States and the federal government will spend at least $700 million this year to pay the tax for their Medicaid health plans. The three dozen states that use Medicaid managed care plans will give those insurers more money to cover the new expense.

As director of the California Department of Managed Health Care, Shelley Rouillard is the chief regulator for health plans that cover more than 21 million Californians. She's also a major player in the state's implementation of the federal health law.

Being a doctor in private practice today is more complicated than it used to be, with growing financial pressures, more government regulation, greater oversight by insurers, rapid developments in medicine and pressure to keep up with technology.

Next year, more corporate workers are likely to be offered high-deductible plans — sometimes known more benignly as consumer-directed plans.

The measure by Assemblywoman Lorena Gonzalez (D-San Diego) would require employers to give their workers at least three paid sick days per year. Supporters say it would provide paid leave to approximately 6.5 million workers in the state.