Comments on Proposed Office of Health Care Affordability Statewide Health Care Spending Target Recommendations

Laurel LuciaandMiranda Dietz

These comments were submitted to the California Office of Health Care Affordability (OHCA) in response to the proposal of a 3.0% statewide health care spending growth target for 2025 to 2029. The comments discuss how the erosion in job-based coverage affordability over the last 20 years underscores the need for OHCA to set a spending target that at a minimum keeps health care affordability from getting worse, and ideally makes meaningful improvements in consumer affordability. The recommended methodology for setting the spending target based on household income growth centers consumer affordability. The proposed 3.0% spending target is in a similar range as other states’ targets and exceeds inflation projections by the California Department of Finance and Congressional Budget Office. The OHCA-recommended use of a 20-year historical average in setting the target promotes a more stable target with predictive accuracy that is similar to using a 5-year or 10-year average. The recommended spending target is one of multiple facets of OHCA’s overall work in slowing spending growth while also promoting high value health care and a stable health care workforce.

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