Health In California
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This article summarizes healthcare in California.


California State Department of Health Care Services

The California Department of Health manages state government projects in California.


Health insurance

As of 2018, most of the insured in California were in plans regulated by the
California Department of Managed Health Care The Department of Managed Health Care (DMHC) is a regulatory body governing managed health care plans, sometimes referred to as Health Maintenance Organizations (HMOs) in California. The DMHC was created as the first state department in the countr ...
(DMHC) with about 60% regulated by either DMHC or the
California Department of Insurance The California Department of Insurance (CDI), established in 1868, is the agency charged with overseeing insurance regulations, enforcing statutes mandating consumer protections, educating consumers, and fostering the stability of insurance marke ...
(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 The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("man ...
plans where providers take on risk have arisen, and in 2019 the DHMC announced plans to regulate these "risk-bearing entities".


Medi-Cal

As of 2018, about one-third of California was covered by
Medi-Cal The California Medical Assistance Program (Medi-Cal or MediCal) is California's Medicaid program serving low-income individuals, including families, seniors, persons with disabilities, children in foster care, pregnant women, and childless adults wi ...
, which is California's Medicaid program. It is administered by the
California Department of Health Care Services The California Department of Health Care Services (DHCS) is a department within the California Health and Human Services Agency that finances and administers a number of individual health care service delivery programs, including Medi-Cal, which pr ...
, which operates it in accordance with California's Medicaid State Plan and Title XIX of the Social Security Act.


Private markets

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 Kaiser Permanente (; KP), commonly known simply as Kaiser, is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser P ...
had about 50% of the market, followed by
Blue Shield of California Blue Shield of California is a mutual benefit corporation and health plan founded in 1939 by the California Medical Association. It is based in Oakland, California, and serves 4.5 million health plan members and more than 65,000 physicians acro ...
,
Anthem Blue Cross Elevance Health, Inc. is an American health insurance provider. The company's services include medical, pharmaceutical, dental, behavioral health, long-term care, and disability plans through affiliated companies such as Anthem Blue Cross and ...
, and
Health Net Health Net, LLC, a subsidiary of Centene Corporation, is an American health care insurance provider. Health Net and its subsidiaries provide health plans for individuals, families, businesses and people with Medicare and Medicaid, as well as com ...
(a subsidiary of Centene). L.A. Care was among the top six in 2015, and the largest county-based insurer. As of 2017,
UnitedHealthcare UnitedHealth Group Incorporated is an American multinational managed healthcare and insurance company based in Minnetonka, Minnesota. It offers health care products and insurance services. UnitedHealth Group is the world's seventh largest c ...
was sixth-largest.


Marketplace

Covered California Covered California is the health insurance marketplace in the U.S. state of California established under the federal Patient Protection and Affordable Care Act (ACA). The exchange enables eligible individuals and small businesses to purchase priv ...
is the
health insurance marketplace In the United States, health insurance marketplaces, also called health exchanges, are organizations in each state through which people can purchase health insurance. People can purchase health insurance that complies with the Patient Protection ...
. Kaiser Permanente and Blue Shield of California had about two-thirds of the market share as of 2018. In 2017 Anthem stopped selling on the exchange.


Healthcare by region


Los Angeles

Los Angeles offers all available health care services. Notable health systems or hospitals in the region include
Los Angeles County Department of Health Services Los Angeles County Department of Health Services (abbreviated DHS and LADHS) operates the public hospitals and clinics in Los Angeles County, and is the United States' second largest municipal health system, after NYC Health + Hospitals. DHS op ...
, Kaiser Permanente,
UCLA Health UCLA Health is a health system which comprises a number of hospitals, the David Geffen School of Medicine at UCLA and an extensive primary care network in the Los Angeles region. As a regional health provider, it benefits from the academic affili ...
,
Cedars-Sinai Cedars-Sinai Medical Center is a nonprofit, tertiary, 886-bed teaching hospital and multi-specialty academic health science center located in Los Angeles, California. Part of the Cedars-Sinai Health System, the hospital employs a staff of over 2 ...
, Verity Health, Providence Health,
UCI Medical Center The University of California, Irvine Medical Center (UCIMC or UCI Medical Center) is a major research hospital located in Orange, California, Orange, California. It is the teaching hospital for the University of California, Irvine School of Medi ...
, and
Keck Hospital of USC The Keck Hospital of USC, formerly USC University Hospital, is a private 401–licensed bed teaching hospital of the University of Southern California (USC). The hospital is part of the USC Keck School of Medicine, it is located on the USC Healt ...
.


San Francisco Bay Area

San Francisco offers all available health care services. Large health systems in Northern California include
Sutter Health Sutter Health is a not-for-profit Integrated delivery system, integrated health delivery system headquartered in Sacramento, California, Sacramento, California. It operates 24 acute care hospitals and over 200 clinics in Northern California. Sut ...
,
Kaiser Permanente Kaiser Permanente (; KP), commonly known simply as Kaiser, is an American integrated managed care consortium, based in Oakland, California, United States, founded in 1945 by industrialist Henry J. Kaiser and physician Sidney Garfield. Kaiser P ...
, UCSF Health,
Dignity Health Dignity Health (formerly Catholic Healthcare West) was a California-based not-for-profit public-benefit corporation that operates hospitals and ancillary care facilities in three states. Dignity Health was the fifth-largest hospital system in th ...
, and Stanford Medical. In 2018, a lawsuit was filed against Sutter Health for alleged antitrust.


Infrastructure

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Health care districts in California Health care districts are California special districts created to build and operate hospitals and other health care facilities and services in underserved areas. As of 2019, there are 79 health care districts in California. Each health care distric ...


Proposed single-payer healthcare

A
single-payer health care Single-payer healthcare is a type of universal healthcare in which the costs of essential healthcare for all residents are covered by a single public system (hence "single-payer"). Single-payer systems may contract for healthcare services from p ...
system for California has been suggested multiple times. Two bills in the
California State Legislature The California State Legislature is a bicameral state legislature consisting of a lower house, the California State Assembly, with 80 members; and an upper house, the California State Senate, with 40 members. Both houses of the Legisla ...
that would have implemented universal health coverage were vetoed by Governor
Arnold Schwarzenegger Arnold Alois Schwarzenegger (born July 30, 1947) is an Austrian and American actor, film producer, businessman, retired professional bodybuilder and politician who served as the 38th governor of California between 2003 and 2011. ''Time'' ...
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. On January 31, 2022 the bill was shelved and not voted on by the assembly.


Outbreaks, plagues, and epidemics

*
COVID-19 pandemic in California Ten of the first twenty confirmed COVID-19 cases in the United States occurred in California, the first of which was confirmed on January 26, 2020. All of the early confirmed cases were persons who had recently travelled to China, as testing wa ...


See also

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California Medical Association The California Medical Association (CMA) is a professional organization based in California that advocates on behalf of nearly 50,000 physicians in legislative, legal, regulatory, economic, and social issues. The organization was founded in 1856 ...
*
California Health and Safety Code The California Health and Safety Code is the codification of general statutory law covering the subject areas of health and safety in the state of California. It is one of the 29 California Codes and was originally signed into law by the Governor ...
*
California Senate Bill 277 California Senate Bill 277 (SB277) is a California law that removed personal belief as a reason for an exemption from the vaccination requirements for entry to private or public elementary or secondary schools in California, as well as day care c ...
removed personal belief as exemption from vaccination requirements for entry to schools


References


External links


California Department of Health Care ServicesCalifornia Department of Public Health
*
The California Health Care Landscape
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