Fiscal Outlook: Medi-Cal

Nov 15, 2017 - ACA Optional Expansion In 2014, California expanded Medi-Cal eligibility to childless adults with incomes up to 138  percent of the federal poverty level, a population known as the ACA optional expansion population.
https://lao.ca.gov/Publications/Report/3715

The 2025-26 California Spending Plan: Health

Oct 16, 2025 - The 2025-26 California Spending Plan: Health 100 100 a The spending plan assumes a portion of funds designated for this service ($88 million) cannot be allocated due to implementation issues and instead will be spent in 2027.
https://lao.ca.gov/Publications/Report/5075

The 2017-18 Budget: An Overview of the Governor's Proposition 56 Proposals

Feb 22, 2017 - (Based on the administration ’s revenue and backfill projections, we estimate that this cap will be $88  million in 2017 ‑18.) As noted below, Proposition  56 separately provides funding for BOE ’s enforcement activities. $400,000 for State Auditor in 2017 ‑18.
https://lao.ca.gov/Publications/Report/3573

The 2017-18 Budget: Analysis of the Medi-Cal Budget

Mar 9, 2017 - The Governor ’s budget assumes CHIP funding is reauthorized in federal fiscal year 2017 ‑18, but at a 65  percent federal medical assistance percentage (FMAP) in California instead of the 88  percent FMAP authorized by the ACA.
https://lao.ca.gov/Publications/Report/3612

The 2017-18 Budget: Overview of the Governor's May Revision Medi-Cal Budget Proposal

May 17, 2017 - The May Revision budget proposal assumes an increase in General Fund spending of $396  million in 2017 ‑18 relative to what would be the cost if California received the enhanced 88  percent FMAP. This is $139  million less than estimated in the January budget proposal.
https://lao.ca.gov/Publications/Report/3674

The 2018-19 Budget: Governor's May Revision Medi-Cal Budget

May 14, 2018 - Adopting Lower Caseload Estimate Could Free Up Funding for Other Priorities . . . Assuming a more rapid decline in the families and children caseload as described above would free up General Fund in Medi-Cal for other priorities in the state budget.
https://lao.ca.gov/Publications/Report/3839

Fiscal Outlook: Medi-Cal

Nov 14, 2018 - Beginning in 2015, the ACA temporarily enhanced the federal share of cost for CHIP to 88  percent (a 12  percent state share).  Subsequent Congressional action extended the ACA ’s enhanced federal share of cost for CHIP through September 2019.
https://lao.ca.gov/Publications/Report/3898

The 2016-17 Budget: Analysis of the Medi-Cal Budget

Feb 11, 2016 - Currently, the federal government pays 88  percent of the costs for children enrolled in CHIP and the state pays 12  percent. Finally, under ACA, the federal government will pay 100  percent of the costs of providing health care services to the newly eligible Medi –Cal population from 2014 through 2016.
https://lao.ca.gov/Publications/Report/3350

Considering Medi-Cal in the Midst of a Changing Fiscal and Policy Landscape

Oct 24, 2025 - In July 2025, Congress passed and the President signed H.R. 1 —titled the One Big Beautiful Bill Act. This legislation includes about $1  trillion in federal Medicaid reductions over ten years, representing the most significant changes to federal Medicaid policy since the ACA.
https://lao.ca.gov/Publications/Report/5083

The 2026-27 Budget: Medi-Cal Fiscal Outlook

Nov 19, 2025 - Pursuant to state law, most of the decline in revenue will affect supplemental payments to private hospitals, with only a portion (around 25  percent) resulting in less money for existing Medi ‑Cal costs.
https://lao.ca.gov/Publications/Report/5092