The 2026-27 Budget: Medi-Cal Fiscal Outlook

Nov 19, 2025 - How much of these savings accru e to California, however, is uncertain. California could choose to continue streamlining eligibility policies, even absent federal enforcement of the new rules. Recoupments for Excess Payments.
https://lao.ca.gov/Publications/Report/5092

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

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 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 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

The 2025-26 Budget: Medi-Cal Pharmacy Spending

Apr 3, 2025 - In 2023 ‑24, we estimate these rebates comprised 3  percent of gross spending, up from as low as 1  percent in some years. This increase was expected following the switch to the Medi ‑Cal Rx system in 2022.
https://lao.ca.gov/Publications/Report/5026

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

Feb 16, 2021 - The preliminary actuals we have reviewed indicate that 5  p ercent of the enrollees added since the beginning of the pandemic are SPDs. If SPDs make up a smaller share of pandemic ‑related caseload growth than the administration assumes, the result likely would be significantly lower per ‑enrollee costs since SPDs can be two ‑to ‑three times as costly per enrollee.
https://lao.ca.gov/Publications/Report/4373

Enhancing Federal Financial Participation for Consumers Served by the Department of Developmental Services

Nov 9, 2021 - Moreover, some individuals and families uncomfortable with signing up for Medi ‑Cal may not be able to afford what would have been the federal portion of the cost of the RC ‑coordinated services. Consequently, this approach could be more punitive in nature than the three alternative approaches discussed below, given that a family would have to pay for or forgo services if they did not want to enroll the consumer in Medi ‑Cal.
https://lao.ca.gov/Publications/Report/4471