Key Takeaways
- California can lead from a position of strength. With the Office of Health Care Affordability in place and a recent run of cost and consumer protection reforms, the state has the foundation to build on.
- Other states are taking action. Minnesota, Massachusetts, New Jersey, and others have tested affordability policies California can consider.
- The biggest opportunities span four connected areas. Cutting administrative waste, preventing medical debt, controlling hospital prices, and curbing consolidation address costs from multiple directions.
Overview
For years, health care costs in California have grown faster than wages, leaving families under mounting financial pressure. Californians across the political spectrum now want affordability to be a top priority for policymakers, according to CHCF’s 2026 Health Policy Survey.
California enters this reform moment from a position of strength. The state has established institutions, significant market influence, and a track record of meaningful policy action, including the recent launch of the California Office of Health Care Affordability (OHCA). This issue brief scans five years of state legislative and regulatory activity across the country and identifies policy opportunities California could pursue in four priority areas. Some can move forward through existing agency authority; others will require new law.
What You’ll Learn
The full brief is available for download at the bottom of this page. It presents policies other states have taken across four priority areas. Each priority area is available as a separate issue spotlight below.
Reducing administrative complexity and waste. Administrative costs consume as much as one-quarter of all US health care spending. The brief examines ways to make prior authorizations quicker and less burdensome, a single uniform companion guide for HIPAA transactions, standardized payer-provider contract terms, streamlined credentialing, and a first-of-its-kind Billing Complexity Index.
Preventing medical debt and providing consumer relief. Options include extending financial assistance requirements beyond hospitals, establishing a statewide medical debt relief program, and shielding patients from harmful collection tactics.
Controlling unreasonable hospital prices. The brief looks at capping payments within California Public Employees’ Retirement System and California State Teachers’ Retirement System, extending caps across all commercial payers, and fully enforcing OHCA’s hospital cost growth targets.
Addressing consolidation and anti-competitive market practices. The brief explores ownership and financial transparency, stronger oversight of mergers and acquisitions, and prohibiting anti-competitive contract terms.
