Big wins (and a few losses) in California’s new budget

This past month, APLA Health joined health care advocates across California to fight deep cuts to the programs millions of people rely on to see a doctor, fill a prescription, and stay healthy. Governor Newsom had proposed those cuts over the past year, and we pushed the Legislature hard to stop them.

And it worked — mostly.

The final budget, now signed by the Governor, delays many of the worst cuts until July 1, 2027. By then, California will have a new governor and, we hope, a healthier budget.

What We Won

Most of the victories protect Medi-Cal, especially for immigrant Californians, along with the community health centers (like ours) that care for them. The new budget:

• Protects payments to community health centers — for now. Planned cuts to payments for care provided to undocumented patients are delayed.
• Delays cuts to dental coverage for those same patients.
• Keeps full Medi-Cal coverage for refugees, asylum seekers, and survivors of trafficking and domestic violence through July 1, 2027. Without this action, federal law would have ended their coverage in October.
• Invests $26 million to support access to gender-affirming care for Medi-Cal beneficiaries.
• Keeps acupuncture as a covered Medi-Cal benefit.
• Provides over $100 million to help lower monthly premiums for people who buy insurance through Covered California — real relief after Congress ended federal premium assistance last year and costs skyrocketed.

What We Couldn’t Stop

Today, most Medi-Cal patients get care through managed care plans — networks that connect them with doctors and specialists. The new budget moves undocumented patients out of those networks starting January 1, 2027. Their primary care will not change, but seeing a specialist — a cardiologist, an oncologist, a surgeon — will become far harder, because very few specialists accept Medi-Cal’s lower direct payment rates. For many patients, that could mean going without the care they need.

The Bigger Storm

These state victories matter, but Washington has made the road ahead much harder. Last year, Congress passed the so-called “One Big Beautiful Bill,” cutting one trillion dollars from Medicaid over the next ten years. It was the largest cut to healthcare programs in American history.

Fifteen million Californians depend on Medi-Cal, including 70% of APLA Health’s patients. Those federal cuts will strain the program, and the people who rely on it, for years to come.