The Healthy California for All Commission, established in 2019 through Senate Bill 104, was created to advance efforts towards a health care system that delivers affordable, equitable, accessible, high quality health care for all Californians through a unified financing system. Two of the Commission recommendations have already been implemented this year. First, with the expansion of Medi-Cal eligibility to all adults between the ages of 26-49 regardless of immigration status, all California residents are now eligible for the full scope of Medi-Cal benefits. Second, the state passed legislation that established …

Medicaid serves nearly one in five Americans, including many with chronic conditions, and purchases about 10% of total prescription medications dispensed in the U.S.[1] From 2013 to 2016, Medicaid’s nationwide drug spending increased almost 50%, from $22.4 billion to $33.4 billion.[2] Medicaid programs consume an increasing percentage of state budgets and threaten to overtake funding for other programs like education and infrastructure.[3] In 2018, the National Association of State Budget Officers (NASBO) estimated that Medicaid accounted for nearly 30% of total state spending and is the fastest growing component of …

On June 27, 2018, the Centers for Medicaid and Medicare Services (CMS) denied Massachusetts’ request to implement a closed drug formulary in its Medicaid program. In a previous post, the Source described the request and explained why it has the potential to save the state millions of dollars every year. In denying the request, CMS said that it would consider the waiver if Massachusetts no longer used the federal Medicaid Drug Rebate Program in which manufacturers give the state rebates when the state purchases a drug to ensure that Medicaid …