Office of Health Care Quality and Affordability.

Existing federal law, the Patient Protection and Affordable Care Act (PPACA) , enacts various health care market reforms. Existing state law creates the California Health Benefit Exchange (Exchange) , also known as Covered California, to facilitate the enrollment of qualified individuals and qualified small employers in qualified health plans as required under PPACA. Until January 1, 2023, existing law requires the Exchange to administer a program to provide health care coverage financial assistance to California residents with household incomes at or below 600% of the federal poverty level. This bill would create the Office of Health Care Quality and Affordability to analyze the health care market for cost trends and drivers of spending, develop data-informed policies for lowering health care costs, and create a strategy to control health care costs. The bill would require the office to be governed by a board with specified membership, and would require the board to hire an executive director to organize, administer, and manage the operations of the office. The bill would require health care entities to report specified data to the board, which the board would be required to keep confidential. Based on that data, the bill would require the board to annually establish statewide health care cost growth targets beginning in the 2022 calendar year and sector-based health care cost growth targets beginning in the 2023 calendar year. This bill would require health care entities to comply with the above-described health care cost growth targets and would authorize the board to assess civil penalties for violations of the health care cost growth targets. The bill would establish the Health Care Quality and Affordability Fund, within the State Treasury, into which civil penalties would be deposited. Upon appropriation by the Legislature, the bill would require moneys in the fund to be expended by the board in a manner that prioritizes the return of the moneys to consumers and payers. Existing constitutional provisions require that a statute that limits the right of access to the meetings of public bodies or the writings of public officials and agencies be adopted with findings demonstrating the interest protected by the limitation and the need for protecting that interest. This bill would make legislative findings to that effect.