An act to amend Sections 127660 and 127662 add and repeal Chapter 7.3 (commencing with 127668) to Part 2 of Division 107 of the Health and Safety Code, relating to health care.
AB 2353 would expand California’s existing University of California–run health-benefit review framework by creating a new Health Mandates Review Program focused on hospital-related mandates. Beginning no later than January 1, 2028, the program would review legislation that would require hospitals to add services, activities, staffing, equipment, facility changes, or charitable/discounted care when those proposals are expected to affect a majority of hospitals or a majority of a recognized class of hospitals. The program would produce written analyses before hearings, publish annual summaries of analyzed legislation, and convene a workgroup with hospital finance and operations expertise.
The bill also directs the Department of Health Care Access and Information to partner with the University of California on a separate Center for Health Provider Policy Impact to evaluate state and federal policies affecting hospitals. That center would assess impacts on health care delivery, access, workforce, system sustainability, and regional disparities, and would issue at least annual reports. The bill creates two new funds—the Health Care Mandates Fund and the Health Provider Impact Fund—to support these activities, and it authorizes annual assessments on hospitals, capped at $3 million, to finance the hospital-focused review program and center. The bill is temporary and would repeal these new provisions on January 1, 2033.
AB 2353 would amend Health and Safety Code Sections 127660 and 127662 and add a new Chapter 7.3 to Division 107, creating a new statutory framework for reviewing hospital mandates while preserving the existing CHBRP process for health benefit mandates. It would add new duties for the University of California, the Department of Health Care Access and Information, and the Legislature, including analysis timelines, reporting requirements, and public posting obligations. The bill would also establish new special funds in the State Treasury and authorize hospital assessments to pay for the program, which the digest characterizes as a tax. Its practical effect would be to create a formal, nonpartisan review process for hospital-related legislation that could affect operating costs, access, and financial stability, while shifting some of the cost of that review onto hospitals.
The bill appears to have received generally favorable committee treatment, as reflected by the 11-0 do pass as amended vote on April 21, 2026. The bill’s findings and intent language frame it as a tool to improve evidence-based policymaking, affordability, and access to high-quality care by giving the Legislature current, credible data on the consequences of proposed mandates. There is no recorded committee transcript in the provided materials, and the last action indicates the first hearing was later canceled at the author’s request, so the public record here shows support in committee but limited further movement.
The main point of contention is likely the bill’s funding mechanism and its characterization as a tax on hospitals. The measure would require annual hospital fees, capped at $3 million, to support the new review and policy-impact functions, which could draw concern from hospitals about added costs and administrative burden. Another possible area of debate is the scope of mandatory review: the bill would require analyses for legislation affecting a majority of hospitals or a majority within a recognized class, which could be viewed as either a useful safeguard against costly mandates or an added procedural hurdle for health policy proposals. The bill also expressly states there would not be an independent review board process with full access to claims payer database and hospital discharge data, which may reflect privacy or data-access limits but could also be seen as constraining the depth of analysis.