ITUP conducts a series of regional and statewide issue workgroups every year and provides executive summaries of all proceedings. These summaries provide an overview of the main topics of discussion, ranging from local enrollment success and challenges, local reform initiatives, and developing issues that stakeholders are grappling with. Regional Workgroups North Central Regional Workgroup Executive […]

Opportunities for California Under Section 1332 of the Affordable Care Act

February 16, 2016

ITUP’s report, Opportunities for California Under Section 1332 of the Affordable Care Act, is now available. California has made great progress implementing the Affordable Care Act (ACA), with 6 million people newly enrolled in either Medi-Cal or Covered California since December 2013. The state strives to improve the quality, outcomes and effectiveness of care and […]

Covered California: Consumers Still Have Through Feb. 6 to Finish Their Applications

February 5, 2016

From Covered California’s website: SACRAMENTO, Calif. — With three days left for consumers to finish their applications for affordable, quality health care coverage through the Patient Protection and Affordable Care Act, Covered California announced that more than 425,000 consumers had made plan selections during its third open-enrollment period. “In the last four days of open […]

Transforming Drug Medi-Cal: Key Considerations for a Waiver Amendment

June 2, 2014

California’s expanded Medi-Cal program and expanded Substance Use Disorder (SUD) benefit provides an opportunity for beneficiaries to access improved services through the Drug Medi-Cal (DMC) program. In California, 1.9 million individuals are newly enrolled in Medi-Cal in 2014, [1] and an anticipated 147,000 to 195,000 of these individuals are in need of SUD treatment. [2] […]