Average Family with CCH Savings
Annual per-capita savings computed from statewide 10% net savings on ~$500B total CA healthcare spend, divided across ~39.4M residents, then multiplied by household size. Adjust the slider above to see your estimate.
| Average Family ($80,000 salary) | With CCH | Now, Pre-CCH |
|---|---|---|
| Worker premium contribution | $0 | $6,296 |
| Deductibles + copays | $0 | $2,000 |
| CCH payroll contribution | $4,800 | $0 |
| Net change | $3,700 saved | 0 |
CA has ~13.43M households. A 10% net savings on ~$500B equals ~$50B statewide, or roughly ~$3,700 per household per year (directional). Actual savings vary by income, household size, and current coverage type.
Family Health Insurance: Before vs. After CCH
KFF 2024 Employer Health Benefits Survey: average total family premium $25,572/year; worker share $6,296. Under CCH, premiums and cost-sharing are eliminated entirely and replaced by the payroll tax.
CCH Estimated Annual Revenue — All Sources
Existing public funds (Medi-Cal + Medicare CA share) total ~$331B. New CCH revenue sources add ~$185.5B. Combined: ~$516B. Medi-Cal figures from the 2025–26 California Budget Act. Medicare CA share estimated proportionally (~12% of $1.12T national Medicare spend for ~7M CA beneficiaries).
| Source | Basis | Estimated annual revenue | Type |
|---|---|---|---|
| Existing public funds redirected to CCH | |||
| Medi-Cal — federal funds (FMAP) | 2025–26 CA Budget Act; ~61.8% federal match | ~$120B | Redirected |
| Medi-Cal — state General Fund | 2025–26 CA Budget Act GF appropriation | ~$45B | Redirected |
| Medi-Cal — special & other funds | MCO tax revenue, county funds, reimbursements | ~$32B | Redirected |
| Medicare — California beneficiary share | ~7M CA enrollees × ~12% of $1.12T national Medicare spend (requires federal CMS agreement) | ~$134B | Federal |
| Existing public subtotal | ~$331B | ||
| New CCH revenue sources | |||
| Employer payroll tax (6%) | ~$1.32T taxable CA wage base (above 250% FPL) | ~$79B | New |
| Employee payroll tax (6%) | Same taxable base as employer | ~$79B | New |
| Stock-based compensation levy (12% combined) | ~$75B est. CA annual RSU/equity grants; 6% employer + 6% employee at issuance | ~$18B | New |
| Corporate windfall profit assessment (10%) | Businesses >$10M revenue with profit margins above 10% | ~$8B | New |
| Luxury real estate transfer fee (1–2%) | CA property sales over $5M; tiered 1%–2% rate | ~$1.5B | New |
| New CCH revenue subtotal | ~$185.5B | ||
| Grand total — all sources | ~$516B | ||
Projected Savings Breakdown (Illustrative)
Administrative simplification (40%), drug price negotiation (25%), care delivery & coordination (25%), fraud/abuse controls (10%). Source: Shrank et al. (2019), JAMA.
California Spend Before vs. After Reforms
Uses CMS/OHCA 2024–25 estimated CA total spend (~$500B) and applies a conservative 10% net savings assumption to show directional impact (~$50B statewide savings).
New CCH Revenue Sources Breakdown
The two 6% payroll taxes (employer + employee) on wages above 250% FPL are by far the largest new revenue source, drawing on California's ~$1.85T annual wage base (Federal Reserve / BEA 2025). The stock levy, windfall assessment, and real estate fee are supplemental but significant.
Key Caveats & Important Notes
- Medicare requires a federal agreement. Redirecting ~$134B in Medicare funds to CCH requires a formal waiver or agreement with the Centers for Medicare & Medicaid Services (CMS). No state has accomplished this at scale. This is the single largest legal and political challenge in the CCH proposal and will require dedicated federal negotiation.
- Payroll base estimate. Total CA wages are ~$1.85T (BEA/Federal Reserve 2025). Approximately 29% of CA workers earn below 250% of the Federal Poverty Level (~$36,000/individual) and are excluded from the taxable base, yielding ~$1.32T in taxable wages.
- Stock levy estimate is conservative. CA LAO data shows RSU/stock-based withholding grew 11.5% year-over-year in tech sectors in 2024. The ~$75B annual equity grant estimate may increase significantly as AI-sector compensation grows.
- Windfall profits are broadly defined. The 10% profit-margin threshold applies to all businesses with >$10M revenue, including healthcare providers. This is intentional — the proposal treats healthcare as a public good, not a profit center.
- Savings projections are directional. The 10% net savings figure is conservative relative to peer-reviewed estimates (Shrank et al., 2019 estimated $760B–$935B in achievable national savings). Actual CA savings will depend on implementation quality and actuarial modeling by the CCH Board.
- Uninsured population absorption. California has ~2.8M uninsured residents. CCH will need to absorb this newly covered population, partially offsetting gross savings in the early years.
References & Data Sources
- California Budget Act 2025–26 — Medi-Cal
CA Senate Budget Committee: Medi-Cal Expenditure Authority 2025–26
Total Medi-Cal: $202.7B ($45.6B GF, $120.7B federal, $36.4B special funds). - CMS — National Health Expenditure Data 2024
CMS NHE Fact Sheet 2024
National Medicare spending: $1.118T (2024). CA share ~12% based on ~7M of ~67M beneficiaries. - CA LAO — Medi-Cal Fiscal Outlook 2026–27
LAO: Medi-Cal Fiscal Outlook
GF support grows from $44.9B (2025–26) to $51.6B by 2029–30. - Federal Reserve / BEA — California Wages & Salaries 2025
FRED: Total Wages and Salaries in California
~$1.85T total CA wages and salaries (seasonally adjusted annual rate, 2025). - CA LAO — Tech Stock Compensation & Withholding 2025
LAO EconTax: Tech Company Stock Pay & Withholding Growth
Tech-sector withholding grew 11.5% YoY in first 11 months of 2024 vs. 4.9% for other sectors. - KFF — 2024 Employer Health Benefits Survey
KFF Employer Health Benefits Survey 2024
Family premium $25,572/year; worker share $6,296; employer share $19,276. - JAMA — Shrank et al. (2019): Waste in the U.S. Health Care System
JAMA: Waste in the U.S. Health Care System
Estimates $760B–$935B in achievable annual savings nationally across 6 waste domains. - Commonwealth Fund — Mirror, Mirror 2024
Commonwealth Fund: Mirror, Mirror 2024
Comparative international analysis; U.S. ranks last among high-income nations on equity and access. - California Medicare Enrollment — CMS 2025
CMS: California Medicare Enrollment 2025
7,050,213 California residents enrolled in Medicare as of 2025 open enrollment.
All revenue and savings figures are directional projections for public education purposes. Formal actuarial modeling will be commissioned by the CCH Board prior to full implementation, consistent with Section 5 of the CCH Act. Estimates will be updated as new data becomes available.