California 2023 Legislative Session Preview

California State Capitol Lit by Setting Sun

I’m Cassidy Wilson, your Government Relations Manager for the Far West Division of HCA Healthcare. I look forward to sharing relevant updates about local, state, and national issues affecting our profession and our lives. Please reach out if you have any questions.

This is an especially exciting time as the California Legislature began its 2023 regular session on January 4th. The legislature is the most diverse it has ever been, with a record number of women, Latinx, and members who identify as LGBTQ+. There are 33 new legislators stepping into their roles. The session will sine die in September.

Here’s a rundown of key issues that may be addressed during this legislative session:

$22.5 Billion Budget Deficit

The state faces a $22.5 billion budget deficit, in stark contrast to its previous years of record budget surpluses. If tax revenues don’t rebound, California lawmakers will have to make significant cuts and delay some of the state’s prior spending commitments.

Gov. Newsom has proposed a $296.9 billion spending plan for 2023-2024, which includes investments in key priorities such as education, homelessness and housing, Medi-Cal, climate change, public safety, and small business support. While legislators will use the governor’s plan as a starting point, they will likely revise some of the proposals to align with their own priorities.

Medi-Cal Expansion

Medi-Cal serves nearly 15 million low-income individuals in California. The program has undergone several reforms in recent years, and legislators are now calling for further expansion to improve access and quality of care, as well as control costs. They plan to continue implementing the California Advancing and Innovating Medi-Cal (CalAIM) initiative, which began in 2018, to improve Medi-Cal services in the state.

Gov. Newsom’s budget proposal includes:

  • $844 million to expand free health care to low-income undocumented immigrants
  • $10.7 billion for CalAIM
  • Measures to make prescriptions more affordable through CalRX.

Mental Health

One of the governor’s budget priorities is improving mental and behavioral healthcare services. He has proposed $215 million to implement the Community Assistance, Recovery & Empowerment (CARE) Act, the state’s initiative to provide vulnerable residents with substance abuse and mental health services.

Additionally, the governor’s budget proposal includes investments in maintaining and improving mental and behavioral health services, especially for children and teens.

Mental health is a priority for legislators like Assemblymember Dr. Corey Jackson and first-time Senator Caroline Menjivar. They want to learn from the challenges posed by the pandemic and allocate more funding for counties to establish CARE courts – systems for individuals with severe mental illness – which will launch by October 1.

Social Services

Assemblymember Laurie Davies has introduced a bill requiring counties to use a displayed identifying number when making calls to applicants or recipients of social services benefits programs. Assemblymember Davies views this as a way to avoid confusion and prevent individuals from missing out on benefits because they don’t recognize the number or answer calls from blocked numbers.


California has the highest rate of homelessness in the United States, with 30% of the nation’s homeless population. Several initiatives to address California’s housing crisis will go into effect this year, including new laws that aim to speed up the development of affordable housing in former commercial areas. Assembly Speaker Rendon sees housing as a key priority during this legislative session and will work to ensure accountability for the billions of tax dollars that California has spent on homelessness and development programs in recent years.

Assemblymember Jackson has already introduced a bill (AB11) to address California’s high cost of living by 2026. This legislation would create the Affordable California Commission to investigate the causes and effects of the rising cost of living in the state and develop approaches to make it more affordable.

Lawmakers will also consider a bill to make it easier for religious organizations and nonprofit colleges to build 100% affordable housing on their property. Gov. Newsom has proposed funding to build more affordable housing in his 2023-2024 budget.

Public Safety and Fentanyl

The governor and legislative leaders have pledged to enhance public safety regarding fentanyl. Assemblymember Jasmeet Bains (D-Bakersfield), a family physician, has introduced a bill to create a task force to address fentanyl addiction in the Central Valley. The proposed task force would work to ensure access to healthcare, addiction, and rehabilitation services.

Special Session on Oil Taxes?

In addition to the regular legislative session, Gov. Newsom is also calling for a special session for lawmakers to consider imposing an excess profits tax on oil refiners. The potential tax would cap the profit margin for refiners and could fine companies that exceed that limit. The governor has argued that this tax would help deter future gas price spikes in the state.

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