AB 2081 — Medi-Cal: Home and Community-Based Alternatives Waiver.

Summary

Existing law establishes the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income individuals receive health care services. The Medi-Cal program is in part governed by, and funded pursuant to, federal Medicaid program provisions. Under existing law, home- and community-based services (HCBS) approved by the United States Department of Health and Human Services are covered for eligible individuals to the extent that federal financial participation is available for those services under the state plan or waivers granted in accordance with certain federal provisions. Existing law authorizes the Director of Health Care Services to seek waivers for any or all approvable HCBS. Existing law sets forth provisions for the implementation of the Nursing Facility/Acute Hospital Transition and Diversion Waiver, which is the predecessor of the Home and Community-Based Alternatives (HCBA) Waiver, for purposes of providing care management services to individuals who are at risk of nursing facility or institutional placement, subject to federal cost neutrality. Existing law authorizes the director to propose that the waiver provide for achievement of annual cost neutrality in the aggregate to allow enrollment and authorization of waiver services based on medical necessity, and to require care management contractors to enroll at least 60% of all total annual enrollments from certain health care settings or populations. Existing law additionally sets forth provisions authorizing the director to expand the number of waiver slots up to 5,000 additional slots. This bill would recast the above-described waiver provisions to refer to the HCBA Waiver. The bill would authorize the director, beginning January 1, 2027, to semiannually evaluate the populations receiving the priority enrollment described above, and to designate additional populations to receive priority enrollment based on this evaluation, subject to applicable cost-neutrality requirements. The bill would delete the provision relating to the 5,000 slots. The bill would instead require the department, beginning in 2027, and for the HCBA Waiver period, to increase the total number of waiver slots by 5,000, in addition to any planned expansion of waiver slots federally approved as of January 1, 2026, as specified, consistent with the above-described requirements.

Bill Text

• Enrolled 09/02/26 - Enrolled html September 02, 2026
• Amended 08/13/26 - Amended Senate html August 13, 2026
• Amended 03/26/26 - Amended Assembly Current pdf March 26, 2026
• Introduced 02/18/26 - Introduced pdf February 18, 2026
• AB2081 View text html

AI-generated reading aid from the bill's amendatory text — verify against the official bill.

This bill amends 1 section(s) of the California codes: Section 14132.991 of the Welfare and Institutions Code.

• Section 14132.991 of the Welfare and Institutions Code

  10,000, Nothing in this subdivision is intended to alter or supersede existing federal requirements applicable to the HCBA Waiver, including requirements related to enrollment priorities for individuals transitioning from institutional settings or similar programs and for individuals under 21 years of age. The addition of new waiver slots pursuant to this subdivision shall be implemented in a manner consistent with those requirements. (c)(1)By March 1, 2027, the department shall seek any necessary amendments to the HCBA Waiver to ensure that there is sufficient capacity to enroll all individuals who are eligible for, and express an interest in, participating in the HCBA Waiver who are currently on a waiting list.(2)The department shall continue to monitor the capacity of the HCBA Waiver and shall expand capacity through any necessary HCBA Waiver amendments at least 180 calendar days prior to reaching capacity, based on enrollment trends, to ensure that no individual is placed on a waiting list for the HCBA Waiver. (d) (e) → (6) Beginning January 1, 2027, semiannually evaluate the populations described in paragraph (3) based on the net impact of enrollment in the HCBA Waiver on health care utilization costs in order to maintain the aggregate cost neutrality described in paragraph (2). Based on this evaluation, the department may designate additional populations under paragraph (3) for whom enrollment in the HCBA Waiver would be cost neutral in order to respond to changes in the needs of the eligible population and available health care services over time. 5,000, This subdivision does not require the department to enroll individuals in all waiver slots described in this subdivision if doing so would be inconsistent with achieving the aggregate annual cost neutrality described in paragraph (2) of subdivision (a) or with the most recent evaluation conducted pursuant to paragraph (6) of subdivision (a). (c) (d)

  amended

Action History

1. September 18, 2026

   Vetoed by Governor.

2. September 08, 2026

   Enrolled and presented to the Governor at 3:30 p.m.

3. August 28, 2026

   Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 77. Noes 0. Page 6805.).

4. August 27, 2026

   In Assembly. Concurrence in Senate amendments pending.

5. August 27, 2026

   Read third time. Passed. Ordered to the Assembly. (Ayes 39. Noes 0.).

6. August 25, 2026

   Ordered to special consent calendar.

7. August 17, 2026

   Read second time. Ordered to third reading.

8. August 13, 2026

   From committee: Amend, and do pass as amended. (Ayes 7. Noes 0.) (August 13).

9. August 13, 2026

   Read second time and amended. Ordered returned to second reading.

10. June 29, 2026

    In committee: Referred to APPR. suspense file.

11. June 18, 2026

    From committee: Do pass and re-refer to Com. on APPR. with recommendation: To Consent Calendar. (Ayes 11. Noes 0.) (June 17). Re-referred to Com. on APPR.

12. June 03, 2026

    Referred to Com. on HEALTH.

13. May 22, 2026

    In Senate. Read first time. To Com. on RLS. for assignment.

14. May 22, 2026

    Read third time. Passed. Ordered to the Senate. (Ayes 73. Noes 0. Page 5263.)

15. May 18, 2026

    Read second time. Ordered to third reading.

16. May 14, 2026

    From committee: Do pass. (Ayes 15. Noes 0.) (May 14).

17. May 14, 2026

    Coauthors revised.

18. April 08, 2026

    In committee: Set, first hearing. Referred to APPR. suspense file.

19. April 06, 2026

    Re-referred to Com. on APPR.

20. March 26, 2026

    Read second time and amended.

21. March 25, 2026

    From committee: Amend, and do pass as amended and re-refer to Com. on APPR. with recommendation: To Consent Calendar. (Ayes 16. Noes 0.) (March 24).

22. March 02, 2026

    Referred to Com. on HEALTH.

23. February 19, 2026

    From printer. May be heard in committee March 21.

24. February 18, 2026

    Read first time. To print.

Sponsors

• Catherine Stefani · Primary

Votes

Subjects