Healthy California for All Commission

AB 1810, signed into law in July of 2018 by Gov. Jerry Brown, created a five-member Council on Health Care Delivery Systems to write a plan to provide California residents with universal health care coverage. The charge to the Council was to make recommendations to the Governor and Legislature regarding steps needed to achieve access to health care for all Californians through a unified financing system. Five million dollars was allocated to the Council.

During the 2019 July budget session, SB 104 revised AB 1810 and changed the five-member Council to a 13-member Commission, Healthy California for All (HCFA). SB 104 calls on the State to submit an analysis of California’s existing health care delivery system and options to transition to a unified financing system. These options are to be guided by five principles: The system should be accessible, affordable, equitable, high quality, and universal.

The Commission has 13 voting members: four legislative appointees, eight gubernatorial appointees plus the Chair, Dr. Mark Ghaly, Secretary of the CA Health and Human Services Administration (HHSA). The Commission serves in an advisory role to the Governor and Legislature. Thus, the Commission and its members do not have decision-making authority for the state. A consulting team provides professional guidance, issue analysis and prepares recommendations for the Commission’s consideration.

The Governor’s appointees are health experts from various fields in public health, medicine, academia, business, and labor. Five ex officio, non-voting members also advise the Commission – the acting director of the Department of Health Care Services, the Executive Director of Covered California, the Chief Health Director of CalPERS, the Chairs of the Senate Health Committee, and the Assembly Health Committee; HHSA staff provide support to the Commissioners.

The Commission met for the first time in January 2020. In August, after the first report was sent to the Governor and Legislature, the HHSA suspended the activities of the Commission for the remainder of 2020 due to the COVID-19 pandemic. The Commission resumed its work May 21, 2021. Monthly public meetings were held during the seven remaining months. An additional public meeting was held February 23, 2022.

More information, recordings of the hearings and the August report can be found on the HCFA website: chhs.ca.gov/healthycaforall/.

The final report to Governor and Legislature is to include key design considerations for the financing system:

  • eligibility and enrollment
  • quality monitoring
  • covered benefits and services
  • disparities reduction
  • purchasing arrangements
  • information technology
  • cost containment
  • financial management systems
  • quality improvement
  • governance and administration
  • participant cost sharing
  • integration of federal funding