In a recent government meeting, officials discussed the anticipated general fund shortfall linked to Proposition 35, which is set to be voted on by the public. The administration estimates a staggering shortfall of approximately $11.9 billion over the term of the proposed tax, with specific deficits projected at $2.6 billion for the fiscal year 2024-2025, $4.9 billion for 2025-2026, and $4.3 billion for 2026-2027.

Both the administration and the Legislative Analyst's Office (LAO) agree that if Proposition 35 is approved, it will significantly impact the funding available for the Medi-Cal program. Starting January 1, 2025, the initiative would restrict nearly all net revenue from the tax, including an additional $6.7 billion from two amendments to the Managed Care Organization (MCO) tax, to only $2 billion annually for Medi-Cal support during the 2025-2026 and 2026-2027 fiscal years. The remaining funds would be redirected to new expenditures or deposited into newly created subaccounts.

The meeting highlighted concerns regarding the potential for a greater shortfall if there are delays in the collection of MCO tax revenue or federal approval of the amendments. Additionally, the $133 million earmarked for targeted medical provider rate increases in the 2024 Budget Act could become inoperable if Proposition 35 passes, as the financial constraints would not allow for both the initiative and the rate investments to coexist.

Senator Menjivar raised questions about the implications of the language included in the budget negotiations that could hinder future investments. Laura Ayala from the Department of Finance explained that the decision to include this language was based on the administration's assessment of the fiscal sustainability of both the proposition and the investments.

The discussion underscored the complexities of balancing the budget while addressing the needs of the Medi-Cal program, with further proposals expected from the administration in January as they prepare for the upcoming budget cycle. The meeting concluded with a recognition of the evolving purpose of the MCO tax, which has historically provided essential funding for Medi-Cal but may face significant changes depending on the outcome of Proposition 35.