Assembly Democrats’ Budget Protects Health Care Affordability. Here’s How.

Trump is increasing health costs with his punishing cuts to care - $30 billion to Medi-Cal alone. California Assembly Democrats passed a 2026-27 state budget that defends and invests in health care access and coverage, a win for affordability.

SACRAMENTO - Assembly Democrats delivered a state budget this week that protects and defends access to health care - a win for affordability and the cost of living in California.

Health care advocates and community, hospital and nonprofit leaders are praising Assembly Democrats for taking a stand against Trump's relentless attacks on our health care system, which if left unchecked would continue to increase costs by taking more than $30 billion away from California patients, families, seniors and children.

The California budget also makes key health investments to improve affordability:

• supports distressed hospitals by authorizing $190 million in loans
• lower Covered California premiums with $300 million for subsidies
• protects reproductive health care and gender-affirming care by investing tens of millions of dollars

The Legislature's budget also rejects Trump's most damaging cuts to health care, including:

• avoiding and delaying reductions to Medi-Cal coverage
• denying cuts to clinics and dental care
• postponing Trump's punishing cuts that target California's immigrant communities

Because when Californians can afford to see a doctor, that is a win for the cost of living.

Health advocates have called the Assembly Democrats' budget one that, "prioritizes Californians," "makes bold investments in protecting health care," "protects health care access and preserve the services residents rely on every day" and "puts patients first."

This budget comes as health care is under attack. Because of Trump's H.R. 1, costs are surging fast and an estimated 2 million Californians are poised to completely lose Medi-Cal health care coverage - more than one out of every 10 Medi-Cal recipients.

Trump's draconian new work reporting requirements would affect health care eligibility and jeopardize coverage for approximately 3.5 million Californians, as well. And another 4.9 million Californians are at risk due to new, twice-yearly eligibility redeterminations.

An estimated 200,000 immigrants - including refugees, asylees and trafficking survivors - will lose federal funding assistance for health care as well.

Trump's cuts are increasing health care costs, but instead of passing increases on to patients, the Legislature's budget protects access to care, keeps as many Californians covered as possible, and lowers health insurance premiums.

Assembly Budget Leaders Lead the Fight

"Trump's assault on California's patients comes with a $30 billion price tag - and real people pay the cost. That's why our budget fights for health care access. When Californians can see a doctor or get a prescription filled - that's what affordability actually looks like."

- Speaker of the Assembly Robert Rivas

"At a time when the Trump Administration and Congressional Republicans are intentionally defunding health care through H.R. 1, California Democrats are proud to have passed a budget rooted in compassion and opportunity for all. Our legislative budget pushes back on these harmful cuts and funds programs and services that support working families and our most vulnerable communities. Unlike our federal counterparts, California will always support our residents and stand up for our values."

- Assemblymember Jesse Gabriel, chair of the Assembly Committee on Budget

"As Chair of the Assembly Budget Subcommittee 1 on Health I am proud of our Legislative budget. Californians depend on the health care system we have built and expanded over decades. Our budget directly responds to billions in cuts from Trump's H.R. 1 and repeated Republican attacks on health care with a responsible, stable plan that funds physician access, mental health supports, hospital solvency, dental care, pregnancy and maternal health; and protects access to care for women, seniors, children, LGBT people, immigrants, and more. As we weather the largest federal rollback of health care in American history, our legislators are solidly on the side of California's people."

- Assemblymember Dawn Addis, Chair of the Assembly Budget Subcommittee on Health

"Trump's HR 1 is a deliberate attack on the health and dignity of working people to fund tax cuts for his billionaire buddies, but California is fighting back. This budget protects Medi-Cal coverage for millions, defends immigrant communities from Washington's cruelty, and refuses to balance our budget on the backs of children, seniors, people with disabilities, or working Californians. While the federal government abandons its responsibility to the American people, we are stepping up for our own - creating a safety net for the people, not the corporations."

- Assemblymember Mia Bonta, Chair of the Assembly Committee on Health

California Health Advocates Support Defending Health Care Access

"As the safety net is stress tested and preventable hunger rises nationally, the Legislature's upstream investment in the county eligibility workforce is a bold refusal to accept H.R. 1's cruel cuts to food and health care as a foregone conclusion, the consequences of which are already unfolding in other states. The Senate and Assembly's two-party budget agreement supports county eligibility workers in cutting through the federal red tape that stands between millions of Californians being able to see a doctor and keep food on the table. We commend Speaker Robert Rivas, Senate President pro Tempore Monique Limón, budget chairs and subcommittee chairs, and our champion legislators Assemblymembers Schiavo and Sharp-Collins, and Senator Arreguín for prioritizing county eligibility workers as the backbone of our state's safety net even as the federal government walks away from its commitments to our working poor."

- County Welfare Directors Association of California

"This proposal reflects a clear understanding of the challenges H.R. 1 poses to California's local communities. With these initial investments in public hospitals, eligibility services and an alternative to indigent care, legislative leaders are taking meaningful action to protect healthcare access and preserve the services residents rely on every day. We urge the Governor and Legislature to carry these investments through to the final budget agreement. California communities are counting on them."

- California State Association of Counties

"As Californians continue to face federal attacks to our care, our State Legislature is stepping up. The budget announced by State Senate and Assembly leaders puts patients first - taking key steps to ensuring that ultra-wealthy corporations pay their fair share to keep Medi-Cal strong."

- Rachel Linn Gish, interim deputy director at Health Access California

"We appreciate the Legislature's commitment to pursuing revenues from the largest corporations to maintain essential health care that benefits all Californians."

- Kiran Savage-Sangwan, executive director of California Pan-Ethnic Health Network

How Assembly Budget Defends Health Care Affordability

• Supports distressed hospitals: Authorizes up to $190 million in distressed hospital loans.
• Lowers Covered California premiums: Provides an additional $110 million to lower premiums for low-income Covered California enrollees, for a total of $300 million.
• Bolsters Public Hospitals and Indigent Care: Provides $250 million to support California's public hospital system and $125 million to counties to establish an emergency services-only indigent care program, both of which can help stabilize health care services for people at risk due to Trump's health care cuts.
• Protects reproductive health care and gender-affirming care: Adds $40 million for reproductive health care and $26 million for gender-affirming care.
• Rejects immediate Medi-Cal asset limit cuts: There is no change to the asset test in 2026-27, and the asset limit would be lowered to $21,000 in 2027-28, instead of moving to the Governor's proposed $2,000 limit now.
• Delays immediate Medi-Cal dental cuts: Delays dental supplemental payment cuts and UIS dental cuts by 12 months.
• Prevents an automatic UIS premium increase next year: Gives the next Governor the authority to decide whether UIS premiums should increase next year, rather than locking in the increase now.
• Delays restricted-scope Medi-Cal changes for asylees and other qualified immigrants: Adopts the Governor's May Revision proposal to shift asylees and other impacted qualified immigrants to restricted-scope Medi-Cal, but not until 2027-28.
• Funds Medi-Cal eligibility workload: The agreement provides additional funding for county eligibility workload tied to H.R. 1.
• UIS fee-for-service options: Working with the Governor's administration to investigate alternatives.
• Delays most clinic cuts: Delays most clinic cuts by 12 months, giving providers and patients additional time.