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

Official summary

Legislative Counsel’s Digest (official, as of the latest version). Written by nonpartisan legislative staff; reproduced verbatim.

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.

Sponsors

Sponsors by party (alphabetical): Democratic 7

“Support” is shown only as formal sponsorship recorded by the legislature. Roll-call votes are available on the official bill page.

Recent official actions

1. September 18, 2026Vetoed by Governor.
2. September 8, 2026Enrolled and presented to the Governor at 3:30 p.m.
3. August 28, 2026Senate amendments concurred in. To Engrossing and Enrolling. (Ayes 77. Noes 0. Page 6805.).
4. August 27, 2026In Assembly. Concurrence in Senate amendments pending.
5. August 27, 2026Read third time. Passed. Ordered to the Assembly. (Ayes 39. Noes 0.).
6. August 25, 2026Ordered to special consent calendar.
7. August 17, 2026Read second time. Ordered to third reading.
8. August 13, 2026Read second time and amended. Ordered returned to second reading.
9. August 13, 2026From committee: Amend, and do pass as amended. (Ayes 7. Noes 0.) (August 13).
10. June 29, 2026In committee: Referred to APPR. suspense file.
11. June 18, 2026From 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 3, 2026Referred to Com. on HEALTH.