California lawmakers approve $2.8 billion to sustain Medi-Cal health care program
California lawmakers voted Thursday to send $2.8 billion in additional funds to California’s low-income health insurance plan, Medi-Cal, to cover higher-than-anticipated costs as the fiscal year ends.
The move was part of a budget trailer bill, otherwise known as a “budget bill junior,” that gets funds moving before the start of the new fiscal year in July. The bill also authorized spending to support local governments affected by the winter Los Angeles fires, and allocated $181 million in bond funds to nature conservancies for forest resilience.
Republicans in both the Assembly and the Senate mostly opposed the passage of the bill, AB 100, and voiced concern about Medi-Cal coverage for undocumented immigrants. In the past few years, California has gradually opened up Medi-Cal to all income-eligible people, regardless of immigration status, despite pushback from the state’s Republican minority.
The Newsom administration attributed Medi-Cal’s unexpectedly high costs to a few factors: expensive pharmaceutical drugs, continuting COVID-19 era flexibilities, and a higher than anticipated caseload.
California’s Medi-Cal costs
The $2.8 billion from the state’s general fund unlocks $8.3 billion in accompanying federal funds, and adds to a $3.4 billion emergency loan provided to the program earlier this year.
“There’s something wrong with Democrats’ priorities,” said Assembly Republican leader James Gallagher, R-East Nicolaus, in an emailed statement after the vote. ”This spending bill throws nearly $3 billion towards benefits for illegal immigrants with zero accountability for how costs got so out of control.”
Democrats have countered that it is more expensive to keep people off of health insurance, and that the additional allocation is modest in comparison to the entire Medi-Cal budget, which was $161 billion in 2024 and covers about 15 million people.
“People are doing what we want them to do, which is to access health care instead of getting their primary care in the emergency room, which is even more expensive for taxpayers, and which is absolutely harmful to hospitals,” said Senate budget committee Chair Scott Wiener, D-San Francisco, before the vote on Thursday.
During a Wednesday budget subcommittee hearing, some Democratic lawmakers called for a thorough investigation into how the system could cost less.
“I think that we could limit our expenses without dropping people and still have 95% of the state covered, if we were willing to say that there are things that are covered and there are other things that aren’t covered,” said state Sen. Catherine Blakespear, D-Encinitas.
State Sen. Dr. Akilah Weber Pierson, D-San Diego, agreed, saying the system “is not sustainable as-is.”
“I’m looking forward to all of us having conversations as to how we can re-imagine a system that is affordable but still provide the ability for people, regardless of their immigration status, to get some form of health care,” she said.
What Republicans asked for
Through amendments, Republicans hoped to add some of their priorities to the trailer bill.
Former firefighter state Sen. Kelly Seyarto, R-Murrieta, introduced a proposal to shift seasonal firefighting positions with the California Department of Forestry and Fire Protection into full-time roles. He said workers could begin doing vegetation management immediately.
“Right now, we need to get a jump on it,” he said. “This is the perfect vehicle to do that.”
State Sen. Tony Strickland, R-Huntington Beach, proposed an allocation of $400 million for Proposition 36, the tough on crime measure California voters passed last year. He challenged Democrats to prove they were committed to funding the law’s implementation.
“The fact of the matter is, where we are now is zero,” he said. “So don’t look at the rhetoric. Look at the record. The record shows that this legislature is not funding Prop. 36.”
Each suggested amendment, plus one to preserve middle class student scholarships and funding for the University of California and California State University system, was “laid on the table,” a way to reject the changes without holding votes to turn them down. Wiener said all three priorities would be addressed in the new budget the Legislature is currently crafting.
Wiener also acknowledged there could be significant changes to the budget due to what he called a “Death Star” in Washington, D.C.: President Donald Trump and Republican congressional leadership, who on Thursday got closer to a budget that includes significant tax cuts and potential cuts to Medicaid, which would directly affect Medi-Cal.
“I would encourage my colleagues on the other side of the aisle to please talk to your counterparts in Washington, D.C. and ask them to stop trying to defund UC, to stop trying to attack health care and to help us provide all of these services.”
This story was originally published April 10, 2025 at 3:32 PM with the headline "California lawmakers approve $2.8 billion to sustain Medi-Cal health care program."