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 2024-25 California Spending Plan: Health

Sep 17, 2024 - The CCR is funded primarily by federal funds and Proposition  99 tobacco tax revenues, the latter of which has been declining in recent years. The spending plan includes $800,000 of one-time funding in 2024-25 and $2  million ongoing General Fund to support CCR and maintain data system integrity.
https://lao.ca.gov/Publications/Report/4930

The 2026-27 Budget: Medi-Cal Fiscal Outlook

Nov 19, 2025 - Pursuant to state law, most of the decline in revenue will affect supplemental payments to private hospitals, with only a portion (around 25  percent) resulting in less money for existing Medi ‑Cal costs.
https://lao.ca.gov/Publications/Report/5092

Mental Health Services Act: Proposed Restructuring of the MHSA Funding Categories and Impacts on County Spending

Jul 13, 2023 - Whereas current expenditures that would be eligible under the BHSS category currently make up around 60  percent of MHSA dollars, under the proposal, this category would be capped at 30  percent. Consequently, these expenditures would need to be reduced from $1.34  billion to $621  million.
https://lao.ca.gov/Publications/Report/4782

The 2025-26 Budget: Overview of the Governor's Budget

Jan 13, 2025 - The reason for the reduction is the recent voter approval of Proposition  35 (2024), which requires the state to spend less MCO tax money on offsetting General Fund spending and more money on provider rate increases.
https://lao.ca.gov/Publications/Report/4951

The 2026-27 Budget: Department of Developmental Services

Mar 13, 2026 - Under S B  3 , the statewide minimum wage will continue to increase by up to 3.5  percent each year, depending on inflation. In recent years, the cumulative cost of annual minimum wage increases under S B  3 have represented about 5  percent to 10  percent of General Fund spending on services purchased for DDS consumers.
https://lao.ca.gov/Publications/Report/5157

The 2025-26 Budget: Medi-Cal Fiscal Outlook

Nov 20, 2024 - This is because the measure requires the state to use more MCO tax money to increase Medi-Cal services, rather than to offset General Fund spending. The exact fiscal impact depends on how the state implements the measure ’s complex rules.
https://lao.ca.gov/Publications/Report/4941

The 2026-27 Budget: Medi-Cal Analysis

Mar 2, 2026 - DHCS also states that complying with this federal request may qualify California for an up to three ‑year transition period to make the fee more proportionate. Federal Rules Continue to Emerge, Creating Some Uncertainty for Structuring Provider Taxes.
https://lao.ca.gov/Publications/Report/5146

The 2025-26 California Spending Plan: Health

Oct 16, 2025 - To support the fund, the legislation allocates a portion of money from excess balances in health plans ’ special abortion accounts. Health plans that participate in Covered California must use these accounts so that federal subsidies do not pay for abortion services.
https://lao.ca.gov/Publications/Report/5075

Mental Health Services Act: Impact of Governor's Proposal on Funding for Children and Youth

Aug 10, 2023 - To assess the impacts of the proposal on children and youth mental health services spending, we collected 2021-22 program expenditure data from 50 counties (reflecting nearly 99  percent of California ’s population).
https://lao.ca.gov/Publications/Report/4786