The 2024-25 Budget: The MCO Tax Package at May Revision

May 22, 2024 - The 2023-24 budget renewed the MCO tax through the end of 2026. Like the recent past versions, the tax is based on MCOs ’ enrollment in Medi-Cal and private insurance. The tax is much larger than previous versions, raising more than three times the amount of revenue.
https://lao.ca.gov/Publications/Report/4905

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

Feb 27, 2024 - As Figure  2 shows, the substantial upward revision in 2023 ‑24 largely is due to the carryover of General Fund spending enacted from previous years, such as funds for the Children and Youth Behavioral Health Initiative and the CalRx initiative.
https://lao.ca.gov/Publications/Report/4860

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

Oct 24, 2025 - In effect, this would place more cost onto private health insurance and, therefore, its consumers. Using the enrollment base of the existing health plan tax, we estimate that an around $30 per ‑member, per ‑month tax rate on both Medi ‑Cal and commercial enrollment would generate around the same net revenue as the current tax.
https://lao.ca.gov/Publications/Report/5083

The 2025-26 Budget: Health Care Access and Information

Feb 20, 2025 - Implementation Update Insulin Initiative Has Private Partner. In  February 2023, HCAI executed a contract with a nonprofit drug maker (Civica Rx) to produce a biosimilar insulin product. Adopting a public‑private partnership, HCAI is committed to pay the partner up to $50 million for meeting specified project milestones.
https://lao.ca.gov/Publications/Report/4979

The 2026-27 Budget: Medi-Cal Analysis

Mar 2, 2026 - The current health plan tax, enacted in 2023 and expanded in 2024, generates more than three times the revenue of previous versions. This higher revenue level is essentially at the maximum of the current federal revenue limit.
https://lao.ca.gov/Publications/Report/5146

The 2023-24 California Spending Plan: Health

Oct 23, 2023 - Early action trailer bill legislation (Chapter  6 of 2023 [AB  112, Committee on Budget]) establishes the Distressed Hospital Loan Program to provide interest-free loans to public and private nonprofit hospitals experiencing financial distress.
https://lao.ca.gov/Publications/Report/4810

The 2026-27 Budget: Medi-Cal Fiscal Outlook

Nov 19, 2025 - As a result, as Figure  2 shows, Medi ‑Cal comprises 19  percent of overall General Fund spending by the end of our outlook period —slightly lower than the 20  percent share in the 2025 ‑26 enacted  budget.
https://lao.ca.gov/Publications/Report/5092

The 2024-25 California Spending Plan: Health

Sep 17, 2024 - Beginning in 1991, MRMIP provided health insurance benefits to high-risk individuals who could not purchase private insurance. Program enrollment fluctuated over the years, but in more recent years declined to just a few hundred people.
https://lao.ca.gov/Publications/Report/4930

The 2023-24 Budget: Medi-Cal Fiscal Outlook

Nov 16, 2022 - We assume these adjustments return to previous levels in 2023 ‑24, resulting in a net General Fund spending decline of $2.1  billion. Unwinding of PHE Increases Net General Fund Spending in Budget Year.
https://lao.ca.gov/Publications/Report/4649

The 2020-21 Budget: Medi-Cal Fiscal Outlook

Nov 20, 2019 - Figure  2 also shows our Medi-Cal spending projections if the federal government were to reject the state ’s MCO tax. In this latter scenario, General Fund spending in Medi-Cal would grow from around $22.9  billion in 2019 ‑20 to $28.2  billion in 2023 ‑24.
https://lao.ca.gov/Publications/Report/4116