AJR 4: Medi-Cal program: audit.

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 California’s Medi-Cal program, which will grow to $118.1 billion in the 2025–26 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 California’s 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 California’s expansion of full-scope Medi-Cal to individuals without regard to immigration status, also known as undocumented immigrants; and

WHEREAS, The January 2025–26 Governor’s 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 California’s $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 state’s 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 state’s 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.