Office of Health Care Affordability

OHCA, established in 2022, will profoundly shape health care in California. Its legislated goals are to slow health care spending growth, promote high-value system performance, and assess market consolidation. CHA is actively engaged in the implementation process, advocating to improve affordability for patients while ensuring hospitals are able to make much-needed investments to improve access, quality, and equity.

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In addition to in-person advocacy at OHCA meetings, CHA has submitted the following comment letters.

Given the many factors that will undermine providers’ ability to achieve a 3% to 3.5% spending target without negatively impacting care delivery, it is critical that OHCA thoughtfully and thoroughly analyze progress toward the target and the broader effects of that progress on the health care system

CHA letter to OHCA Board Chair Dr. Mark Ghaly – May, 2024

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California’s hospitals recognize that accessible, affordable care is out of reach for too many patients and stand ready to work with the Office of Health Care Affordability (OHCA) and other stakeholders to transform our health care system into one that best serves patients.

CHA letter to OHCA Board Chair Dr. Mark Ghaly – April 19, 2024

Read the full letter

Previous Letters


Senate Bill 184, part of the 2022-23 state budget package, established the Office of Health Care Affordability within the Department of Health Care Access and Information (HCAI). The office’s objectives and responsibilities are to:

Jurisdiction. The office’s authority extends to payers, such as health plans and public health care coverage programs; providers, including hospitals and physician groups; and fully-integrated delivery systems.

Governance. OHCA is housed within the Department of Health Care Access and Information and is overseen by an eight-member board with input from an advisory committee.

See OHCA’s website for links to public meetings, laws and regulations, and additional information.

Implementation of the office will occur gradually over the next several years:

The office’s work coincides with a period of unparalleled financial distress for hospitals. Rising costs, — including expenses for workforce and other needs, along with state-mandated capital improvement projects — mean that hundreds of California’s hospitals are operating with negative margins, losing money every day to care for patients.


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