Our thoughts are with each of you across the state, and particularly our colleagues and their families enduring the Los Angeles wildfires firsthand. We hope you and your loved ones stay safe and well during this tragically challenging time.
While our focus remains on supporting our communities and delivering quality care, it’s also important to stay informed about the policies shaping the future of healthcare in our state. California’s 2025 legislative session reconvened on January 6 and is scheduled to adjourn in September. The regular legislative session is occurring concurrently with a special legislative session called in early December to prepare for anticipated federal challenges under the incoming Trump administration.
With health policy as a top priority for lawmakers, HCA Healthcare is pleased to share this legislative preview to keep colleagues updated on key developments that may affect care and access in the communities we serve.
Under the leadership of Senate President Pro-Tem Mike McGuire (D-District 2) and Assembly Speaker Robert Rivas (D-District 29) and in conjunction with Governor Gavin Newsom (D), this session will address a range of issues from the state budget and healthcare policy to economic development, education, and public safety.
Medi-Cal
Medi-Cal provides healthcare services to almost 15 million Californians, about 2 in 5 state residents. With the Trump administration potentially seeking to cap federal spending on Medicaid, California is likely to take measures this legislative session to protect Medi-Cal funding. Governor Newsom has proposed increased funding for Medi-Cal in his budget, and several bills have already been filed regarding the program, including:
AB 29 would expand the list of Medi-Cal providers eligible to conduct and receive payments for Adverse Childhood Experiences trauma screenings. The bill would include community-based organizations and local health jurisdictions that provide health services through community health workers, as well as doulas, as qualified providers.
AB 55 would revise licensing and Medi-Cal reimbursement requirements for alternative birth centers. Specifically, the bill removes the requirement for these facilities to be certified as providers of comprehensive perinatal services under Medi-Cal provisions, simplifying the criteria for both licensure and reimbursement. By easing certification requirements, AB 55 aims to streamline access to licensure and reimbursement, potentially encouraging the establishment and operation of alternative birth centers while maintaining existing standards for quality of care and safety.
AB 220 would require health facilities to use state-approved forms when submitting treatment authorization requests for pediatric and adult subacute care services under Medi-Cal. The bill would prohibit Medi-Cal managed care plans from using criteria not outlined in these forms to determine medical necessity. The Department of Health Care Services would establish enforcement procedures to ensure compliance and could impose penalties for noncompliance.
Coverage Expansion for Undocumented Californians
AB 4 would expand access to health insurance coverage through Covered California, the state’s health insurance marketplace, to individuals currently ineligible due to their immigration status. The bill would establish a new program to provide coverage in a manner substantially similar to what is available to other Californians, including eligibility determination, benefit design, and contracting requirements. To ensure broad participation, Covered California would conduct outreach and marketing efforts while consulting with stakeholders to refine the program’s design annually. A newly created “Covered California for All Fund” would finance the initiative, using user fees, legislative appropriations, and other funding sources.
Mental Health
AB 37 would aim to address workforce shortages by expanding the number of mental health service providers available to support individuals and families experiencing homelessness. The bill declares the Legislature’s intent to develop legislation targeting this workforce gap, focusing on individuals who lack stable or adequate housing, including those living in shelters, on the streets, or in unfit living conditions. While the bill currently outlines intent rather than specific actions, it signals a commitment to addressing both homelessness and mental health service capacity.
AB 96 would broaden the state’s Welfare and Institutions Code, in part by defining “community health worker” to mean a liaison, link, or intermediary between health and social services and the community to facilitate access to services and to improve the access and cultural competence of service delivery.
Patient Visitation Rights
AB 92, also known as Dianne’s Law, would require facilities to allow specified individuals, including the patient’s children and grandparents, to visit unless health or safety concerns necessitate restrictions or the patient declines visitation. In end-of-life situations, the bill would prohibit facilities from banning in-person visits except at the patient’s request, and would require the provision of personal protective equipment and testing resources for visitors, if readily available. It would also mandate that facilities develop alternative visitation protocols to maintain access while addressing safety concerns. The bill is named after Assemblyman James Gallagher’s aunt, who died while hospitalized during the pandemic when family members were not able to visit in person.
Reproductive Healthcare
Reproductive healthcare will be center stage this legislative session as lawmakers anticipate changes in federal law and policies under the new administration. AB 40 would expand the definition of “emergency services and care” under California law to explicitly include reproductive health services, including abortion. This change would require health facilities and healthcare service plans to provide or reimburse those services as part of emergency medical care, aligning reproductive health services with other urgent medical needs. The bill includes provisions for immediate implementation as an urgency statute, emphasizing its importance to ensure access to emergency reproductive care.
AB 45 would aim to enhance privacy protections related to reproductive healthcare. The bill proposes making it unlawful to use geofencing technology around entities or facilities providing in-person healthcare services, which could protect individuals’ location data at such facilities. Additionally, the bill would prohibit healthcare providers from releasing medical research information about individuals seeking or obtaining abortions in response to subpoenas or requests based on another state’s laws that conflict with California’s Reproductive Privacy Act.
AB 50 would simplify access to contraceptives by allowing pharmacists to furnish over-the-counter contraceptives without following the standardized procedures or protocols currently required for prescription-only self-administered hormonal contraceptives. The bill also permits pharmacists to dispense up to a 12-month supply of FDA-approved, self-administered hormonal contraceptives at a patient’s request. Declared as an urgency statute, this bill would take effect immediately.
Pharmacy Benefit Managers (PBMs)
Last year, the Legislature approved a bill that would require PBMs to be licensed and regulated by the California State Board of Pharmacy, but that legislation was ultimately vetoed by Gov. Newsom. This year, SB 41 proposes significant regulatory reforms affecting pharmacy benefit managers in California, aiming to improve transparency, reduce costs for patients, and prevent discriminatory practices. Key provisions in the bill include licensing requirements, cost-sharing restrictions, prohibitions on certain pricing practices, and increased reporting and oversight.
State Budget
On January 6, Governor Newsom presented a $322.2 billion budget proposal, the second largest state spending plan to date. The proposed budget includes $228.9 billion in general fund spending and nearly $17 billion in combined reserves, including $11 billion in the Rainy Day Fund and $4.5 billion in the Special Fund for Economic Uncertainties. It is of course too early to determine how the wildfires will affect state resources, but it is likely that the impact will be huge.
Highlights of the Governor’s proposed budget, which will be reviewed and likely revised by lawmakers, include:
- Health and Human Services: $188.1 billion is proposed for Medi-Cal, with $500 million to expand behavioral health services in schools and $8 billion for BH-CONNECT programs targeting youth, homeless populations, and justice-involved individuals. Universal school meals are fully funded with an additional $106.3 million.
- Education: $137.1 billion is earmarked for TK-12 education, with $1.5 billion for universal transitional kindergarten, $435 million for after-school and summer programs, and $106.3 million for universal school meals. Literacy and math initiatives would receive $500 million. Higher education would receive $45.1 billion, including $100 million for “Career Passport” programs and $527.2 million for Middle Class Scholarships.
- Climate and Environment: $2.7 billion has been proposed under the $10 billion Climate Bond for wildfire and water resilience, including $231.5 million for dam safety, $183.2 million for clean water projects, $82.2 million for forest health programs, and $148.2 million for Salton Sea restoration. Investments target coastal resilience, biodiversity preservation, and extreme heat mitigation.
- Housing and Homelessness: $1.2 billion would go to support public school-related housing infrastructure and homelessness solutions. Additional proposed funding emphasizes integrating housing and health services to address the needs of unhoused individuals.
- Public Safety and Criminal Justice: $283.6 million would support state and local public safety efforts, with $59.1 million for fire prevention grants and $9.1 million for wildfire mitigation. Continued investments in rehabilitation and reentry programs are designed to enhance community safety.
- Transportation and Infrastructure: Major investments target the modernization of highways, bridges, and public transit, supporting growth and sustainability goals.
- Labor and Workforce Development: $100 million would be directed toward regional career education and workforce initiatives, including apprenticeship programs and Credit for Prior Learning infrastructure.
- Economic Development: Continued support for California Jobs First initiatives would create jobs, attract investments, and drive innovation in strategic sectors like healthcare and clean energy.
Artificial Intelligence
California lawmakers are looking to tackle tech regulation, with a focus on artificial intelligence (AI), social media, and autonomous vehicles. Proposals include measures to assess AI risks, combat false impersonation, and hold social media platforms accountable for harm to children. With state Attorney General Rob Bonta’s support, mental health warning labels for social media may also be considered. Central to this year’s debates will be lawmakers’ attempt to balance public concerns with protecting the state’s tech-driven economy.
Affordability
Senate President McGuire and Assembly Speaker Rivas recently said a priority of theirs this session will be to advance policies to lower the cost of living for working Californians, including by building more housing, making energy cheaper, and improving public infrastructure. Bills have already been filed to address this priority, including AB 6, which would ease construction standards for small apartment buildings, and AB 30, which would increase the amount of ethanol that can be blended with gasoline to reduce gas prices.
Reparations
Several protests occurred last September over reparations bills, and several such bills were passed and signed by Gov. Newsom. This year, California lawmakers are revisiting reparations-related policies after the tabling of a proposal last year to establish a state agency for reparations. New bills this year include admissions preferences at state universities (AB 7), home purchase assistance for descendants of slaves (AB 57), and compensation for properties taken through eminent domain (AB 62).
The Black Caucus has stated its intention to continue pursuing reparations measures in the current legislative session. Assemblymember Tina McKinnor, who reintroduced the eminent domain proposal, noted that achieving broader reparations policies, such as cash payments, may require incremental steps over several years.
Wildfire Relief
Gov. Newsom signed a $2.5 billion bipartisan relief package to accelerate Los Angeles’ recovery from recent wildfire devastation. Passed during the special legislative session, the funding will support emergency response efforts, expedite rebuilding, and aid impacted schools. Additional measures include tax relief, streamlined permitting, fast-tracked temporary housing, and protections against price gouging and real estate speculation.
