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	<ns0:Description>
		<ns0:Id>20250SB__052897AMD</ns0:Id>
		<ns0:VersionNum>97</ns0:VersionNum>
		<ns0:History>
			<ns0:Action>
				<ns0:ActionText>INTRODUCED</ns0:ActionText>
				<ns0:ActionDate>2025-02-20</ns0:ActionDate>
			</ns0:Action>
			<ns0:Action>
				<ns0:ActionText>AMENDED_SENATE</ns0:ActionText>
				<ns0:ActionDate>2025-03-25</ns0:ActionDate>
			</ns0:Action>
			<ns0:Action>
				<ns0:ActionText>AMENDED_SENATE</ns0:ActionText>
				<ns0:ActionDate>2025-05-05</ns0:ActionDate>
			</ns0:Action>
		</ns0:History>
		<ns0:LegislativeInfo>
			<ns0:SessionYear>2025</ns0:SessionYear>
			<ns0:SessionNum>0</ns0:SessionNum>
			<ns0:MeasureType>SB</ns0:MeasureType>
			<ns0:MeasureNum>528</ns0:MeasureNum>
			<ns0:MeasureState>AMD</ns0:MeasureState>
		</ns0:LegislativeInfo>
		<ns0:AuthorText authorType="LEAD_AUTHOR">Introduced by Senator Weber Pierson</ns0:AuthorText>
		<ns0:Authors>
			<ns0:Legislator>
				<ns0:Contribution>LEAD_AUTHOR</ns0:Contribution>
				<ns0:House>SENATE</ns0:House>
				<ns0:Name>Weber Pierson</ns0:Name>
			</ns0:Legislator>
		</ns0:Authors>
		<ns0:Title> An act to add Division 123 (commencing with Section 152500) to the Health and Safety Code, and to add Sections 14042.5 and 24028 to the Welfare and Institutions Code, relating to health care.</ns0:Title>
		<ns0:RelatingClause>health care</ns0:RelatingClause>
		<ns0:GeneralSubject>
			<ns0:Subject>Health care: maintenance and expansion.</ns0:Subject>
		</ns0:GeneralSubject>
		<ns0:DigestText>
			<html:p>
				(1)
				<html:span class="EnSpace"/>
				Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions.
			</html:p>
			<html:p>Existing law establishes, under the Medi-Cal program, the Family Planning, Access, Care, and Treatment (Family PACT) Program. If Family PACT becomes inoperative, existing law requires all persons who have received, or are eligible to receive, comprehensive clinical family planning services pursuant to Family PACT to receive family planning services under other specified provisions of the Medi-Cal program or under the State-Only Family Planning Program, which is also established within the department for purposes of family planning
			 services.</html:p>
			<html:p>This bill would require the department, subject to an appropriation, to develop a new program or to expand any existing state-only-funded health programs, in order to provide to Medi-Cal beneficiaries certain services or benefits that are otherwise covered under the Medi-Cal program but for any lack of, elimination of, reduction in, or limitation on, federal financial participation.</html:p>
			<html:p>For purposes of the expansion above, the bill would require the department to determine the services or benefits, which may include, but are not limited to, abortion and
			 gender-affirming care, based on the levels of federal financial participation, as specified.</html:p>
			<html:p>
				(2)
				<html:span class="EnSpace"/>
				This bill would, subject to an appropriation, require the California Health and Human Services Agency to develop a new program, or to expand an existing state program, as applicable, to provide certain services or benefits that are otherwise covered under the Medi-Cal program but for any lack of, elimination of, reduction in, or limitation on, federal financial participation. Under the bill, these services or benefits would not be limited to the population of Medi-Cal beneficiaries.
			</html:p>
			<html:p>The bill would require the agency to determine the services or benefits, which may include, but are not limited to, abortion, family planning, and gender-affirming care, based on the needs of target populations and the levels of federal financial participation, as specified.</html:p>
			<html:p>The bill
			 would create the Health Care Maintenance and Expansion Fund for purposes of distributing funding, if appropriated, for these services or benefits. The bill would authorize the agency to receive private donations, for deposit into the fund, to support implementation.</html:p>
			<html:p>
				(3)
				<html:span class="EnSpace"/>
				The bill would authorize modification and expansion of the State-Only Family Planning Program, subject to an appropriation, to facilitate implementation of the provisions described in paragraphs (1) and (2), as specified.
			</html:p>
		</ns0:DigestText>
		<ns0:DigestKey>
			<ns0:VoteRequired>MAJORITY</ns0:VoteRequired>
			<ns0:Appropriation>NO</ns0:Appropriation>
			<ns0:FiscalCommittee>YES</ns0:FiscalCommittee>
			<ns0:LocalProgram>NO</ns0:LocalProgram>
		</ns0:DigestKey>
		<ns0:MeasureIndicators>
			<ns0:ImmediateEffect>NO</ns0:ImmediateEffect>
			<ns0:ImmediateEffectFlags>
				<ns0:Urgency>NO</ns0:Urgency>
				<ns0:TaxLevy>NO</ns0:TaxLevy>
				<ns0:Election>NO</ns0:Election>
				<ns0:UsualCurrentExpenses>NO</ns0:UsualCurrentExpenses>
				<ns0:BudgetBill>NO</ns0:BudgetBill>
				<ns0:Prop25TrailerBill>NO</ns0:Prop25TrailerBill>
			</ns0:ImmediateEffectFlags>
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	</ns0:Description>
	<ns0:Bill id="bill">
		<ns0:Preamble>The people of the State of California do enact as follows:</ns0:Preamble>
		<ns0:BillSection id="id_8BB39AF2-5AD7-45A1-A8B5-2B2F91A4AF1C">
			<ns0:Num>SECTION 1.</ns0:Num>
			<ns0:Content>
				<html:p>
					(a)
					<html:span class="EnSpace"/>
					The Legislature finds and declares all of the following:
				</html:p>
				<html:p>
					(1)
					<html:span class="EnSpace"/>
					In 2022, over 15 million Californians – roughly 40 percent of the state’s population – were enrolled in Medi-Cal, the state’s federal Medicaid program.
				</html:p>
				<html:p>
					(2)
					<html:span class="EnSpace"/>
					The state administers Medi-Cal, subject to federal regulations, and financing for the program is shared between California and the federal government through federal matching dollars.
				</html:p>
				<html:p>
					(3)
					<html:span class="EnSpace"/>
					The federal medical assistance percentage (FMAP) is the percentage of costs paid by the federal
				government to state Medicaid programs, which varies by service type or the beneficiary receiving the service. California’s FMAP is 50 percent for most services and beneficiaries, and certain services are eligible for an FMAP of up to 90 percent.
				</html:p>
				<html:p>
					(4)
					<html:span class="EnSpace"/>
					The Medi-Cal program was projected to cost $161 billion in the 2024–25 fiscal year, with $98.5 billion of that amount coming from federal matching funds.
				</html:p>
				<html:p>
					(5)
					<html:span class="EnSpace"/>
					In addition to covering all health care services required by federal law, along with many federal optional benefits that are eligible for federal matching funds, the Medi-Cal program provides coverage using state-only funds for certain health care services that are ineligible for federal matching funds and for certain populations whose care is ineligible for federal matching
				funds.
				</html:p>
				<html:p>
					(6)
					<html:span class="EnSpace"/>
					Certain executive orders issued by United States President Trump in January 2025 direct federal agencies, including the United States Department of Health and Human Services, to ensure that federal funds are not spent on specified abortion care and gender-affirming services.
				</html:p>
				<html:p>
					(7)
					<html:span class="EnSpace"/>
					The United States Congress is considering several proposals that might further drastically reduce federal financial participation in the Medi-Cal program, including through limiting eligible services and reducing FMAP rates.
				</html:p>
				<html:p>
					(b)
					<html:span class="EnSpace"/>
					It is the intent of the Legislature to maximize federal financial participation in the Medi-Cal program in order to ensure that Californians have ongoing access to all covered services, or for the state
				to otherwise maintain those Medi-Cal services or other health care services through state-only programs based on any lack of, elimination of, reduction in, or limitation on, federal financial participation.
				</html:p>
			</ns0:Content>
		</ns0:BillSection>
		<ns0:BillSection id="id_DE47FA9A-AE45-4075-B037-FC4C6FC7F763">
			<ns0:Num>SEC. 2.</ns0:Num>
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				Division 123 (commencing with Section 152500) is added to the 
				<ns0:DocName>Health and Safety Code</ns0:DocName>
				, to read:
			</ns0:ActionLine>
			<ns0:Fragment>
				<ns0:LawHeading id="id_35A9DB06-C99A-499A-A5FA-7771CED1A25F" type="DIVISION">
					<ns0:Num>123.</ns0:Num>
					<ns0:LawHeadingVersion id="id_64BE5FB9-0F93-4E80-8CBF-7F9A4BEABC59">
						<ns0:LawHeadingText>Health Care Maintenance and Expansion</ns0:LawHeadingText>
					</ns0:LawHeadingVersion>
					<ns0:LawSection id="id_9248DBF0-1338-4FF8-B934-2B626EDB1AF2">
						<ns0:Num>152500.</ns0:Num>
						<ns0:LawSectionVersion id="id_E1FFAFD5-970D-4C94-B87F-2923B912DB12">
							<ns0:Content>
								<html:p>
									(a)
									<html:span class="EnSpace"/>
									In accordance with this section, the California Health and Human Services Agency shall develop a new program, or shall expand an existing state program, as applicable, to provide certain services or benefits that are otherwise covered under the Medi-Cal program but for any lack of, elimination of, reduction in, or limitation on, federal financial participation. The services or benefits provided under this division shall not be limited to the population of Medi-Cal beneficiaries.
								</html:p>
								<html:p>
									(b)
									<html:span class="EnSpace"/>
									(1)
									<html:span class="EnSpace"/>
									The agency shall determine the services or benefits described in subdivision (a) based on the needs of target populations, on the levels of eliminated or
						  reduced federal financial participation under the Medi-Cal program or lack thereof, and on the extent of limitations on that federal financial participation.
								</html:p>
								<html:p>
									(2)
									<html:span class="EnSpace"/>
									The services or benefits may include, but are not limited to, abortion, family planning, and gender-affirming care, based on the factors described in paragraph (1).
								</html:p>
								<html:p>
									(3)
									<html:span class="EnSpace"/>
									The target populations may include, but are not limited to, individuals eligible for the Medi-Cal program pursuant to Section 14007.8 of the Welfare and Institutions Code, and other individuals whether or not Medi-Cal beneficiaries, based on the factors described in paragraph (1).
								</html:p>
								<html:p>
									(c)
									<html:span class="EnSpace"/>
									The agency may enter into contracts with service providers, third-party administrators, or other vendors, as
						  necessary to implement this division.
								</html:p>
							</ns0:Content>
						</ns0:LawSectionVersion>
					</ns0:LawSection>
					<ns0:LawSection id="id_E7A8DED4-AAAF-45D0-B48B-508D25FE52A9">
						<ns0:Num>152501.</ns0:Num>
						<ns0:LawSectionVersion id="id_3E0CECCE-4D2A-484E-88C9-4DD4B5DCC45A">
							<ns0:Content>
								<html:p>
									(a)
									<html:span class="EnSpace"/>
									This division shall be implemented subject to an appropriation made by the Legislature for the purpose of this division.
								</html:p>
								<html:p>
									(b)
									<html:span class="EnSpace"/>
									The Health Care Maintenance and Expansion Fund shall be created, to be administered by the California Health and Human Services Agency, to distribute funding, if appropriated pursuant to subdivision (a), for purposes of the services or benefits described in Section 152500.
								</html:p>
								<html:p>
									(c)
									<html:span class="EnSpace"/>
									The agency may receive private donations, for deposit into the fund described in subdivision (b), to support implementation of this division.
								</html:p>
							</ns0:Content>
						</ns0:LawSectionVersion>
					</ns0:LawSection>
				</ns0:LawHeading>
			</ns0:Fragment>
		</ns0:BillSection>
		<ns0:BillSection id="id_AFBCFBAA-D7A0-4A3F-8241-605503A62659">
			<ns0:Num>SEC. 3.</ns0:Num>
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				Section 14042.5 is added to the 
				<ns0:DocName>Welfare and Institutions Code</ns0:DocName>
				, to read:
			</ns0:ActionLine>
			<ns0:Fragment>
				<ns0:LawSection id="id_04B791EB-2AF1-4A42-98CC-5874DAED2046">
					<ns0:Num>14042.5.</ns0:Num>
					<ns0:LawSectionVersion id="id_8FF4737A-F460-4C3A-9855-ECC54D3E4C8B">
						<ns0:Content>
							<html:p>
								(a)
								<html:span class="EnSpace"/>
								Subject to an appropriation made by the Legislature for this purpose, the department shall develop a new program, or shall expand any existing state-only-funded health programs, to provide to Medi-Cal beneficiaries certain services or benefits that are otherwise covered under the Medi-Cal program but for any lack of, elimination of, reduction in, or limitation on, federal financial participation.
							</html:p>
							<html:p>
								(b)
								<html:span class="EnSpace"/>
								The department shall determine the services or benefits described in subdivision (a), which may include, but are not limited to, abortion and gender-affirming care, based on the levels of eliminated or reduced federal financial participation under the Medi-Cal program or lack thereof, and on the extent of limitations on that federal financial participation.
							</html:p>
						</ns0:Content>
					</ns0:LawSectionVersion>
				</ns0:LawSection>
			</ns0:Fragment>
		</ns0:BillSection>
		<ns0:BillSection id="id_9259C9E6-2D8D-440E-889B-ED4B9443559C">
			<ns0:Num>SEC. 4.</ns0:Num>
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				Section 24028 is added to the 
				<ns0:DocName>Welfare and Institutions Code</ns0:DocName>
				, to read:
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			<ns0:Fragment>
				<ns0:LawSection id="id_70BF1C5C-6017-4BC1-ADCE-275C5D15EFAB">
					<ns0:Num>24028.</ns0:Num>
					<ns0:LawSectionVersion id="id_5551C1BB-2635-4F11-8785-B5AFA1217B91">
						<ns0:Content>
							<html:p>Subject to an appropriation made by the Legislature for this purpose, the State-Only Family Planning Program may be modified and expanded to facilitate implementation of Section 14042.5 of this code or Division 123 (commencing with Section 152500) of the Health and Safety Code, depending on the determinations made by the State Department of Health Care Services or the California Health and Human Services Agency under those respective provisions.</html:p>
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