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 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 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 2021-22 Budget: Department of Developmental Services (DDS) May Revision Budget Proposal

May 24, 2021 - The recently passed ARP Act provided one-time Medicaid funding to “enhance, expand, or strengthen ” home- and community-based services (HCBS) by increasing the federal matching rate by 10  percentage points for a one-year period.
https://lao.ca.gov/Publications/Report/4438

The 2024-25 Budget: Department of Developmental Services

Feb 13, 2024 - Background Lanterman Act Lays Foundation for “Statutory Entitlement. ” California ’s Lanterman Developmental Disabilities Services Act (Lanterman Act) originally was passed in 1969 and substantially revised in 1977.
https://lao.ca.gov/Publications/Report/4837

The 2023-24 Budget: Overview of the Governor's Budget

Jan 13, 2023 - Because the State Constitution requires the state to pass a balanced budget, the Governor must propose solutions when the administration estimates the state faces a budget problem. The state has many types of solutions —or tools —for addressing a budget problem, but the most important include: reserve withdrawals, spending reductions, revenue increases, and cost shifts (for example, between funds).
https://lao.ca.gov/Publications/Report/4662

The 2022-23 Budget: Health Care Access and Affordability

Feb 23, 2022 - Attempting to address this issue could require additional market interventions —such as attempting to increase competition, consolidating the purchase of pharmaceuticals to a greater extent than today to increase bargaining power, or passing legislation to regulate costs.
https://lao.ca.gov/Publications/Report/4560