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The 2024-25 Budget: The MCO Tax Package at May Revision


Handout

[PDF] Managed Care Organization Tax: Background and Issues for Consideration on Administration’s Proposal

May 30, 2023 - Presented to: Assembly Committee on Health Assembly Budget Subcommittee No. 1 on Health and Human Services

Report

The 2022-23 Budget: Analysis of the Medi-Cal Budget

February 9, 2022 - This brief analyzes the Governor’s budget proposal for Medi-Cal. We include an analysis of the administration’s caseload projections, provide options for renewing the managed care organization tax (that the Governor proposes to let expire), and provide our assessment of the discretionary budget proposals to provide equity and practice transformation payments and eliminate certain existing provider payment reductions.

Report

[PDF] The 2019-20 Budget: Analysis of the Medi-Cal Budget

February 13, 2019 - In this report, we describe the major changes and proposals in the Governor's proposed $100.7 billion (all funds) Medi-Cal budget. Specifically, we advise the Legislature to seriously consider renewing the managed care organization tax, despite the Governor not proposing to do so; present issues for consideration related to the Governor's proposed expansion of comprehensive Medi-Cal coverage for young adults regardless of immigration status; and provide an initial assessment of the Governor's proposals to use Proposition 56 funding in Medi-Cal to extend and expand provider payment increases. We recommend approval of the Governor's proposals to improve fiscal oversight of the Medi-Cal budget, and also recommend that the Legislature require the administration provide additional information to the Legislature in an effort to improve fiscal oversight and transparency of this very large, complex budget going forward.

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The 2025-26 Budget: MCO Tax and Proposition 35

February 26, 2025 - This post provides an overview of the Proposition 35 spending plan under the 2025-26 Governor’s budget and raises key oversight issues for the Legislature.

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The 2019-20 May Revision: Governor's May Revision Medi-Cal Budget

May 14, 2019 - The Governor’s May Revision includes Medi-Cal spending of $19.7 billion from the General Fund ($93.4 billion total funds) in 2018-19 and $23 billion from the General Fund ($102.2 billion total funds) in 2019-20. As will be described in this post, about half of the reduction in estimated spending in 2018-19 reflects a shift of costs in Medi-Cal to a different budget item, rather than a true reduction in estimated program costs. After accounting for this shift, the May Revision is about $350 million below January estimates across 2018-19 and 2019-20.

Brief

The 2024-25 Budget: Medi-Cal Analysis

February 14, 2024 - This brief provides an overview of the Governor’s proposed budget for Medi-Cal; describes key trends in Medi-Cal caseload; and analyzes proposals around the managed care organization tax, provider payment increases, and other budget solutions.

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The 2023-24 California Spending Plan: Health

October 23, 2023 - This post summarizes overall spending in the 2023-24 budget package for health programs. It is part of our California Spending Plan series, which contains posts focused on each major sector of the state budget.

Brief

[PDF] The 2023-24 Budget: Analysis of the Medi-Cal Budget

February 10, 2023 - This brief provides an overview of the Governor’s proposed budget for Medi-Cal, assesses the administration’s assumptions on caseload and COVID-19-related policies, and analyzes the Governor’s managed care organization tax proposal.

Handout

[PDF] The 2025-26 Budget: Medi-Cal in the May Revision

May 19, 2025 - The 2025-26 Budget: Medi-Cal in the May Revision handout.

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The 2024-25 Budget: Medi-Cal Fiscal Outlook

December 7, 2023 - This post provides our annual fiscal outlook for General Fund spending in Medi-Cal. It summarizes our projections, describes the major factors driving our projections, and highlights key uncertainties.

Handout

[PDF] The MCO Tax Item 4260-101-0001

June 3, 2019 - Presented to: Budget Conference Committee

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Federal Approval of a Reauthorized Managed Care Organization Tax Now Appears More Likely

December 21, 2018 - This post describes recent national developments pertinent to the reauthorization of California’s managed care organization (MCO) tax. The state’s prospects for receiving federal approval—which initially were uncertain—appear to be improved following the recent federal approval of a health insurer tax in Michigan that is structured similarly to California’s MCO tax.

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The 2025-26 Budget: Medi-Cal Fiscal Outlook

November 20, 2024 - This post provides our annual fiscal outlook for General Fund spending in Medi-Cal. It summarizes our projections, describes the major factors driving our projections, and highlights key uncertainties.

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The 2018-19 Budget: Governor's May Revision Medi-Cal Budget

May 14, 2018 - In this post, we describe and provide our initial comments on adjustments to the Medi-Cal budget in the 2018-19 May Revision.

Report

[PDF] The 2023-24 Budget: Overview of the Spending Plan (Final Version)

October 16, 2023 - This publication provides a preliminary overview of the 2023-24 Budget Act, gives a brief description of how the budget process unfolded, and then highlights major features of the budget.