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.

“OHCA should carefully consider the tradeoffs and shortcomings of different measures of inflation when assessing health care spending growth.”

CHA Letter to OHCA Board – June 2024

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“CHA remains concerned that too many transactions would be swept up in OHCA’s CMIR review process and CMIR determinations would inappropriately exclude the potential positive impacts of transactions.”

CHA comments on cost and market impact review proposal – June 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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