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 2018-19 Budget: The Administration’s Proposition 55 Estimates

Mar 1, 2018 - Since January  1, 2016, the Legislature has passed a variety of laws that increase the costs of existing state services, but are not adjustments explicitly allowed in the workload budget definition of Government Code   §13308.05.
https://lao.ca.gov/Publications/Report/3765

The 2025-26 Budget: MCO Tax and Proposition 35

Feb 26, 2025 - These rules required states (including California) to change ho w they pass funds through health plans to providers, tying funds more closely to service delivery and improved health outcomes. In 2024 , more federal rules were enacted on directed payments, including new limits for certain kinds of services.
https://lao.ca.gov/Publications/Report/4992

The 2025-26 Budget: Medi-Cal Fiscal Outlook

Nov 20, 2024 - Under current law, previously planned MCO tax-supported augmentations cannot go into effect if voters pass Proposition  35. Instead, Proposition  35 will determine which services and areas receive increased funding.
https://lao.ca.gov/Publications/Report/4941

The 2018-19 Budget: The Administration's Proposition 55 Estimates in the May Revision

May 22, 2018 - Proposition  55 (2016) extended tax rate increases on high ‑income earners from 2018 until 2030 (which voters originally passed on a temporary basis in 2012 as part of Proposition  30). Revenues raised by the measure benefit the General Fund.
https://lao.ca.gov/Publications/Report/3844

The 2018-19 Budget: Meeting Workforce Demand for Certified Nursing Assistants in Skilled Nursing Facilities

Apr 27, 2018 - Pass a physical (health) screening and criminal background check. Complete an approved training program consisting of at least 60 classroom hours and 100 hours of clinical practice at a SNF. Pass a state CNA certification examination.
https://lao.ca.gov/Publications/Report/3815

The 2023-24 Budget: Assessment of Covered California Budget Solution

Feb 13, 2023 - The American Rescue Plan Act was passed by Congress in 2021 in response to COVID-19. A provision of this act temporarily enhanced federal support for premium subsidies for coverage purchased on health benefit exchanges in 2021 and 2022.
https://lao.ca.gov/Publications/Report/4681

The 2024-25 California Spending Plan: Health

Sep 17, 2024 - The legislation also allows the state to reduce this amount by up to $75  million annually if Proposition  35 (2024) passes. Creates Wellness Coach Benefit. The spending plan includes $9  million ($4  million General Fund), growing to $114  million ($50  million General Fund) over several years, to implement a wellness coach benefit in Medi-Cal.
https://lao.ca.gov/Publications/Report/4930

Building California’s Behavioral Health Infrastructure: Progress Update and Opportunities for the Proposition 1 Bond

Feb 5, 2025 - Proposition  35, which voters passed in November 2024, makes the tax and an associated spending plan permanent in state law. The spending plan includes hundreds of millions of dollars in increases for non ‑specialty mental health services and for services provided in certain behavioral health facilities.
https://lao.ca.gov/Publications/Report/4954

The 2018-19 Budget: Analysis of the Governor's 340B Medi-Cal Proposal

Mar 21, 2018 - These savings would largely be generated under Medi ‑Cal managed care since in FFS covered entities ’ 340B savings should largely already be passed on to the state in the form of lower reimbursement costs.
https://lao.ca.gov/Publications/Report/3790