CALIFORNIA LEGISLATURE 20252026 REGULAR SESSION Assembly Joint Resolution No. 4Introduced by Assembly Member Gallagher(Coauthors: Assembly Members Castillo, DeMaio, Dixon, Essayli, Flora, Lackey, Macedo, Patterson, Ta, and Tangipa)March 20, 2025 Relative to the Medi-Cal program. LEGISLATIVE COUNSEL'S DIGESTAJR 4, as introduced, Gallagher. Medi-Cal program: audit.This measure would declare that the fiscal health of the states Medi-Cal program is in jeopardy and threatens the health and safety of California residents and would call upon the federal Centers for Medicare and Medicaid Services to initiate an audit of the states Medi-Cal program to help restore the fiscal health of the program and support the health of California residents.Digest Key Fiscal Committee: NO Bill TextWHEREAS, Over the past six years, General Fund spending on Medi-Cal has nearly doubled to $42.1 billion, and total spending on Medi-Cal has grown by 84.2 percent to $188.1 billion; andWHEREAS, The federal government makes a significant investment in Californias Medi-Cal program, which will grow to $118.1 billion in the 202526 budget year; andWHEREAS, Continued growth in the cost of Medi-Cal benefits for undocumented immigrants is unsustainable and siphons resources away from critical programs that support Californias most vulnerable populations, such as foster youth, childcare, the elderly, veterans, college students, and those with developmental disabilities; andWHEREAS, Nearly one-half of the growth in General Fund Medi-Cal spending results from Californias expansion of full-scope Medi-Cal to individuals without regard to immigration status, also known as undocumented immigrants; andWHEREAS, The January 202526 Governors Budget reflected an unanticipated $2.8 billion increase in the cost of providing full-scope Medi-Cal to undocumented immigrants, bringing total costs to $9.5 billion in the current year; andWHEREAS, On March 12, 2025, the State Department of Finance approved a $3.44 billion loan from the General Fund to the Medical Providers Interim Payment Fund to allow the Department of Health Care Services to continue making payments for the Medi-Cal program; andWHEREAS, Federal funds used to support Californias $188.1 billion Medi-Cal program are comingled with resources from the General Fund and more than 30 special funds, requiring complex accounting systems for payment tracking and making it difficult to ensure that federal funds are not used to provide unauthorized federal services to undocumented immigrants; now, therefore, be itResolved by the Assembly and the Senate of the State of California, jointly, That the Legislature of the State of California declares that the fiscal health of the states Medi-Cal program is in jeopardy and threatens the health and safety of California residents; and be it furtherResolved, That the Legislature of the State of California calls upon the federal Centers for Medicare and Medicaid Services to initiate an audit of the states Medi-Cal program to help restore the fiscal health of the program and support the health of California residents; and be it furtherResolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the President and Vice President of the United States, to the Speaker of the House of Representatives, to the Majority Leader of the Senate, to each Senator and Representative from California in the Congress of the United States, to the Governor, to the Attorney General, and to the author for appropriate distribution.
CALIFORNIA LEGISLATURE 20252026 REGULAR SESSION Assembly Joint Resolution No. 4Introduced by Assembly Member Gallagher(Coauthors: Assembly Members Castillo, DeMaio, Dixon, Essayli, Flora, Lackey, Macedo, Patterson, Ta, and Tangipa)March 20, 2025 Relative to the Medi-Cal program. LEGISLATIVE COUNSEL'S DIGESTAJR 4, as introduced, Gallagher. Medi-Cal program: audit.This measure would declare that the fiscal health of the states Medi-Cal program is in jeopardy and threatens the health and safety of California residents and would call upon the federal Centers for Medicare and Medicaid Services to initiate an audit of the states Medi-Cal program to help restore the fiscal health of the program and support the health of California residents.Digest Key Fiscal Committee: NO
CALIFORNIA LEGISLATURE 20252026 REGULAR SESSION
Assembly Joint Resolution
No. 4
Introduced by Assembly Member Gallagher(Coauthors: Assembly Members Castillo, DeMaio, Dixon, Essayli, Flora, Lackey, Macedo, Patterson, Ta, and Tangipa)March 20, 2025
Introduced by Assembly Member Gallagher(Coauthors: Assembly Members Castillo, DeMaio, Dixon, Essayli, Flora, Lackey, Macedo, Patterson, Ta, and Tangipa)
March 20, 2025
Relative to the Medi-Cal program.
LEGISLATIVE COUNSEL'S DIGEST
## LEGISLATIVE COUNSEL'S DIGEST
AJR 4, as introduced, Gallagher. Medi-Cal program: audit.
This measure would declare that the fiscal health of the states Medi-Cal program is in jeopardy and threatens the health and safety of California residents and would call upon the federal Centers for Medicare and Medicaid Services to initiate an audit of the states Medi-Cal program to help restore the fiscal health of the program and support the health of California residents.
This measure would declare that the fiscal health of the states Medi-Cal program is in jeopardy and threatens the health and safety of California residents and would call upon the federal Centers for Medicare and Medicaid Services to initiate an audit of the states Medi-Cal program to help restore the fiscal health of the program and support the health of California residents.
## Digest Key
## Bill Text
WHEREAS, Over the past six years, General Fund spending on Medi-Cal has nearly doubled to $42.1 billion, and total spending on Medi-Cal has grown by 84.2 percent to $188.1 billion; and
WHEREAS, The federal government makes a significant investment in Californias Medi-Cal program, which will grow to $118.1 billion in the 202526 budget year; and
WHEREAS, Continued growth in the cost of Medi-Cal benefits for undocumented immigrants is unsustainable and siphons resources away from critical programs that support Californias most vulnerable populations, such as foster youth, childcare, the elderly, veterans, college students, and those with developmental disabilities; and
WHEREAS, Nearly one-half of the growth in General Fund Medi-Cal spending results from Californias expansion of full-scope Medi-Cal to individuals without regard to immigration status, also known as undocumented immigrants; and
WHEREAS, The January 202526 Governors Budget reflected an unanticipated $2.8 billion increase in the cost of providing full-scope Medi-Cal to undocumented immigrants, bringing total costs to $9.5 billion in the current year; and
WHEREAS, On March 12, 2025, the State Department of Finance approved a $3.44 billion loan from the General Fund to the Medical Providers Interim Payment Fund to allow the Department of Health Care Services to continue making payments for the Medi-Cal program; and
WHEREAS, Federal funds used to support Californias $188.1 billion Medi-Cal program are comingled with resources from the General Fund and more than 30 special funds, requiring complex accounting systems for payment tracking and making it difficult to ensure that federal funds are not used to provide unauthorized federal services to undocumented immigrants; now, therefore, be it
Resolved by the Assembly and the Senate of the State of California, jointly, That the Legislature of the State of California declares that the fiscal health of the states Medi-Cal program is in jeopardy and threatens the health and safety of California residents; and be it further
Resolved, That the Legislature of the State of California calls upon the federal Centers for Medicare and Medicaid Services to initiate an audit of the states Medi-Cal program to help restore the fiscal health of the program and support the health of California residents; and be it further
Resolved, That the Chief Clerk of the Assembly transmit copies of this resolution to the President and Vice President of the United States, to the Speaker of the House of Representatives, to the Majority Leader of the Senate, to each Senator and Representative from California in the Congress of the United States, to the Governor, to the Attorney General, and to the author for appropriate distribution.