CaliforniaAB 1162025-2026 Regular SessionHouseWALLET

Budget Act of 2025.

Sponsored By: Jesse Gabriel (Democratic)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

63 provisions identified: 37 benefits, 6 costs, 20 mixed.

Bigger premium help for HIPP and Medicare

Beginning January 1, 2025, or as soon as technically feasible, the state raises the monthly cap it pays for health premiums in HIPP and the Medicare Premium Payment Program. The cap goes from $1,938 to $2,996 per month, up to $1,058 more each month. That is up to $12,696 more per year if your premium hits the cap.

Easier Medi-Cal for seniors and disabled

Beginning January 1, 2026, the state operates a Medi-Cal program for aged and disabled people and includes blind people where federal funding allows. For the 100% federal poverty test, the law adds $230 for one person or $310 for a couple to the income calculation. The state also plans to ignore income between 100% and 138% of the poverty level after other disregards once federal approval and systems are in place. If the state’s payment of your Medicare Part B premium would otherwise make you ineligible, you can keep Medi-Cal once federal approval is secured. People in licensed community care facilities get a new personal and incidental needs deduction after federal approval.

Full Medi-Cal for noncitizens by age

Full‑scope Medi-Cal is available to noncitizens 25 and younger. The department may extend eligibility to people 50 or older no sooner than May 1, 2022 after systems are ready, and to ages 26–49 after systems are ready but no later than January 1, 2024. Each expansion requires a written readiness determination and must follow federal law and funding rules.

Infertility coverage in job‑based plans

Starting January 1, 2026, large‑group employer plans must cover infertility diagnosis and treatment. Coverage follows ASRM guidelines and includes up to three completed egg retrievals and unlimited embryo transfers, with single embryo transfer when recommended. From January 1, 2026 to January 1, 2027, small‑group plans must offer an infertility coverage option, but they are not required to include it.

Infertility coverage required for many plans

For policies issued, amended, or renewed on or after January 1, 2026, large‑group disability insurance must cover infertility diagnosis and treatment, including up to three completed oocyte retrievals and unlimited embryo transfers (use single‑embryo transfer when appropriate). Small‑group policies must offer this coverage. Coverage cannot discriminate, cannot limit fertility drugs more than other prescriptions, and cannot deny coverage based on third‑party participation. Exemptions include certain limited policies, religious employers, and PERS plans until July 1, 2027, and Medi-Cal managed care contracts are not covered by this mandate.

Medi-Cal pays Medicare costs for low-income

If you are elderly or disabled, entitled to Medicare, and your income is at or below the federal poverty level, Medi-Cal pays your Medicare premiums, deductibles, and coinsurance. The state also pays additional drug coverage costs for qualified beneficiaries. The Part A buy‑in starts January 1, 2025, or later when systems are ready and the Department of Finance is notified. These steps require federal approvals and federal funding.

Better pay rules for community clinics

FQHC and RHC services are covered Medi‑Cal benefits and are paid per visit. Per‑visit rates rise each October 1 by the Medicare Economic Index while federal law requires it. Clinics can apply once a year for a scope‑of‑service rate change if net costs move by 1.75% or more, filed within 90 days of the fiscal year start. New sites can pick from set methods, including 100% of projected costs for the first 12 months, and may elect one PPS rate across locations after a full year of data. New clinic rates apply back to the later of federal qualification, new facility, or relocation; clinics may bill fee‑for‑service until enrollment is approved. Visits at certain intermittent or mobile sites, or locations added before January 1, 2017, are paid the same rate as the parent clinic.

More payments and bonuses for nursing homes

The state paid back amounts from the prior 10% cut for services June 1, 2011–July 31, 2012 and restored pre‑cut rates from August 1, 2012 to July 31, 2013, adjusted for new mandates. Managed care plans (except SCAN and AHF) adjusted payments effective July 1, 2012. A Workforce and Quality Incentive Program adds performance‑based payments for rating periods Jan 1, 2023–Dec 31, 2025, targeting $280 million in 2023, subject to federal approval and budget. The state can also use General Fund dollars, as appropriated, to raise rates for freestanding nursing homes using a CMS‑approved method.

Asset transfers can block Medi‑Cal care

Beginning January 1, 2026, giving away assets for less than fair market value creates a period of ineligibility for Medi‑Cal home and facility care, as federal law requires. Certain items like some notes, loans, life estates, and annuities count as transfers if they do not meet rules. You can avoid ineligibility by showing an allowed reason, like exempt assets at transfer, adequate payment received, or other listed exceptions. The state must adopt regulations by January 1, 2030. Durable medical equipment bought only with Medi‑Cal funds must be returned when no longer medically needed.

Higher fines for medical data leaks

If a provider unlawfully shares medical data, the Department of Public Health can fine them. The first violation can be up to $25,000 per patient, later ones up to $17,500, plus $100 per day for late reporting after 15 business days. All penalties for one event are capped at $250,000. A licensee can ask for a hearing within 10 days or pay 75% of the penalty within 30 business days instead of disputing.

Medi‑Cal for disabled under 250% FPL

The state offers Medi‑Cal to disabled people with net countable income under 250% of the federal poverty level, if federal funding and approvals are in place. Enrollees pay a monthly premium equal to 5% of countable income, or 5% of combined spousal income if spousal deeming applies. The premium is at least $20 and at most $250 per person per month.

Most Medi-Cal members must join managed care

Starting January 1, 2022, many Medi-Cal members who are not on Medicare must enroll in a managed care plan if plans meet readiness standards. Beginning January 1, 2023, most people on both Medicare and Medi-Cal must also enroll, with listed exemptions. The state must review plan readiness, including access in rural ZIP Codes, and cannot require enrollment for a group if readiness is not met. Exemptions include categories such as restricted‑scope coverage, PACE, certain foster care situations, some share‑of‑cost cases, and members defined as Indians.

New Medi-Cal for disabled adults with premiums

The law creates a Medi-Cal option for people who meet federal disability rules and have net countable income under 250% of the federal poverty level, with resources within state limits. Enrollees pay a monthly premium equal to 5% of countable income (minimum $20, maximum $250 per person; spousal deeming can apply). If you become temporarily unemployed, you can keep this coverage for up to 26 weeks if you keep paying premiums. The law also excludes disability income when testing eligibility and treats earned income kept in a separate account as an exempt resource. These provisions operate only when federal funding and approvals are available, and some pieces sunset January 1, 2027.

Nursing homes: staffing fines and fast appeals

Skilled nursing facilities that miss required nursing or direct care hours can be fined. Failing on 5%–49% of audited days is a $25,000 fine; over 49% is $50,000. If not disputed, payment is due in 30 days and can be taken from DHCS payments. Facilities can file an appeal with DHCS and DPH within 30 days; DHCS starts a hearing within 60 days and decides within 120 days. The DHCS hearing officer’s decision is final for DPH.

Bigger state drug rebates, stricter deadlines

Beginning January 1, 2026, drug makers renewing or signing new rebate deals must give at least 20% of AMP if the federal rebate is under 50% of AMP, or at least 15% if it is 50% or more. For drugs added on or after January 1, 2026, if no deal is signed within 60 days, the state rebate must be at least 25% of AMP; after 120 days, the drug is available only with an approved prior authorization. Manufacturers owe interest on late state rebate invoices starting 38 days after mailing; the state sends notices at 38, 68, and 98 days. If unpaid by 180 days, the contract can be in default and ended; after 270 days, products may require prior authorization.

Community health worker help and billing

Community health worker (CHW) services are a covered Medi‑Cal benefit, subject to federal approval and funding. Plans must tell members about the benefit, how to get referred, and which CHW groups they contract with. By July 1, 2025, plans must set up billing so supervising providers, including hospitals, can be paid for CHW services during ER visits and related follow‑ups. DHCS will also issue fee‑for‑service billing guidance by July 1, 2025.

Higher income limits for ADAP and PrEP

Beginning January 1, 2025, or as soon as technically feasible, the income limit for ADAP and the PrEP Assistance Program rises to 600% of the federal poverty level. Your household MAGI and household size set the limit. The director can still approve drugs for people above 500% FPL if one year’s drug costs are over 20% of their income. This expands who can qualify for help with HIV treatment and prevention.

More ADAP drug access and funding

All drug rebates and interest for the AIDS Drug Assistance Program go into the ADAP Rebate Fund. The Fund pays only for ADAP drugs, ADAP services, certain HIV prevention, and TGI Wellness and Equity Fund services, and is continuously available. Starting Jan 1, 2025, ADAP uses an open formulary, so more prescriptions can be covered. The department can award ADAP‑related contracts and grants faster because some normal procurement reviews do not apply.

More HIV/STD supplies and disease control

Starting July 1, 2024, the state funds $10 million per year for three years to buy HIV prevention supplies for syringe access programs. It also provides a one‑time $5 million through 2028 to a community group to distribute internal and external condoms. Beginning July 1, 2025, the state makes $9 million available for disease intervention specialists and $1 million to buy rapid Hepatitis C testing equipment for local distribution in high‑need areas.

More Medi-Cal coverage for nutrition and OTC

Medi-Cal covers prescribed enteral nutrition products on the state list for tube feeding; children in EPSDT are not limited to tube‑only products. The department may also cover non‑tube nutrition for certain diagnoses if not experimental. Coverage took effect June 1, 2011 or later once federal approvals were secured. Medi-Cal can also cover selected over‑the‑counter acetaminophen (including children’s) and cough/cold products the department designates by bulletin or notice.

More mental health help in schools

The state can award competitive grants to build school‑linked behavioral health services for children and youth up to age 25. Grants can expand licensed medical and behavioral staff and certified wellness coaches, build a statewide provider network, improve data sharing, and add telehealth in schools. Of any funds for higher education, at least two‑thirds must go to California Community Colleges. The law also creates a certified wellness coach role with required training and supervision by licensed or credentialed school staff.

No‑cost COVID tests, vaccines, treatments

Health plans must cover COVID‑19 diagnostic tests, preventive services and vaccines with an A/B USPSTF rating or ACIP recommendation, and FDA‑approved or EUA treatments without cost sharing. Plans cannot require prior authorization. In‑network providers are paid their negotiated rates; out‑of‑network providers must be paid a reasonable rate and cannot balance‑bill you. Out‑of‑network protections end six months after the federal public health emergency expires. No‑cost testing has applied since March 4, 2020; coverage for new or renewed contracts applies for therapeutics on the operative date.

Nursing homes need 96-hour backup power

Skilled nursing facilities must have onsite backup power for at least 96 hours during outages. If they use generators, they must store fuel for 96 hours or have guaranteed delivery with no delays. If they use batteries or renewables, they must have enough storage and a plan for a generator and fuel if power is not back in 96 hours. This applies on or after January 1, 2026, starting with the first Medi-Cal SNF rate year after the state posts notice that funding for a per‑diem add‑on is appropriated.

Rides to medical visits covered

Medi‑Cal covers nonmedical rides to get covered care when you attest you have no other reasonable way to get there. If you have managed care, your plan must provide the ride. Covered options include car, taxi, bus passes, mileage, vouchers, or train tickets. Rides must be accessible and follow disability rights laws.

Safer, higher‑staff units in state hospitals

State‑run acute psychiatric hospitals may operate Enhanced Treatment Programs. These units must keep at least a 1:5 licensed staff‑to‑patient ratio and use single rooms with 24‑hour staff visual access, in‑room toilets and sinks, emergency egress, and compliant seclusion and restraint practices. Doors can be locked when clinically needed, and a full‑time independent patients’ rights advocate is required. This program sunsets on January 1, 2030.

One-time relief for clinic crises

FQHCs and RHCs can request lump‑sum payments for extraordinary events beyond their control when normal PPS payments are not enough. The cost impact must be at least $200,000 or 1% of total costs, whichever is less, and must be well documented. Payments apply to the affected years and must be repaid if not used for the stated purpose. Events after December 31, 2001 can qualify.

Telehealth visits and consent at clinics

Telehealth visits at FQHCs and RHCs are paid at the clinic’s per‑visit rate when care and billing rules are met. Video, audio‑only (with limits), and store‑and‑forward count if they meet the standard of care. New patient relationships generally cannot start by audio‑only except for sensitive services or when a patient lacks video. Clinics that use audio‑only must also offer video by a department date no sooner than January 1, 2024, and must offer or arrange in‑person care. Clinics must tell Medi‑Cal patients that telehealth is voluntary, in‑person care is available, nonmedical transportation may help, and explain risks, and must document the acknowledgment.

Minimum nurses for psychiatric facilities

The state will set minimum licensed nurse‑to‑patient ratios for psychiatric health facilities. Emergency rules may be used first. Final rules must be adopted by July 31, 2027, or within 1.5 years of any emergency rules, whichever is sooner. The rules must reflect psychiatric patient needs and may allow flexibility for rural hospitals.

State partnerships to boost drug supply

The state health agency may partner with authorized groups, when funded, to make, buy, or distribute naloxone, drugs, vaccines, and medical supplies. The goal is to increase competition, lower prices, and fix shortages. Partners must be legally authorized to develop, manufacture, procure, or distribute these products.

Health plans must police their PBMs

Health plans that hire PBMs must make them follow PBM laws, act in good faith, and tell pharmacists about complaint rights. For contracts issued, amended, or renewed on or after Jan 1, 2026, plans must require PBMs to submit required data to the state. If you complain about a PBM, regulators treat it as a complaint against your insurer or plan, and the department can investigate plans that fail to oversee PBMs and order audits.

PBMs defined and owe a fiduciary duty

The law clearly defines who counts as a PBM and who is excluded. PBMs owe a fiduciary duty to their payer clients. They must act in the payer’s best interests and be fair, truthful, and diligent.

Stronger penalties and funds for PBMs

The director can suspend or revoke PBM licenses and fine PBMs for listed violations, using standard penalty factors for plans. A Pharmacy Benefit Manager Fund holds PBM‑related revenues and keeps only a prudent 5% reserve unless finance officials say otherwise. Starting July 1, 2025, PBM fines go into a dedicated fines and penalties fund and cannot be used to lower PBM assessments.

Adult day health care now limited

Medi-Cal adult day health care is limited to three days per week starting 30 days after the act’s effective date. If the department director makes the declaration in Health and Safety Code 14525.1(g), the limit increases to five days per week. This change can increase caregiver time or costs when more than three days are needed.

Tougher Medi-Cal asset and annuity rules

Beginning January 1, 2026, you are not eligible for home or facility medical assistance if your home equity is over $750,000, indexed yearly and rounded to the nearest $1,000, with listed exceptions (such as a spouse or qualifying child living in the home). For annuities bought on or after February 8, 2006, or changed after that date, the state becomes the remainder beneficiary to the extent federal law requires. If you file a notice blocking the state from getting that remainder, the law treats the annuity as a transfer for less than fair market value and applies Medi-Cal transfer penalties. Annuity issuers must report withdrawals and beneficiary changes to the state, and you carry the burden of proof to show any exception applies.

Study and cap Medi‑Cal payment cuts

The department must find places to reduce Medi‑Cal payments while following federal law. Any cuts across all providers and services cannot total more than 10% in aggregate.

PBMs now need a state license

Starting Jan 1, 2027 (or when the process is set), a pharmacy benefit manager must hold a state license to operate for payers in California. Applicants must file detailed organizational, ownership, and audited financial documents, and pay processing costs up to $25,000; licensed PBMs also owe annual assessments based on claims. Licensed PBMs must report changes, get approval before major operational changes, and licenses remain valid until suspended or revoked. If denied, an applicant gets written reasons and a 30‑day hearing right. The director can reinstate after more than one year with conditions and up to a $500 petition fee, and can accept surrenders or summarily revoke for nonoperation, nonpayment, or missing reports; certain application and report information may be kept confidential.

Backfill HIV funds and modernize ADAP

Beginning July 1, 2025, up to $65 million from the ADAP Rebate Fund replaces reduced or lost federal HIV/AIDS funds, with allocations made as soon as possible and no later than 30 days after notice. CDPH must submit a plan with the 2025–26 Governor’s Budget to modernize and expand ADAP and related programs. If federal funds are later restored, money advanced from the Rebate Fund must be repaid to the Rebate Fund within 180 days; local agencies and community groups repay only after they receive the restored federal funds.

New Medi-Cal asset rules for seniors

The law updates Medi‑Cal asset and income rules for seniors and people with disabilities. Until Jan 1, 2026, the state seeks federal OK to ignore all resources for some non‑MAGI cases; this interim rule ends that day. Starting Jan 1, 2026, Medi‑Cal disregards $130,000 for one person plus $65,000 per extra member (up to 10), after systems are ready and approved. Your main home stays exempt if it meets listed rules; the state can record a lien only as federal law allows. The state limits when it can claim a remainder from certain annuities, but counts refundable or usable entrance fees at continuing care communities as a resource. Small mortgage notes (up to $6,000) from selling your home are treated as real property, and the SSI/SSP amount used in income tests matches the May 1, 2009 level until payments rise above it.

New rules for Medi‑Cal drugs and supplies

Starting January 1, 2026, if a drug is on prior authorization, you can get it only after an approved request. The state must give you at least 60 days’ notice before removing a drug from the contract list and explain your hearing rights. Medi‑Cal covers diabetic testing supplies from pharmacies, subject to limits. Paper outpatient prescriptions are covered only if written on tamper‑resistant forms when federal rules require it.

Premiums and limits for some noncitizens

No sooner than July 1, 2026, noncitizens described in Section 14007.8(a) who are 19–59 and not pregnant must pay $30 per month for Medi‑Cal; adults 19 or older under that subdivision get only emergency dental. Starting July 1, 2027, noncitizens in Section 14007.5(c) or (d), excluding those under 19, 60 or older, or pregnant, must pay $30 per month for full‑scope Medi‑Cal; up to 90 days of nonpayment limits eligibility to pregnancy‑related and emergency services until paid. The state may fund long‑term care for applicants who are not lawfully present only if the Budget Act provides money, capped at serving up to 110% of the 1999–2000 estimated eligible population unless lawmakers allow more.

Stricter Medi‑Cal checks, e‑verification first

Starting January 1, 2026, applicants not already on aid must sign an income and resource affirmation. The department does not grant aid until it gets independent proof of income, withholdings, benefits, and property if federal law allows; a signed statement is used if proof is truly unavailable. Before asking you for papers, the state must try to verify electronically with agencies like IRS, SSA, EDD, CalFresh, CalWORKs, CHIP, and Covered California. A temporary version of these verification rules is in place until it becomes inoperative January 1, 2026 and is repealed January 1, 2027. The state also trains county staff on counting income, resources, and the lookback period starting January 1, 2026.

Clinic pay fixes and physician types

FQHCs and RHCs now calculate per‑visit payment shortfalls against third‑party payers on a contract‑by‑contract basis, protecting PPS revenue. The law also clarifies who counts as a physician for per‑visit billing, including MDs, osteopaths, podiatrists, dentists, optometrists, and chiropractors. Clinics cannot get a PPS top‑up for Drug Medi‑Cal or specialty mental health services billed outside the PPS.

Clinics can bill pharmacy and addiction care

FQHCs and RHCs may elect fee‑for‑service payment for pharmacy and dental using Medi‑Cal fee schedules. Those costs are removed from the clinic’s PPS base rate, and the prior rate is restored (with MEI and scope changes) if the clinic later reverses the choice. Clinics can also bill Drug Medi‑Cal under county or state contracts. When moving DMC services outside PPS, clinics must file a scope‑of‑service request on the set timeline; approved changes are retroactive no earlier than January 1, 2018. DHCS issues an interim rate equal to 90% of projected allowable cost within 90 days and audits to set the final rate.

Past caps and cuts to Medi-Cal payments

The law set a one‑time 10% cut to most nursing facility payments for services from June 1, 2011 to July 31, 2012 and capped rate increases (e.g., 2.4% in 2011–12). It also capped average Medi‑Cal rate increases in several past years, including 3.93% or 3.14% in 2010–11 depending on the federal FMAP boost, and required actuarially equivalent reductions to contracting managed care plan payments starting July 1, 2011. Starting January 1, 2013, the skilled nursing facility quality assurance fee is unenforceable unless the department pays required restored rates. These provisions limit payment growth overall while adding a protection tied to required payments.

New state funds for health oversight

The law creates three state accounts to strengthen oversight and enforcement. Penalties from skilled‑nursing staffing rules go into a dedicated account that DPH can use to run and enforce those rules. DPH also gets an account to use certain penalty dollars for internal quality improvements, with interest kept in the account and spending only when the Legislature approves. A Medi‑Cal Anti‑Fraud Fund holds intercepted provider payments during a suspension; the department returns them or uses them to offset debts after the suspension ends.

Stronger sanctions on Medi‑Cal contractors

Starting January 1, 2025, if voters approved related changes at the March 5, 2024 election, the department can end contracts or order fixes when Medi‑Cal contractors break rules. Allowed penalties include stopping new enrollments, suspending staff or subcontractors, appointing temporary managers, and civil fines capped at $25,000 for many violations, $100,000 for discrimination or serious misrepresentation, and up to $15,000 per affected person for discriminatory denials (within the $100,000 cap). The department can collect fines by withholding payments, but not more than 25% of a contractor’s monthly funds; if needed, it continues offsets until fully collected. From July 1, 2024 through June 30, 2027, nonfederal fine money goes to the General Fund to help pay the state share of Medi‑Cal and support the workforce, when appropriated. The department may temporarily withhold payments until problems are fixed, and contractors have clear hearing and appeal timelines. The department can implement these rules with letters and bulletins without formal rulemaking.

PBMs must report prices and finances

PBMs must give drug pricing and transaction data to the Department of Health Care Access and Information for the Health Care Payments Data System. The department sets formats and timing, may use emergency rules until Jan 1, 2028, and will seek three years of past data. Licensed PBMs must also file annual audited and quarterly financial statements and submit all required reports to the state.

Temporary PBM data fee on plans

From July 1, 2025 through June 30, 2027, the state may charge licensed health plans an annual fee to fund PBM and data work. The fee must equal only the actual, necessary costs of the departments. Collected fees move to the Pharmacy Benefit Manager Fund and are spent if the Legislature approves.

Faster notice after medical data breaches

Clinics, health facilities, home health agencies, and hospices must report a medical data breach to the state and tell affected patients within 15 business days of finding it. Notice can be delayed if law enforcement says it would harm an investigation (up to 60 days in writing, 30 days if oral). Email notice is allowed only if the patient agreed to it in writing.

2026 Medi‑Cal medically needy rules, outreach

Beginning January 1, 2026, the law defines who counts as medically needy. It includes aged, blind, or disabled people who meet SSI rules, some foster care children, certain parents or caretakers, children under 21, and pregnant women, when income or resources are not enough to cover health costs. Some categories apply only when federal matching funds are available. No sooner than August 1, 2025, the department convenes a stakeholder group to plan outreach for a resource‑disregard policy that becomes operative January 1, 2026, subject to federal approvals and funding.

ADAP admin cap and faster drug access

County health departments that run ADAP can use no more than 5% of collected payments for administration. Counties must make newly added ADAP drugs available within 60 days of the director’s action. This helps keep more money for medications and speeds access for ADAP clients.

Clear nursing home Medi-Cal notices

Starting January 1, 2026, Medi-Cal and nursing facilities must give you a short, separate, 10‑point type notice that explains income and resource rules, exempt resources, spousal protections, and home transfer effects. The notice must be signed by the person admitted, the spouse, and any legal representative. Willful failure can lead to a class B citation. On request, the state will quickly assess and document a couple’s total resources, give each spouse a copy, and include fair hearing rights, with a modest fee allowed if it is not part of an application.

Grants for trans‑inclusive care and housing

The TGI Wellness and Equity Fund provides grants, when appropriated, to coordinate trans‑inclusive health care, build provider capacity, support therapeutic arts, help people access supportive housing, and fund gender‑affirming services. Hospitals and clinics must apply with a TGI‑serving organization. Starting July 1, 2025, the fund receives $5 million per year for three years to support HIV prevention and care for eligible people living with HIV and AIDS.

Medi‑Cal covers tuberculosis services

Beginning January 1, 2026, Medi‑Cal pays allowable TB‑related services for people with income and resources at or below the disabled‑person limit. Implementation depends on any needed federal approvals.

Faster insanity evaluations before commitment

When a person pleads not guilty by reason of insanity, the community program director must evaluate them and give placement advice to the court within 15 judicial days. The person cannot be admitted to a state hospital or placed on outpatient status without this evaluation. The court must provide required records before admission, and the medical director must send status reports every 12 months.

Faster state health oversight and contracting

State health agencies can act faster. Public Health can run nursing‑home staffing penalties by letters instead of formal rules and can hire qualified groups with some contracting rules waived. Managed Health Care can enforce PBM rules and hire consultants and IT vendors through June 30, 2028, with conflict‑of‑interest limits. Health Care Access and Information can use faster contracting and skip some reviews through June 30, 2028. The health department can also choose a different local fiscal agent to manage ADAP funds when needed.

More transparency on health data and penalties

The state creates a public advisory committee for the Health Care Payments Data Program. It has 10 to 12 members, meets at least quarterly, follows the Bagley‑Keene open‑meeting law, and members may get per diem and expense reimbursement. Civil penalty money from health facilities goes into state and federal citation accounts. The State account cannot exceed $10,000,000. The department posts quarterly online reports with sources, unallocated amounts, and detailed spending, without resident names.

Define advanced practice and allied clinicians

The department must define “advanced practice clinicians and allied health care professionals” and include the right careers in that list. The work must follow the required stakeholder input process.

New fund and 2025–26 hospital payments

The law creates the Nondesignated Public Hospital Supplemental Fund. It gets $1,900,000 each year from the General Fund and may receive other money and interest. Private donations are accepted only if the donor certifies they qualify for federal Medicaid matching; ineligible donations can be returned. For 2025–26, extra balances pay hospitals in two steps: first to restore some hospitals to the amounts transferred plus federal match, then the rest by each hospital’s Medi‑Cal inpatient days and utilization rate as of July 1, 2025.

Planning for HIV and PrEP navigation

The state provides $200,000 in 2024–25 for a Ryan White client navigation and retention needs study, and $200,000 in 2024–25 to assess needs for a PrEP navigation program. Both amounts are available until June 30, 2027.

Start dates and repeals in health laws

Some Medi‑Cal and Medicare‑related sections change timing. One chapter becomes operative on Jan 1, 2026. Another section becomes inoperative on Jan 1, 2026 and is repealed Jan 1, 2027. The law repeals Section 14006.1 and former Section 14105.38. Two amendments set conflicting start and stop dates for a Medicare Part A buy‑in section.

Old health funds ended or consolidated

On July 1, 2025, the Internal Health Information Integrity Quality Improvement Account is abolished, and all money moves to the Internal Departmental Quality Improvement Account. Administrative fines under Civil Code 56.36 now go to the receiving account. On December 31, 2028, the Nondesignated Public Hospital Supplemental Fund is abolished and any money left goes to the General Fund. A separate chapter of the Welfare and Institutions Code is also repealed.

State cash‑flow loans and annuity deposits

The State Controller can temporarily lend money from the Skilled Nursing Facility Minimum Staffing Penalty Account to the General Fund under existing law. Money the State receives from annuity remainder interests goes to the General Fund starting January 1, 2026. These steps manage state cash and deposits and do not change who owes or gets benefits.

Sponsors & Cosponsors

Sponsor

Jesse Gabriel
Democratic • House

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 147 • No: 48

House vote • 6/27/2025

Item 1000 — Assembly AFLOOR

Yes: 58 • No: 15

Senate vote • 6/27/2025

Item 80 — Senate SFLOOR

Yes: 25 • No: 10

legislature vote • 6/25/2025

Vote in CS62

Yes: 11 • No: 6

House vote • 3/20/2025

Item 46 — Assembly AFLOOR

Yes: 53 • No: 17

Actions Timeline

Chaptered by Secretary of State - Chapter 21, Statutes of 2025.
6/30/2025Senate
Approved by the Governor.
6/30/2025legislature
Enrolled and presented to the Governor at 3:15 p.m.
6/27/2025legislature
Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 58. Noes 15. Page 2332.).
6/27/2025House
Assembly Rule 63 suspended. (Ayes 54. Noes 19. Page 2329.)
6/27/2025House
In Assembly. Concurrence in Senate amendments pending.
6/27/2025House
Read third time. Passed. Ordered to the Assembly. (Ayes 25. Noes 10. Page 1804.).
6/27/2025Senate
Read second time. Ordered to third reading.
6/26/2025Senate
From committee: Do pass. (Ayes 11. Noes 6.) (June 25).
6/25/2025Senate
From committee chair, with author's amendments: Amend, and re-refer to committee. Read second time, amended, and re-referred to Com. on B. & F. R.
6/24/2025Senate
Referred to Com. on B. & F. R.
4/2/2025Senate
In Senate. Read first time. To Com. on RLS. for assignment.
3/20/2025Senate
Read third time. Passed. Ordered to the Senate. (Ayes 53. Noes 17. Page 721.)
3/20/2025House
Read second time. Ordered to third reading.
3/18/2025House
(Ayes 53. Noes 17. Page 643.)
3/17/2025House
Ordered to second reading.
3/17/2025House
Withdrawn from committee.
3/17/2025House
Referred to Com. on BUDGET.
2/3/2025House
From printer. May be heard in committee February 8.
1/9/2025House
Read first time. To print.
1/8/2025House

Bill Text

Chaptered
6/30/2025
HTML
Enrolled
6/27/2025
HTML
Amended Senate
6/24/2025
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Introduced
1/8/2025
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