This issue brief explores the affordability of health coverage in California in 2018, the latest year for which data are available, with a particular focus on health insurance deductibles and on who reports the greatest affordability challenges. Where possible, this brief compares data in 2018 to 2013, the last year before full implementation of the ACA, to assess trends under the ACA.

Health care is still far too expensive for many Californians. Crucial to any cost containment effort is a detailed understanding of what costs are being reduced, where they are coming from, and who has the potential to capture the savings. This report focuses on the landscape of health care spending and a framework for understanding cost containment approaches in California.

Controlling the growth of health spending is central to any state effort to achieve universal coverage and to relieve consumers struggling with out-of-pocket costs. California can learn from four states that have established state commissions to measure, monitor, and set targets to control health care cost increases.

This issue of CIN Connections features insights on California's policy landscape from California Health and Human Services Secretary Mark Ghaly and California Senator Holly Mitchell, tips on building a new model for complex care, and CIN partners' future goals in tackling CIN priority areas.