Transcript Highlights:

• For 2025-26 and 2026-27 that we're anticipating?
• And this is exactly the structure that H.R. 1 sought to change.
• However, we do anticipate a need to increase DUI... 2026-27.
• This was before H.R. 1 was signed.
• Please hold the line against H.R. 1 and tax billionaires.

Summary: The committee first heard May Revision child care and human services items. The Department of Child Support Services described two technical adjustments, which the analyst supported. The Department of Social Services then walked through child care proposals, including a reduction in federal and Proposition 64 funding absorbed through a shift from General Child Care to the Alternative Payment program, a 2.01% child care COLA, disaster-related infrastructure grants, a new administrative support cost structure for Alternative Payment agencies, the removal of prospective pay funding after a federal rule change, a reappropriation for existing infrastructure grants, and estimates of unspent child care funds. The Legislative Analyst’s Office recommended asking for more justification for shifting reductions to CAP, supported the COLA reduction but wanted consistency across programs, recommended removing prospective pay funding, opposed the administrative cost shift, and suggested further review of disaster grant alignment. Members pressed the administration on why more slots would be cut for the same savings, why the COLA was reduced, and whether the administrative percentage would grow over time. The administration said the changes were intended to avoid disrupting currently enrolled families, reflect point-in-time relinquishments and unspent funds, and stabilize contractor operations. Public commenters, including providers, advocates, and county representatives, urged full COLA funding, rejection of child care slot reductions, preservation of prospective pay, and continued investment in child care infrastructure and access. The subcommittee then recessed before moving to health items. In Part B, the Department of State Hospitals presented its May Revision proposals, including a central utility plant replacement project at Metropolitan State Hospital, funding for a continuum electronic health record system, reduced county bed billing authority to reflect phase-in of additional LPS beds, limited contract exemption authority for online clinical subscription services, reversion of prior-year unspent operating funds, and a workforce development proposal to use Behavioral Health Services Act funds instead of General Fund for training programs. The department said the EHR would modernize records and improve continuity of care, and that the contract exemption would prevent delays in essential clinical information services. No votes were taken in the excerpt provided.

Transcript Highlights:

• For us, the 2026–27 May Revision includes $5.4 billion.
• The May Revision projects H.R. 1 disenrollment of 44,000 in 2026–27 and 1.3 million by 2029–30.
• The May Revision projects H.R. 1 disenrollment of 44,000 in 2026–27 and 1.3 million by 2029–30, which
• to account for the additional caseload associated with H.R. 1.
• We support H.R. 1 navigators for clinics and appreciate the dollars for county H.R. 1 administrative

Transcript Highlights:

• recognition.<04:27:15.359><c> Of</c><04:27:15.680><c> the</c><04:27:15.920><c> last</c><04:27:16.399
• > the</c><04:27:18.399><c> line</c><04:27:18.640><c> of</c><04:27:18.800><c> duty,</c><04:27:19.760><
• of the<04:27:29.359><c> decisions</c><04:27:29.840><c> made</c><04:27:30.399><c> by</c><04:27:30.640
• </c><04:27:34.960><c> does</c><04:27:35.199><c> not</c><04:27:35.359><c> care</c><04:27:35.520><c> if
• :27:10.638><c> as</c><05:27:10.798><c> I</c><05:27:10.958><c> may</c><05:27:11.200><c> consume.

Bills: HCR22 , HR1039 , HR586 , HR970 , HR877 , HR1228 , HR983 , HR981 , HCR9

Keywords: HIV/AIDS, National Black HIV/AIDS Awareness Day, Black health, public health, HIV testing, HIV prevention, PrEP, antiretroviral therapy, viral suppression, U=U, undetectable equals untransmittable, AIDS, Minority AIDS Initiative, community health centers, culturally competent care, health disparities, racial disparities, health equity, Black Americans, African Americans

Transcript Highlights:

• H.R. 1 and other hostile actions taken by the federal administration.
• First, it is balanced, as it must be constitutionally, in the budget year 2026-27.
• And in 2026-27, we're repaying a billion dollars.
• We have about 27 minutes until session starts.
• The changes that are proposed are administrative cost sharing due to H.R. 1.

Committee: House Budget

Transcript Highlights:

• Needs to be part of our solution for 26-27.
• H.R. 1 didn't tackle the deficit.
• While the governor claims that this is the result of a new federal policy change of H.R. 1, H.R. 1 does
• You know, what H.R. 1 does to...
• H.R. 1 puts that continuity at risk.

Summary: The Senate Budget and Fiscal Review Subcommittee held an oversight hearing on the impacts of H.R. 1 on California’s safety net, focusing on Medi-Cal and CalFresh. The chair and vice chair framed the issue as a major federal disruption that would reduce benefits and shift costs to the state, counties, hospitals, and other local systems. The first panel included the Legislative Analyst’s Office, the Department of Finance, the UC Berkeley Labor Center, and the Food Research and Action Center, each describing projected enrollment losses, higher state and county costs, and implementation challenges. The LAO outlined H.R. 1’s main changes: new and expanded work requirements, more frequent eligibility redeterminations, restrictions on certain non-citizen eligibility, and financing changes affecting provider taxes and federal matching rates. The LAO estimated that 1 to 2 million people could be disenrolled from Medi-Cal and more than 600,000 could lose CalFresh, with additional costs from reduced federal support and possible state and county administrative burdens. The Department of Finance said the Governor’s budget includes about $1.4 billion General Fund in 2026-27 to respond to H.R. 1, with larger out-year reductions in federal funds and projected Medi-Cal caseload losses of up to 2 million by 2029-30. The UC Berkeley Labor Center projected up to 3 million Californians could lose full-scope Medi-Cal by 2028 when H.R. 1 is combined with state budget changes, while noting the state could choose policies that would reduce some of those losses. The Food Research and Action Center warned that CalFresh cuts and time limits would increase hunger, worsen health outcomes, and strain local economies and emergency systems. Members questioned the witnesses about procedural disenrollments, regional variation, the overall growth in Medi-Cal spending, the future of the MCO tax, the CalFresh error rate, and the downstream effects on hospitals and county indigent care. Several senators argued that the federal law was driven by tax cuts for high-income earners and would disproportionately harm low-income Californians, immigrants, and communities of color. Administration witnesses said some impacts are still being analyzed, that counties and departments are working on implementation, and that the Legislature may need to use statute, reporting, and oversight tools as federal guidance develops. No votes or formal actions were taken during this portion of the hearing.

Transcript Highlights:

• One thing H.R. 1 did not do was extend enhanced premium tax credits.
• these program requirements pursuant to H.R. 1.
• to H.R. 1.
• You also asked about our outreach strategy for H.R. 1.
• So we know that H.R. 1 imposes these work requirements.

Transcript Highlights:

• hotline<02:27:11.439><c> to</c><02:27:11.680><c> receive</c><02:27:12.000><c> notifications</c><02:27
• .<02:27:15.920><c> All</c><02:27:16.080><c> points</c><02:27:16.319><c> of</c><02:27:16.479><c> order
• /c><02:27:34.720><c> as</c><02:27:34.880><c> amended</c><02:27:35.439><c> and</c><02:27:35.680><c> on
• one one<02:27:40.399><c> hour</c><02:27:40.640><c> of</c><02:27:40.800><c> debate</c><02:27:41.439><
• Pursuant to clause<03:27:48.880><c> eight</c><03:27:49.120><c> of</c><03:27:49.279><c> rule</c><03:27

Bills: HB4305 , HB2965 , HR916

Keywords: small business, regulatory burden, advocacy, government oversight, compliance assistance, Red Tape Hotline, regulatory budget, Small Business Administration, fiscal responsibility, rulemaking

Transcript Highlights:

• That resolution comes as H.R. 308.
• That resolution comes as H.R. 310.
• H.R. 301 by Representative Baham to designate July 27 through August 2 as Alpha Kappa Epsilon Week in
• H.R. 301 by Rep.
• H.R. 85. H.R. 85. Reported favorably. Passed to third reading. H.C.R. 85 by Representative M.

Bills: HR308 , HR309 , HR310 , HR311 , HR312 , HR313 , HR314 , HR315 , HR316 , HR317 , HR318 , HR319 , HR295 , HR296 , HR297 , HR298 , HR299 , HR300 , HR301 , HR302 , HR303 , HR304 , HR305 , HR306 , HR307 , HCR115 , HCR116 , HCR117 , SCR71 , SCR72 , SCR73 , HR73 , HR118 , HR144 , HR196 , HR237 , HR249 , HR260 , HR267 , HR272 , HR273 , HR276 , HR278 , HCR85 , HCR100 , HCR105 , HCR107 , HCR113 , HCR114 , SCR5 , SCR29 , SCR33 , SCR37 , SCR63 , HB255 , HB378 , HB509 , HB1090 , SB80 , SB131 , SB143 , SB251 , SB254 , SB279 , SB367 , SB384 , SB388 , SB389 , SB398 , SB408 , SB431 , SB468 , SB469 , SB496 , SB25 , SB132 , SB155 , SB157 , SB202 , SB295 , SB433 , HR179 , HR223 , HR225 , HR274 , HCR89 , HR252 , HR253 , HCR96 , HCR103 , HCR108 , HCR26 , HB250 , HB265 , HB339 , HB427 , HB445 , HB463 , HB468 , HB606 , HB639 , HB649 , HB665 , HB746 , HB781 , HB853 , HB861 , HB872 , HB886 , HB916 , HB937 , HB1054 , HB1068 , HB1117 , HB1237 , HB74 , HB108 , HB956 , HB1085 , HB1137 , HB62 , HB193 , HB210 , HB220 , HB246 , HB364 , HB420 , HB475 , HB584 , HB622 , HB772 , HB784 , HB949 , HB953 , HB1043 , HB1070 , HB1092 , HB1134 , HB1162 , HB1176 , HB1196 , HB1214 , HB1199 , SB268 , SB283 , HB782 , SB149 , HR84 , HB646 , HB998 , SB56 , SB163 , SB197 , SB97 , SB326 , SB341 , SB518 , SB123 , SB353 , SB479 , SB495 , HB901 , HR20 , HR74 , HR168 , HCR65 , HCR71 , HCR98 , HB284 , HB302 , HB306 , HB341 , HB366 , HB393 , HB458 , HB577 , HB603 , HB605 , HB614 , HB625 , HB733 , HB752 , HB773 , HB798 , HB911 , HB955 , HB996 , HB1035 , HB1069 , HB1113 , HB1140 , HB1180 , HB1191 , HB1240 , HB1255 , SB82 , SB89 , HB134 , HB258 , HB359 , SB29 , SB42 , SB43 , SB217 , SB274 , SB300 , SB379 , SB382 , SB441 , SB449

Summary: The House convened with prayer, pledge, and a quorum, then spent much of the day on recognitions and commemorative resolutions. Members honored coach Jeffrey Craig Whittington, tourism and the Louisiana Oil Makers Association, Motorcycle Safety Awareness Month, the Tangipahoa Parish Fair, Washington Parish festivals, ACOG’s 75th anniversary, Louisiana Tech women’s basketball, and Memorial Day. A major Memorial Day presentation commended Lane Frenchy Boudreau for helping recover the body of Army Sgt. First Class James H. Moore in Vietnam; the House observed a moment of silence and presented a flag to Moore’s family. The chamber also received Senate messages, enrolled bills, and committee reports, and introduced several new resolutions on topics including Pope Leo XIV, orphan wells, scenic rivers, Teche water quality, and the LaMelle family’s pilgrimage to Rome. The House then took up numerous resolutions and bills, often adopting them without objection. Among the measures adopted or advanced were studies on neighborhood crime prevention districts, parish solid waste and disaster resiliency in Washington Parish, the Louisiana Climate Action Plan, the Louisiana Maneuvers museum/trail, cash-rounding practices after penny production ends, residential construction costs and inspection practices, roundabout education, Taiwan relations, TSA worker loan assistance in Shreveport, human growth and development standards, and the state income tax credit for water utility customers. The chamber also adopted or concurred in several Senate amendments on bills dealing with financial disclosure, video voyeurism, personal information protections, online child safety, STEM advisory council changes, dual enrollment tuition, fleet vehicle registration, menhaden fishing rules, recording fees, amusement ride insurance, drone footage authentication, garbage and trash contracts, insurance prescription periods, retirement system changes, juror qualifications, fireworks, inspection stickers, employment discrimination, and inactive boards and commissions. Several measures drew discussion or division. H.B. 1199, requiring coverage for genetic testing and treatment for SCN2A-associated disorders, passed 94-0 after being discharged from Appropriations. H.B. 302, which would prohibit vape sales within 300 feet of schools, passed 86-4. H.B. 84, encouraging an interest-free loan program for TSA workers at Shreveport Regional Airport, passed 64-27. H.B. 1054 on self-authentication of law enforcement drone footage passed 78-12, and H.B. 1137 limiting employment discrimination protections to state employees passed 71-23. The House rejected Senate amendments on H.B. 468 (residential real property wholesaling), H.B. 1117 (insurance contractual payments and prescriptive periods), H.B. 956 (fireworks dates), and H.B. 74 (Spectrum Alert for missing children with autism), while concurring in or adopting amendments on many other bills. The session ended amid continued consideration of Senate Bill 56 on the West Bank/Lafitte levee governance structure, including an adopted amendment to ensure Lafitte-area representation on the board, with extended remarks about the history and accomplishments of the existing levee authority.

Transcript Highlights:

• We must confront the reality that under H.R. 1, We must confront the reality that under H.R. 1, the number
• . 1, and we are still learning more about H.R. 1.
• Provisions of H.R. 1 go into effect upon enactment of H.R. 1, which was July 4, 2025, and others may
• H.R. 1 also establishes cost-sharing requirements.
• We can refuse to compound the cruelty of H.R. 1.

Committee: House Health

Transcript Highlights:

• &gt;&gt; The<04:27:21.520><c> gentleman</c><04:27:21.840><c> from</c><04:27:22.080><c> Texas</c><04:27
• States and<04:27:32.640><c> communities</c><04:27:33.120><c> are</c><04:27:33.359><c> being</c><04:27
• Those<05:27:11.520><c> are</c><05:27:11.680><c> the</c><05:27:11.840><c> communities</c><05:27:12.080
• :27:33.840><c> public</c><05:27:34.160><c> health</c><05:27:34.558><c> and</c><05:27:34.718><c> the</
• ,</c><05:27:39.200><c> I</c><05:27:39.360><c> stood</c><05:27:39.520><c> up</c><05:27:39.600><c> to</

Bills: HR1156 , HB6398 , HB6409 , HR965 , HR1174 , HR1176 , HCR40

Keywords: tax cuts, working families, tax relief, income tax, healthcare, education, overtime pay, child tax credit, environmental regulations, EPA, clean air, reducing duplication, federal projects, Clean Air Act, emissions, air quality, international pollutants, economic impact, temporary protected status, Haiti

Transcript Highlights:

• > conducted</c><00:27:11.440><c> a</c><00:27:11.679><c> survey</c><00:27:12.159><c> on</c><00:27:12.559
• They<00:27:13.919><c> found</c><00:27:14.320><c> 71%</c><00:27:15.360><c> of</c><00:27:15.600><c> veterans
• ><c> that's</c><00:27:17.840><c> a</c><00:27:18.080><c> clear</c><00:27:18.240><c> choice.
• Speaker,<00:27:20.080><c> as</c><00:27:20.320><c> our</c><00:27:20.559><c> nation</c><00:27:20.880><c
• its 250th<00:27:23.120><c> birthday,</c><00:27:24.320><c> HR</c><00:27:25.039><c> 9237</c><00:27:26.240

Bills: HB4970 , HR1420 , HB5362

Keywords: Orland Project, Central Valley Project, Sacramento Canal Unit, water transfer, water rights, drought relief, federal reclamation, Bureau of Reclamation, California water, irrigation, water management, Reclamation States Emergency Drought Relief Act, Reclamation Reform Act, water users association, water supply, drought resilience

Transcript Highlights:

• We were anticipating H.R. 1.
• This budget subcommittee started talking about the impacts of H.R. 1 last year before H.R. 1 was even
• H.R. 1 will certainly harm this network.
• H.R. 1 fundamentally...
• As we prepare... ...beyond the 2026-27 year.

Transcript Highlights:

• Then a few observations updating from last year regarding H.R. 1 impacts.
• El Centro and Pioneers are two hospitals that each, I think, got $27 or $28 million.
• Authorized by H.R. 1 under CMS's direction.
• The 2026-27 Governor's Budget proposes $841.2 million and 844 staff positions for HCAI.
• Today, we are still in the process of developing a proposed budget for fiscal year 2026-27.

Summary: The Assembly Budget Subcommittee on Health heard updates on five health-related budget items. First, members reviewed state support for distressed hospitals and health facilities. The California Health Facilities Financing Authority and HCAI described the Distressed Hospital Loan Program as a lifeline for 16 hospitals, many of which remain financially strained and are expected to seek loan forgiveness rather than repayment. Speakers cited reduced contract labor, new service lines, strategic partnerships, and the reopening of Madera Hospital as signs of progress, but also warned that federal policy changes under H.R. 1 will likely increase uncompensated care and pressure emergency departments. Public commenters from hospital, dental, and consumer groups supported additional funding, including a request to refresh the program with another $300 million. The committee then heard HCAI’s update on the California Rural Health Transformation Program, a five-year federal initiative funded at $233.6 million for California. HCAI said the program will focus on rural care models, workforce development, and health technology, with grants to be rolled out on a fast timeline and all funds obligated by October 30, 2026. Members raised concerns about rural provider capacity to apply for grants, and HCAI said it will use a third-party administrator, a technical assistance center, webinars, and other supports to help applicants. HCAI also presented its budget request for the health care payments database, seeking ongoing non-General Fund support to continue operations and expand data, including pharmacy benefit manager data. The Emergency Medical Services Authority presented three budget change proposals: funding to replace disaster medical services fleet vehicles, funding for IT security work, and additional positions for HR, enforcement, and legal workload. A member also raised concern that EMSA has not yet completed the annual ambulance rate reporting required by AB 716, and EMSA said it remains committed to the requirement but lost prior funding through later budget reductions. Covered California reported that it is still finalizing its own budget, but expects a lower operating budget due to efforts to reduce baseline costs and align spending with actual expenditures; it also projected enrollment declines tied to the expiration of enhanced premium tax credits, H.R. 1, and federal rule changes, while noting that revenues may still rise because premiums are expected to increase. Finally, the Department of Managed Health Care outlined budget proposals tied to menopause coverage and education, PBM licensure and enforcement under AB 116 and SB 41, credentialing reforms under AB 1041, and prior authorization reporting under SB 306. Public testimony generally supported the menopause and PBM proposals, while also urging clearer language and attention to Medi-Cal parity. The hearing concluded after public comment, including additional advocacy for sickle cell services and rural health workforce funding.

Transcript Highlights:

• And this is H.R. 1, or this is part of the asset test that... It's H.R. 1. This is H.R. 1.
• That is our understanding under H.R. 1.
• But now H.R. 1 is imposing and it requires...
• H.R. 1 requirements more broadly.
• it if we didn't have H.R. 1, but with H.R. 1, it just ends up being a falsity, I would say, to say that

Summary: The joint informational hearing focused on the impact of H.R. 1 on older Californians and related county administration issues. Chair Jackson and Chair Addis opened by emphasizing California’s rapidly aging population and the need to protect seniors’ access to food, health care, housing, and in-home support services. Testimony from the Department of Social Services, Department of Health Care Services, and Department of Aging described how H.R. 1 would expand work and reporting requirements in CalFresh and Medi-Cal, increase redeterminations, and create new eligibility barriers. Witnesses and advocates warned that these changes could lead to large coverage losses, especially for adults ages 55 to 64, people experiencing homelessness, caregivers, and some immigrant groups, while also increasing administrative burden on counties. The LAO noted that many provisions do not directly apply to Californians 65 and older, but highlighted indirect effects and some direct impacts, including a new home equity limit for certain long-term care recipients and narrower immigration eligibility rules. Committee members pressed the administration and counties on how exemptions would be identified and implemented, whether data systems could automatically protect eligible people, and how outreach would reach older adults, women, LGBTQ seniors, and people with limited digital access. DHCS and CDSS said they are working to use existing data, cross-program information sharing, and human-centered communications to maximize exemptions and reduce churn, including text outreach, print and radio campaigns, and navigator support. Members also raised concerns about the need for legal aid and county eligibility workers to help people navigate complex rules, and requested updated analyses on the number of people likely to lose both Medi-Cal and CalFresh and the broader human and system impacts. No votes were taken. The second major topic was the administration’s proposal to shift some future IHSS costs to counties by establishing a statewide baseline for average authorized hours per case. CDSS said the proposal is intended to improve consistency in assessments and not reduce services, while counties and labor groups strongly opposed it, arguing that rising hours reflect real increases in need, an aging and higher-acuity caseload, and state-mandated assessment tools rather than county error. County representatives said the proposal would strain already limited local revenues, worsen the effects of H.R. 1, and could force cuts to other safety-net services. Committee members questioned the proposal’s timing and impact, but the hearing ended without action, with the chairs asking for continued updates, additional analysis, and more information before May Revision.

Transcript Highlights:

• </c><04:27:31.880><c> the</c><04:27:32.159><c> Japanese</c><04:27:32.600><c> Yen</c><04:27:32.840><c>
• currency<04:27:35.880><c> basket</c><04:27:36.479><c> influences</c><04:27:37.399><c> the</c><04:27:
• :39.479><c> rate</c><04:27:40.479><c> all</c><04:27:40.760><c> other</c><04:27:41.760><c> uh</c><04:27
• ><c> know</c><07:27:54.798><c> she</c><07:27:55.040><c> had</c><07:27:55.240><c> no</c><07:27:55.478>
• ><c> photos</c><07:27:56.318><c> were</c><07:27:56.520><c> being</c><07:27:56.798><c> taken</c><07:27

Bills: HR736 , HR692 , HR965 , HR975 , HR386 , HR224

Keywords: diaper need, infant health, family well-being, basic needs, public health, childcare, September 11, terrorist attacks, education, curriculum, first responders, national security, temporary protected status, Haiti, immigration, refugees, quorum, House of Representatives, business proceeding, legislative procedure

Transcript Highlights:

• The resolution comes H.R. 19 and lies over.
• It comes H.R. 20 and lies over.
• The resolution comes H.R. 23 and lies over.
• The resolution becomes H.R. 27 and lies over.
• House Resolution 27 lies over.

Bills: HR19 , HR20 , HR21 , HR22 , HR23 , HR24 , HR25 , HR26 , HR27 , HR28 , HR29 , HR30 , HR31 , HR32 , HR33 , HR34 , HR35 , HR36 , HR37 , HR38 , HCR15 , HCR16 , HCR17 , HCR18 , HB115 , HB208 , HB465 , HB832 , HB964 , HB965 , HB966 , HB967 , HB968 , HB969 , HB970 , HB971 , HB972 , HB973 , HB974 , HB975 , HR14 , HR15 , HR16 , HR17 , HR18 , HCR14 , SCR4 , SCR7 , SCR8 , HB362 , HB963 , HB207 , HB300 , HB331 , HB428 , HB464 , HB587 , HB618 , HB629 , HB801 , HB853 , HB891 , HB78 , HB112 , HB148 , HB149 , HB190 , HB221 , HB346 , HB354 , HB355 , HB356 , HB358 , HB384 , HB427 , HB657 , HB675 , HB716 , HB901

Summary: The House convened with 97 members present, heard an invocation by Pastor Morris St. Angelo, and recited the Pledge of Allegiance. The chamber then received Senate messages noting concurrence in HCR 8, HCR 9, and HCR 12, and the adoption of SCR 10, which expressed condolences on the death of Dr. Norman Christopher Francis. The House also received an enrollment report confirming several resolutions as properly enrolled. A series of personal privilege recognitions highlighted local and civic observances, including Amite Oyster Festival Day, Opportunity in Action Day at the Capitol, and a visit from international policy fellows. The House introduced numerous resolutions and bills, including measures to designate special days and highways, express condolences, commend individuals and organizations, create or modify local districts, address bail, parole, rural health clinic Medicaid reimbursement, and establish a Department of Public Service. Several committee reports were also received, including transportation and ways and means reports on multiple bills. The House adopted, without objection, several resolutions already lying over, including HR 14, HR 16, HR 18, SCR 4, SCR 7, and SCR 8, while other resolutions and bills were referred or left to lie over. Members also moved to discharge and withdraw certain bills from committee files without objection. The chamber was reminded of upcoming committee meetings, an interim emergency board ballot deadline, and adjourned until 1:00 p.m. the following day.

Transcript Highlights:

• And then we just have the projections on performance for FY 26 and FY 27.
• That's the last column is what the agencies have requested for FY 27.
• But basically, in H.R. 1, there is a measure of deficit spending.
• But anyway, I think on that, H.R. 1...
• It had nothing to do with H.R. 1.

Committee: House Tobacco Settlement Revenue Oversight Committee

Transcript Highlights:

• So today, after H.R. 1, all of these requirements still remain in place.
• H.R. 1 was never approved.
• Yeah, yeah, you can move into the H.R. 1 interaction.
• The limits that are in H.R. 1 are on a gross basis.
• Then it would just be for the other half of '27.

Summary: The subcommittee heard a lengthy Department of Health Care Services presentation on the governor’s Medi-Cal budget, including a $229.1 billion total-funds proposal, projected Medi-Cal enrollment declines as redeterminations continue, and several major cost drivers such as managed care growth, Medicare-related costs, pharmacy spending, and changes tied to federal policy. Members focused heavily on the elimination of Prop. 56 dental supplemental payments beginning July 1, 2026, questioning the likely impact on provider participation and utilization. DHCS said it is completing the required rate reduction/access analysis for CMS, has been holding stakeholder meetings and issuing provider bulletins, but could not yet quantify the real-world effect. The committee also discussed a $50 million savings proposal tied to new hospice utilization management authority and asked about possible effects on emergency dental care and provider participation. The hearing then moved through the November 2025 family health estimate and several county and program administration issues, including CCS, GHPP, and Every Woman Counts. DHCS said family health costs are rising despite slight caseload declines because of higher utilization and medical costs, and members raised concerns about CCS website accessibility, county administrative funding, and the transition of youth aging out of CCS. The department said most CCS beneficiaries are also on Medi-Cal, that counties have long raised funding concerns, and that it had clarified use of maintenance-and-operations dollars to address some county workload issues. Members also asked about Every Woman Counts potentially seeing higher demand as Medi-Cal changes take effect; DHCS said that is possible and that the program has multiple funding sources including General Fund. A major portion of the hearing focused on provider taxes and federal changes under H.R. 1, especially the Medi-Cal managed care organization tax and the hospital quality assurance fee. DHCS explained that H.R. 1 restricts new or increased health care-related taxes, phases down allowable tax levels over time, and tightens “generally redistributive” rules, which could sharply reduce the state’s ability to use the MCO tax for Medi-Cal financing. Members asked whether the Legislature could amend Prop. 35 or whether voters would need to act; DHCS said a three-fourths legislative amendment may be possible if it aligns with the measure’s purpose, but the department is still evaluating options. The committee also discussed hospital financing, with DHCS describing recent increases in state-directed payments and the effect of H.R. 1 in capping those payments at Medicare levels, and the LAO noting the tradeoff between preserving provider taxes and maintaining Medi-Cal funding. The subcommittee also reviewed a series of DHCS budget change proposals and trailer bill items, including managed care final-rule implementation, managed care operations, a hospital value strategy, a one-year extension of skilled nursing facility financing, long-term care payment transparency, and interoperability/prior authorization requirements. Members repeatedly questioned the use of limited-term versus permanent positions, the overlap among proposals, and the timing of new financing reforms. DHCS said the SNF extension would preserve current workforce standards, sanctions, growth limits, and the SNF quality assurance fee while the department develops a broader 2027-28 redesign. No votes were taken; items were repeatedly held open for later action. Covered California then presented on the expiration of the federal enhanced premium tax credit and the resulting affordability crisis. The agency said Californians will lose about $2.5 billion in premium assistance for 2026, average premiums could nearly double for many enrollees, and as many as 400,000 people could eventually leave marketplace coverage. Open enrollment ended with 1.9 million sign-ups, down 3% from the prior year, with especially steep declines among middle-income consumers and increased movement into bronze plans. Covered California said the state’s $190 million affordability subsidy is helping lower-income enrollees retain coverage, but cannot fully replace the lost federal assistance. Members also asked about the Health Care Affordability Reserve Fund, repayment of loans from that fund, the status of federal review of California’s essential health benefits benchmark, and implementation of the new gender-affirming care benefit under AB 144.

Transcript Highlights:

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Bills: HB1531 , HB6644 , HB3190 , HB3390 , HB3682 , HB5616 , SB3705

Keywords: Taiwan, China, banking organizations, financial regulators, national security, Burma, sanctions, foreign relations, accountability, economic oversight, military accountability, discount window, Federal Reserve, Federal Reserve Act, Board of Governors, liquidity, bank liquidity, emergency lending, lender of last resort, financial stability

Transcript Highlights:

• these program requirements pursuant to H.R. 1.
• You also asked about our outreach strategy for H.R. 1.
• And then if you see policy change... ...the new H.R. 1.
• It relates to H.R. 1 Medi-Cal implementation.
• As a reminder, you have one minute, and we are talking about H.R. 1 and the impacts of H.R. 1 on Medi-Cal

Summary: The Assembly Budget Subcommittee on Health held a hearing on the impacts of H.R. 1 and related federal actions on Covered California, Medi-Cal, and immigrant access to care. The chair framed the discussion around three main issues: expected losses in marketplace coverage as enhanced federal premium subsidies expire, new federal work and renewal requirements that would add administrative burden to Medi-Cal, and the loss of eligibility for certain lawfully present immigrants. Covered California testified that H.R. 1 and new federal rules, combined with the end of enhanced premium tax credits, are driving higher premiums, lower new enrollment, and more cancellations, especially among middle-income, Latino, and Black enrollees. The agency said California’s $190 million state subsidy program is helping lower-income enrollees but cannot replace the lost federal assistance, and it noted that roughly 120,000 lawfully present immigrants in Covered California will lose federal tax credits in 2027. On Medi-Cal, the Department of Health Care Services said H.R. 1 will require work and community engagement verification, six-month renewals for certain adults, and other changes that the department expects will reduce enrollment substantially. DHCS estimated 233,000 members could lose coverage by June 2027 from the work requirement and 289,000 from six-month renewals, with losses rising much higher by 2028; it also said it is using automation, outreach, clinic navigators, coverage ambassadors, community health workers, and street medicine providers to reduce procedural disenrollments. The department described a two-phase outreach plan and said it is working with counties on implementation, while the Department of Finance said the Governor’s budget maintains $190 million for the state subsidy program and does not propose additional changes at this time. The LAO said its independent forecast is somewhat higher than the administration’s, estimating about 2.1 million fewer Medi-Cal enrollees by June 2028, and urged the Legislature to review county administrative workload and readiness. Public testimony and member comments focused on the human and fiscal consequences of coverage losses. A representative from the Sacramento Native American Health Center warned that reduced reimbursement and coverage losses would destabilize community health centers, increase uncompensated care, and worsen outcomes by pushing patients into emergency care. Members raised concerns about paperwork burdens, county capacity, outreach effectiveness, and whether the state should do more to preserve coverage, including possible modeling of additional H-CARF spending and support for middle-income consumers and immigrant enrollees. The hearing did not take any votes or formal actions, but it ended with public comment and continued discussion of implementation and budget options.