The 2026-27 Budget: Medi-Cal Fiscal Outlook

Nov 19, 2025 - As we have noted in previous publications , predicting pharmacy spending is inherently uncertain given the dynamic nature of the prescription drug market. Many of the pharmacy‑related budget solutions are subject to this uncertainty.
https://lao.ca.gov/Publications/Report/5092

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

May 22, 2024 - To the extent the Legislature still wishes to pursue certain augmentations, we recommend it (1)  focus on augmentations that are relatively simple to implement and have relatively predictable positive effects on access to quality health care, (2)  focus on rates that are relatively low, and (3)  keep in mind the state ’s budget problem.
https://lao.ca.gov/Publications/Report/4905

Climate Change Impacts Across California - Crosscutting Issues

Apr 5, 2022 - A recent scientific  study  by United States Geological Survey researchers predicted that under scenarios of three feet to six feet of sea‑level rise, up to two‑thirds of Southern California beaches may become completely eroded by 2100.
https://lao.ca.gov/Publications/Report/4575

The 2023-24 Budget: Medi-Cal Fiscal Outlook

Nov 16, 2022 - Factors that tend to predict future inflation suggest there is a considerable risk inflation will remain elevated for an extended period of time. Should inflation continue to be higher than historical levels, General Fund spending in Medi ‑Cal could be higher than we project.
https://lao.ca.gov/Publications/Report/4649

The 2022-23 Budget: Analysis of the Medi-Cal Budget

Feb 9, 2022 - Changes in the timing of payments occur regularly and are difficult to predict. Additionally, implementing new Medi ‑Cal programs and policy changes often occurs more slowly than the budget anticipates, which can result in shifts of funding to subsequent years.
https://lao.ca.gov/Publications/Report/4522

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

Jul 13, 2023 - Moreover, the policy relies on a DHCS determination, which may make it difficult for counties to predict when a withdrawal would be available. (We note that counties may have been able to access their prudent reserves in 2013-14, 2015-16, and 2018-19 to the extent that their projected allocation of CSS funds was insufficient to continue to serve the same number of in dividuals served by specified programs in the previous fiscal year.
https://lao.ca.gov/Publications/Report/4780

The 2021-22 Budget: Analysis of the Medi-Cal Budget

Feb 16, 2021 - The COVID ‑19 ‑related public health emergency is unprecedented in the history of Medi ‑Cal, and so its impact on Medi ‑Cal caseload is difficult to predict. As a result, any projections of near ‑term caseload growth and associated costs are highly uncertain.
https://lao.ca.gov/Publications/Report/4373

Impact of COVID-19 on Health Care Access

May 7, 2021 - These predictions have proven significantly overstated for reasons that are not entirely clear. Data on job loss patterns, however, provide some insight. While there were 1.5  million net job losses as of December 2020, the net decline in job-based health care coverage was closer to 300,000.
https://lao.ca.gov/Publications/Report/4426

The 2022-23 Budget: Health Care Access and Affordability

Feb 23, 2022 - The administration has stated that it expects any caseload impacts of the premium reductions would be minor and difficult to predict. As such, they do not estimate a caseload impact from the proposed policy change, nor any associated costs.
https://lao.ca.gov/Publications/Report/4560