The 2026-27 Budget: Medi-Cal Fiscal Outlook

Nov 19, 2025 - The second report— Considering Medi‑Cal in the Midst of a Changing Fiscal and Policy Landscape —provides more information on many of the federal policy changes that drive this year’s Medi‑Cal outlook.
https://lao.ca.gov/Publications/Report/5092

The 2025-26 Budget: Medi-Cal Pharmacy Spending

Apr 3, 2025 - Several factors can drive changes in federal rebates. For example, increasing use of generic drugs, which come with lower costs and lower rebates than brand name drugs, can drive down rebates. State Supplemental Rebates Appear to Be Increasing.
https://lao.ca.gov/Publications/Report/5026

The 2025-26 Budget: Understanding Recent Increases in the Medi-Cal Senior Caseload

Mar 6, 2025 - This means that to explain what is driving recent increases in the senior caseload, we need to account for about 225,000 seniors in excess of this pre ‑pandemic policy baseline (hereafter, “senior growth due to policy changes ”).
https://lao.ca.gov/Publications/Report/5010

The 2023-24 Budget: Medi-Cal Fiscal Outlook

Nov 16, 2022 - The 2023-24 Budget: Medi-Cal Fiscal Outlook Key Uncertainties Summary This brief describes our fiscal outlook for Medi ‑Cal, the major factors that we expect to drive changes in General Fund spending in Medi ‑Cal, and key uncertainties of our projections.
https://lao.ca.gov/Publications/Report/4649

The 2024-25 Budget: Medi-Cal Fiscal Outlook

Dec 7, 2023 - These redeterminations are expected to drive a substantial decline in caseload. We estimate that monthly caseloads will average 12.1  million in 2024-25, a decrease of 1.9  million from the 2023-24 level.
https://lao.ca.gov/Publications/Report/4820

The 2026-27 Budget: Department of Developmental Services

Mar 13, 2026 - Four Key Factors Drive Spending in DDS. As discussed in the analysis that follows, the Lanterman Act, due to its foundational role, influences all cost drivers in the developmental services system. These cost drivers (similar to other health and human services programs) include caseload, available services, utilization of services, and the rates paid for services.
https://lao.ca.gov/Publications/Report/5157

The 2025-26 Budget: Health Care Access and Information

Feb 20, 2025 - This is because (1)  generic drugs often do not require the same level of research and development to go to market and (2)  entry of generic drugs creates market competition that drives down prices. As   Figure  6 shows, while brand drugs represented a small share of commercial health plan fee‑for‑service claims in 2021, they comprised a majority of spending.
https://lao.ca.gov/Publications/Report/4979

The 2025-26 Budget: Medi-Cal Fiscal Outlook

Nov 20, 2024 - Recent Surge in Senior Caseload Driving Increase in Costs. From January 2024 through July 2024, we have observed a sharp increase in Medi-Cal enrollment among the senior population. Specifically, monthly growth averaged about 14,500 people, notably higher than the previous six months (averaging 1,600) or even during the continuous coverage period (averaging 6,200), when the state temporarily paused redeterminations of enrollee eligibi lity.
https://lao.ca.gov/Publications/Report/4941

The 2024-25 Budget: Department of Health Care Access and Information

Feb 27, 2024 - In Current Year, Deferred One-Time Funds Drive Down General Fund Spending. Excluding the carryover of spending from previous years, one-time General Fund spending is down in 2023 ‑24 relative to budget enactment.
https://lao.ca.gov/Publications/Report/4860

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

Oct 24, 2025 - Three Key Questions Will Drive Legislative Decision ‑Making. In revisiting the Medi ‑Cal program, the Legislature faces three key questions: (1)  who should Medi ‑Cal serve, (2)  what per ‑enrollee service level should Medi ‑Cal provide, and (3)  what non ‑General Fund financing options are available?
https://lao.ca.gov/Publications/Report/5083