California Health Care Foundation

Introduction

The Inland Empire counties of Riverside and San Bernardino span a vast stretch of Southern California — from densely populated urban centers in the west to sparsely populated desert communities reaching the Nevada border. The region’s population continues to grow, but residents are more likely to be low income and less likely to have a college education than C...

Up to two million Californians could lose Medi-Cal coverage as new federal requirements take effect — including work mandates, more frequent eligibility checks, and restrictions on immigrant coverage.

The state has options, but none are simple. Each involves trade-offs between cost, access, and the scope of benefits.

Two Care Alternatives

At a convening in Sacramento in November 2025, experts from across California discussed ways to strengthen the primary care sector of the health care system. Among the participants were, from left to right in foreground, Alyson Spencer, MHA, vice president of clinical quality at Blue Shield of California, and Abbie Totten, president of a Sacramento-based health plan ...

Every year, the California Health Care Foundation steps back to ask a fundamental question: Given everything happening in California’s health care system, where can we have the most impact? This year, that question felt more urgent than usual.

The environment we’re operating in right now is unlike anything I’ve seen in my decade at the foundation. Federal policy...

Key Takeaways Adult residen­tial facilities (ARFs) and residential care facilities for the elderly (RCFEs) – jointly referred to as assisted living facilities (ALFs) – offer a proven, cost-effective path to stability and independence for Californians with serious mental illness and/or substance use disorders — yet they remain significantly underutilized for people with beh...