All Roll Calls
Yes: 156 • No: 43
CaliforniaAB 1442025-2026 Regular SessionHouseWALLET
Budget Act of 2025.
Sponsored By: Jesse Gabriel (Democratic)
Signed by Governor
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Bill Overview
Analyzed Economic Effects
38 provisions identified: 26 benefits, 5 costs, 7 mixed.
Abortion Access Fund and transfers
The state creates a continuously funded Abortion Access Fund to pay for abortion services using grants and contracts. Starting in fiscal year 2025–26 through 2028–29, health plans that offer Exchange coverage must transfer money from segregated accounts to the fund, up to set caps. By Oct 30, 2025, a plan must transfer up to the Exchange‑provided total, but not more than 75% of its July 1, 2025 ending balance. By Sept 1 each year through 2028–29, a plan must transfer up to that year’s Exchange‑provided total, but not more than 50% of the ending balance amount above prior‑year claims. Some contract and grant details are confidential under state law. The program becomes inoperative July 1, 2029 and is repealed January 1, 2030.
Easier Medi‑Cal financial checks
Medi‑Cal lets some people self‑declare income and assets without paper proof, after a two‑county pilot and a budget appropriation. This does not apply to people eligible only due to age, blindness, or disability unless they are in a family with a Medi‑Cal child, parent, or spouse. Beginning January 1, 2026, Medi‑Cal disregards $130,000 in assets for one person plus $65,000 for each extra household member, up to 10 members, when eligibility is not based on MAGI. These changes need federal approvals, available federal funding, and system readiness before they start.
No-cost preventive care in most plans
For plan years on or after January 1, 2025, most new or renewed health plans must cover key preventive care with no copays or deductibles. This includes services with USPSTF A or B ratings and vaccines recommended as of January 1, 2025, plus pediatric and women’s preventive guidelines in effect on that date. Items integral to these services and related office visits are also covered with no cost sharing. New recommendations start one year after they are issued. The law also updates vaccine references to follow state public health guidance, and willful plan noncompliance is a crime.
Higher, annually adjusted lab fees
The law sets specific license fees and ties annual adjustments to program costs. Examples: many specialty licenses $570; clinical laboratory scientist $300; phlebotomist $150; trainee $45. Clinical lab fees scale by test volume (for example, under 2,001 tests: $335; over 1,000,000 tests: $8,630 plus $420 for each extra 500,000 tests). Tissue bank license application and renewal are $950, subject to annual adjustment. The department must publish the new fee list by January 1 each year.
Medi‑Cal: adult limits, youth protections
Starting January 1, 2026, adults 19 or older without satisfactory immigration status who apply on or after that date get only pregnancy‑related care and emergency services. Starting July 1, 2026, most adult dental coverage for specified noncitizens is limited to emergency treatment; full dental continues until age 26 for nonminor dependents and people eligible under Section 14005.28. People age 25 and under without satisfactory immigration status remain eligible for full‑scope Medi‑Cal, subject to service limits. Specified nonminor dependents and foster youths do not pay a $30 monthly Medi‑Cal premium, and those premiums cannot start before July 1, 2027. The dental limits start only after the Director confirms system updates in writing.
Health care reserve fund and $600M loan
The state creates a Health Care Affordability Reserve Fund and directs a one‑time $333,439,000 transfer from the General Fund. In 2023–24, the state can loan $600,000,000 from this fund to the General Fund. The loan must be repaid in three payments of $200,000,000 in 2026–27, 2027–28, and 2028–29.
Covered California cost‑sharing study
Covered California must design options to lower out‑of‑pocket costs for people with incomes up to 400% of the federal poverty level. Options include zero deductibles and gold‑tier cost sharing for 200%–400% FPL, with a report due by January 1, 2022. The Exchange considers federal funding and how to put options in place for 2023.
Medi‑Cal covers ACIP vaccines
Medi‑Cal covers vaccines that national medical groups recommend, like ACIP, AAP, and ACOG. The state can add coverage by written notice. Coverage needs any required federal approvals and funding.
More places to get vaccines
Pharmacists can independently give any vaccine that had an ACIP recommendation on January 1, 2025, for people age 3 and up, as modified by state guidance. Dentists and podiatrists can prescribe and give flu and COVID‑19 shots to ages 3 and up, with biennial training and state registry reporting. In skilled nursing facilities, registered nurses and pharmacists can give flu and pneumococcal shots to patients 50+ under approved standing orders. Licensed providers must follow the State Department of Public Health’s vaccine recommendations.
More vaccines covered under Medi‑Cal
Medi‑Cal covers vaccines that major medical groups recommend, plus state updates. This applies only when federal funding and approvals are available.
No-cost COVID tests and prevention
Disability insurance that covers medical care must pay for FDA‑authorized COVID‑19 tests and related care with no copays or deductibles and no prior authorization. Plans must also cover certain COVID‑19 preventive services, vaccines, and approved therapeutics at no cost and adopt state updates within 15 business days. During a Governor‑declared public health emergency, plans must cover specified preventive, testing, and treatment items for that disease with no cost sharing or prior authorization. Out‑of‑network cost‑sharing protections for COVID‑19 testing and related care end six months after the federal public health emergency ends.
No‑cost COVID tests, shots, treatments
Health plans must cover FDA‑approved or emergency‑authorized COVID‑19 tests and related services without copays, deductibles, or prior approval. Plans must also cover proven COVID prevention items and shots with no cost sharing if they had USPSTF A/B or ACIP recommendations on Jan 1, 2025. Plans must cover FDA‑approved or emergency‑authorized COVID treatments with no cost sharing when prescribed. Out‑of‑network protections end six months after the federal public health emergency ends. During any Governor‑declared public health emergency, plans must add or remove covered preventive items within 15 business days after the state posts updates.
Preventive care for kids is covered
Group health plans must cover preventive care for children age 16 and under based on the 2025 pediatric schedule. This includes checkups, vaccines, and related lab tests. For ages 17 and 18, plans and group disability insurers must offer preventive benefits that follow the same 2025 schedule. Insurers and plans must tell group policyholders these benefits are available. The state may update the vaccine list.
Seniors offered shots in facilities
Each year from October 1 to April 1, long‑term care facilities must offer flu and pneumococcal shots to residents 65+. New residents must be offered pneumococcal vaccine. Hospitals must offer these shots to inpatients 65+ before discharge when vaccine is on hand. People can refuse if the vaccine is medically contraindicated or against their beliefs or wishes (or a decisionmaker’s wishes). The state now sets the guidance and posts flu education online. Facilities get standard Medi‑Cal payment for covered residents unless Medicare already covers it.
ADAP backfill and faster contracting
Starting July 1, 2025, the state may use up to $75 million from the ADAP Rebate Fund to keep ADAP services running when federal funds drop. Up to $65 million may backfill services (including up to $18 million for state operations), with Finance approval within 30 days. If federal funds return, the money must be repaid to the Fund within 180 days. Contracts and grants under this authority can bypass some state procurement rules to speed services.
Breast cancer care and research funding
Cigarette tax dollars go to a Breast Cancer Fund split equally between research and control programs. Ten percent of research funds go to state cancer surveillance and 90% to a UC research program. Control funds pay for early detection services for uninsured and underinsured women. The state reports each year by February 28.
Exchange pays for gender‑affirming care
For plan years starting January 1, 2026, the Exchange pays health insurers for the state‑required gender‑affirming care that is above essential health benefits. Payments match reported costs and are made only if the Legislature funds them.
Free state flu vaccine clinics
The state supplies flu vaccine at no charge to local and nonprofit agencies for public clinics. Agencies may charge up to $2 per person to cover clinic costs. The state can also supply other respiratory vaccines to groups it identifies as high risk. Volunteer nonprofits that host clinics get limited liability if they follow state standards. Until January 1, 2030, people who give required vaccines under state guidance also have liability protection unless there is willful misconduct or gross negligence.
State vaccine list and flu info
The state sets the vaccine and preventive care baseline as of January 1, 2025 and can update it. The health department must publish updates, which take effect when posted and are filed with the Secretary of State. The department must also post clear flu information, including health benefits, insurance coverage, and where to get free or low‑cost shots.
Medi-Cal premiums for some noncitizens
Beginning July 1, 2027, certain noncitizens in Medi‑Cal must pay a $30 monthly premium per person to keep full‑scope coverage. After 90 days without payment, Medi‑Cal covers only pregnancy‑related and emergency care until you pay what you owe. People under 19, over 59, and pregnant are exempt, and nonminor dependents and those eligible under Section 14005.28 are exempt until age 26. If you apply under the listed categories, you must show USCIS registration or other proof of immigration status; you get 30 days or the county’s normal processing time, whichever is longer, to submit proof. If you were 19 or older without satisfactory status and lost full‑scope Medi‑Cal (not pregnant at disenrollment), you can reenroll within three months; if you were dropped for nonpayment, you must first pay the balance. If you qualify under subdivision (a), you must enroll in a Medi‑Cal managed care plan when allowed by law. The premium rules start only after the Director confirms systems are ready.
Price limits for Medi‑Cal supplies
The state sets maximum prices for certain medical supplies in Medi‑Cal and can require independent testing. Prices are based on the average wholesale selling price of similar products in California and provider costs. Providers get at least 30 days’ notice before changes. These actions are exempt from the normal rulemaking process.
HPV vaccine notices for schools, colleges
Schools must give parents an HPV vaccine notice at admission or advancement to grade 6. Through June 30, 2026, the notice follows Jan 1, 2025 guidance; starting July 1, 2026, it follows current state guidance. Beginning July 1, 2026, the state advises first‑time college enrollees age 26 or younger to be fully vaccinated for HPV. These are advisories, not vaccine mandates.
Interpreter pilot for Medi‑Cal
The state runs a pilot at up to four sites to improve medical interpretation for people with limited English. It can spend up to $3 million plus $5 million available until June 30, 2026. The pilot checks satisfaction, errors, disparities, and care quality.
Medi‑Cal veteran outreach pilot
The state uses a two‑year pilot in three consenting counties with VA medical centers to find Medi‑Cal enrollees who are veterans or their dependents. It helps them connect to VA health benefits and may refer high‑cost cases to county veteran service officers. If cost‑effective, the state may continue it statewide.
Standard school medical exemption, appeals
Since January 1, 2021, doctors must use a single statewide electronic form for school immunization medical exemptions, sent to the state registry. A temporary exemption can last no more than one year. If a medical exemption is revoked, families can appeal within 30 days; a panel of three physicians reviews the case, and the child may stay in school during a timely appeal. The panel’s decision is final.
Make school mental health easier
DHCS must hold a working group twice a year on school‑linked behavioral health. A contractor must match student records with plan enrollment and pay claims on time. The California Health and Human Services Agency will publish a manual to help school districts follow federal rules. These steps make services easier to access and bill.
Extra EMS help for LA 2028
Out‑of‑state licensed EMTs and similar providers can work at approved California Olympic and Paralympic sites in 2028 if the state EMS chief medical officer authorizes them. Authorization runs from May 15, 2028 through September 15, 2028. Providers must show a valid out‑of‑state license and photo ID. They get limited liability protection for good‑faith care.
Funding for disease intervention, HCV tests
Starting July 1, 2025, $9 million funds disease intervention specialists, including up to $1.64 million for state operations. Another $1 million buys rapid Hepatitis C test equipment, which the department distributes based on geographic need.
More reporting on family planning
The Office of Family Planning must collect and post yearly reports and data on family planning services. It sets goals, coordinates with other programs, and updates detailed data each year to improve access and planning.
Protection for people giving kids vaccines
Beginning January 1, 2030, people who give vaccines to minors under required shots or state outreach programs are generally not liable for injury. This protection does not cover willful misconduct or gross negligence. It only applies to those required or outreach immunizations.
Temporary health rules for 2028 Olympics
For the 2028 Olympics and Paralympics, invited out‑of‑state or international practitioners can provide care without a California license after required notices. A team representative may consent to treatment when an athlete cannot and no guardian is reachable. Approved clinics at sanctioned sites are exempt from California licensure from May 15 to Sept 15, 2028. Authorized out‑of‑state EMS can work at sanctioned sites during the same dates and are protected for good‑faith acts.
Yearly increases to many state fees
State departments must raise certain permit, license, registration, and document fees each year. The change matches the percent change printed in the Budget Act for that department’s costs, as set by the Department of Finance. Total collections cannot be more than the program’s higher costs. Each department must publish the new fee amounts every year.
Medi‑Cal asset rule delayed to 2026
The MAGI‑exempt asset disregard cannot start before January 1, 2026. It begins only after DHCS finishes system updates and the Director issues a written determination.
New licensing rules and fees for genetic counselors
The law requires a license to use the title “genetic counselor.” You must have a master’s degree in genetics and pass a department-approved exam. Licenses last three years, and renewal needs 45 hours of continuing education, with at least 30 hours in genetics. The fee is $300 to get the license and $300 to renew; the department can raise fees after input, but not above $500. A temporary license is allowed for up to 24 months if you have applied for the first available exam. It costs $300, requires supervision by a licensed genetic counselor or a licensed physician, and ends when you get a full license, 30 days after failing the exam, or after 24 months; the department may revoke it for certain felonies.
Medical interpreter program ends in 2026
The article that set up medical interpretation services becomes inoperative on July 1, 2026, and is repealed on January 1, 2027. Services may stop unless another law keeps them going.
One health code section repealed
The law repeals Section 11756.8 of the Health and Safety Code. The repealed text is not included here, so specific effects for households are not stated.
Administrative shifts in Medi‑Cal programs
DHCS now oversees the Breast Cancer Fund and related accounts, changing reporting and removing a past screening funding rule. The requirement to run medical supply rebate demonstration contracts is repealed. Two Welfare and Institutions Code sections (14007.95 and 14100.95) are repealed. How services shift depends on later guidance and operations.
School vaccine rules shift to state
Starting July 1, 2026, the State Department of Public Health replaces the federal advisory committee for some school vaccine guidance and admission rules. HPV notices for grade 6 list ACIP guidance as of January 1, 2025 through June 30, 2026, and follow current state guidance beginning July 1, 2026.
Sponsors & Cosponsors
Sponsor
Jesse Gabriel
Democratic • House
Cosponsors
There are no cosponsors for this bill.
Roll Call Votes
House vote • 9/12/2025
Item 1000 — Assembly AFLOOR
Yes: 61 • No: 18
Senate vote • 9/12/2025
Item 70 — Senate SFLOOR
Yes: 29 • No: 8
legislature vote • 9/10/2025
Vote in CS62
Yes: 13 • No: 0
House vote • 3/20/2025
Item 74 — Assembly AFLOOR
Yes: 53 • No: 17
Actions Timeline
Chaptered by Secretary of State - Chapter 105, Statutes of 2025.
9/17/2025SenateApproved by the Governor.
9/17/2025legislatureEnrolled and presented to the Governor at 3:45 p.m.
9/12/2025legislatureSenate amendments concurred in. To Engrossing and Enrolling. (Ayes 61. Noes 18. Page 3361.).
9/12/2025HouseAssembly Rule 63 suspended. (Ayes 55. Noes 20. Page 3360.)
9/12/2025HouseIn Assembly. Concurrence in Senate amendments pending.
9/12/2025HouseRead third time. Passed. Ordered to the Assembly. (Ayes 29. Noes 8. Page 2948.).
9/12/2025SenateRead second time. Ordered to third reading.
9/11/2025SenateFrom committee: Do pass. (Ayes 13. Noes 0.) (September 10).
9/10/2025SenateFrom 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.
9/9/2025SenateSenate Rule 29.3(b) suspended. (Ayes 28. Noes 8. Page 2568.)
9/9/2025SenateIn committee: Hearing postponed by committee.
6/30/2025SenateIn committee: Hearing postponed by committee.
6/25/2025SenateJoint Rule 62(a) suspended. (Ayes 27. Noes 9. Page 1703.)
6/23/2025SenateReferred to Com. on B. & F. R.
4/2/2025SenateIn Senate. Read first time. To Com. on RLS. for assignment.
3/20/2025SenateRead third time. Passed. Ordered to the Senate. (Ayes 53. Noes 17. Page 735.)
3/20/2025HouseRead second time. Ordered to third reading.
3/18/2025House(Ayes 53. Noes 17. Page 643.)
3/17/2025HouseOrdered to second reading.
3/17/2025HouseWithdrawn from committee.
3/17/2025HouseReferred to Com. on BUDGET.
2/3/2025HouseFrom printer. May be heard in committee February 8.
1/9/2025HouseRead first time. To print.
1/8/2025House
Bill Text
Chaptered
9/17/2025
Enrolled
9/12/2025
Amended Senate
9/9/2025
Introduced
1/8/2025