The 2026-27 Budget: Medi-Cal Analysis

Mar 2, 2026 - One possible reason for our higher estimate is that our model reflects not only disenrollment among current enrollees, but also reduced enrollment flows over time and a persistent risk of disenrollment among eligible individuals due to added administrative burden.
https://lao.ca.gov/Publications/Report/5146

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

Oct 24, 2025 - …But Potentially With Added Complexity. Adding more flexibilities also could come with the potential downside of more complexity for beneficiaries and counties. For example, exempting high unemployment counties from work requirements could create more volatility.
https://lao.ca.gov/Publications/Report/5083

The 2026-27 Budget: Medi-Cal Analysis [Publication Details]

Mar 2, 2026 - In this report, we analyze the Governor’s budget for Medi-Cal, with a focus on base spending trends, changes to provider taxes, implementation of new H.R. 1 rules, oversight over enacted budget solutions, and considerations for identifying additional savings in Medi-Cal.
https://lao.ca.gov/Publications/Detail/5146

Considering Medi-Cal in the Midst of a Changing Fiscal and Policy Landscape [Publication Details]

Oct 24, 2025 - We describe the changing fiscal and policy landscape for Medi-Cal resulting from Congressional enactment of H.R. 1 and the key issues facing the Legislature.  See our companion infographic
https://lao.ca.gov/Publications/Detail/5083

The 2026-27 Budget: Medi-Cal Fiscal Outlook

Nov 19, 2025 - Why Does the Health Plan Tax Decline Under H.R. 1? Existing Health Plan Tax Disproportionately Taxes Medi ‑Cal Enrollment. The existing tax on health plans (also known as the Managed Care Organization Tax) charges rates on every monthly Medi ‑Cal and commercial enrollee.
https://lao.ca.gov/Publications/Report/5092

The 2026-27 Budget: Medi-Cal Fiscal Outlook [Publication Details]

Nov 19, 2025 - This brief summarizes our annual outlook for General Fund spending on Medi-Cal.
https://lao.ca.gov/Publications/Detail/5092

The 2025-26 Budget: MCO Tax and Proposition 35

Feb 26, 2025 - The 2025-26 Budget: MCO Tax and Proposition 35 3.6 MCO = managed care organization. Continues Funding 2024 Rate Increase … Though the MCO tax spending plan has changed over time, a few augmentations have remained throughout each plan.
https://lao.ca.gov/Publications/Report/4992

The 2026-27 Budget: Department of Developmental Services

Mar 13, 2026 - The department stated that its budget projections for 2026 ‑27 do not incorporate any potential added costs due to the changes in H.R 1. Will the department be able to determine whether its costs increase in the future due to H.R. 1?
https://lao.ca.gov/Publications/Report/5157

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

Feb 5, 2025 - The managed care organization tax, a tax on health plans that allows California to draw down additional federal funding for Medi ‑Cal, is supporting provider rate increases for a variety of services.
https://lao.ca.gov/Publications/Report/4954

Mental Health Services Act: Revenue Volatility and the Governor’s Proposal to Reduce Allowable County Reserves

Jul 13, 2023 - MHSA Tax Three Times More Volatile Than PIT. Figure  2 compares the AD of MHSA tax revenue to the ADs of the General Fund share of PIT, SUT, and all General Fund tax revenue. As shown in the figure, MHSA tax revenue is about three times more volatile than the General Fund share of PIT and General Fund tax revenues, and is nearly five times more volatile than SUT.
https://lao.ca.gov/Publications/Report/4780