Health.

The bill was expanded from a single-section placeholder into a comprehensive health budget bill covering at least 24 distinct policy areas across the Business and Professions Code, Government Code, Health and Safety Code, Insurance Code, Penal Code, Revenue and Taxation Code, and Welfare and Institutions Code.

Renamed the California Reproductive Health Equity Program to the California Reproductive and TGI Health Equity Program, expanding its purposes to include gender-affirming care. Authorized use of the Abortion Access Fund for grant funding to safety net providers and expanded the California Reproductive Health Equity Fund to include gender-affirming care services.

Conformed state Medi-Cal provisions to federal H.R. 1 (Public Law 119-21), including semi-annual eligibility redeterminations for Medicaid expansion adults (ages 19-64 at up to 138% FPL), work or community engagement requirements (minimum 80 hours of work/community service or half-time educational enrollment per month), and reduced retroactive coverage from 3 months to 1 month for expansion adults.

Established new requirements for general acute care hospitals seeking to operate skilled nursing distinct parts, including case-by-case approval, ownership and governance conditions, and a new 'composite distinct part' category for noncontiguous components on different campuses. Limited hospitals to one licensed skilled nursing distinct part.

Imposed a moratorium on issuing new home health agency licenses or adding branch offices, with exceptions only upon demonstration of unmet need. Prohibited ownership transfers within 5 years of initial licensure. Required existing agencies to submit management personnel information by March 31, 2027.

Required counties to meet minimum expenditure levels for Behavioral Health Services Act (MHSA) funds starting in FY 2028-29, set at the average annual distributed amount over the preceding 3 years. Authorized the department to impose corrective action plans, monetary sanctions, or payment withholdings for non-compliance.

Required health care service plan contracts and health insurance policies to cover medically necessary treatments for menopausal symptoms, with utilization review criteria based on current standards of menopause care beginning January 1, 2027. Added menopause care to the Medi-Cal benefit schedule.

Extended the CalAIM initiative end date from December 31, 2026 to December 31, 2031, subject to federal approvals, making an appropriation for continued implementation.

Phased out detoxification-only substance use treatment licenses: required them to expire by July 1, 2027, prohibited new or extended licenses for detox-only services after that date, and recast the concept as 'withdrawal management' integrated into other levels of care under ASAM Criteria.

Delayed the requirement that FQHC and RHC services be eligible for federal financial participation to receive Medi-Cal reimbursement from July 1, 2026 to July 1, 2027.

Extended the Forensic Conditional Release Program independent evaluation panel provisions indefinitely (previously set to end June 30, 2026) and renamed it the 'independent placement panel.'

Delayed compliance with the California Health and Human Services Data Exchange Framework until July 1, 2027 for community clinics, intermittent clinics, and rural health clinics (previously July 1, 2026).

Required certain individuals without satisfactory immigration status to pay a monthly Medi-Cal premium of $30 to $50 (set by the Governor's 2027-28 May Revision), no sooner than May 14, 2027. Delayed dental ineligibility for these individuals from July 1, 2026 to no sooner than July 1, 2027.

Changed the Medi-Cal resource limit for non-MAGI cases from a $130,000 disregard (plus $65,000 per additional household member) to a $21,000 limit for one member, $31,000 for two members, and $1,550 per additional member up to 10, effective July 1, 2027.

Changed individuals without satisfactory immigration status who are eligible for full-scope Medi-Cal from being required to enroll in a managed care plan to being eligible for services in the fee-for-service delivery system.

Authorized the State Department of Public Health to spend up to $134,840,000 in FY 2026-27, $134,490,000 in FY 2027-28, $126,590,000 in FY 2028-29, and $130,090,000 in FY 2029-30 from the ADAP Rebate Fund for disease intervention, housing support, HIV treatment, and overdose prevention programs, plus up to $50,000,000 for related purposes.

Provided that qualifying physicians, osteopathic physicians, and nurse practitioners who complete CME courses in perimenopause, menopause, and postmenopausal care receive double credit (2 hours per hour completed) starting July 1, 2027, capped at 8 hours for physicians and 6 hours for nurse practitioners.

Required the Health Care Affordability Reserve Fund to be used, upon appropriation, for payments covering the cost of abortion services in Covered California individual market plans where federal funding is prohibited (previously at least $1 per enrollee per month).

Established the Hospital Fair Pricing Penalties Fund to collect administrative penalties for hospital violations of fair pricing requirements (discount payment notices, charity care policies, patient debt sale restrictions).