Director Michelle Landsberg used her executive report to highlight several initiatives and legislative developments shaping California’s health‑care affordability agenda.

Landsberg opened with a land‑acknowledgment and described the agency’s first formal tribal consultation, stressing the importance of engaging tribal leaders about rural care access and culturally appropriate services. She then announced that, through HCAI’s Calyrex biosimilar insulin initiative, "California has become the first state to offer its own low cost insulin starting on 01/01/2026," with insulin glargine pens capped at $55 for a five‑pack and pharmacies able to procure product for about $45.

Landsberg reviewed recent legislation that will affect the office’s work. She said AB 1415 expands OCA’s oversight of management‑service organizations and private‑equity‑backed entities, SB 660 moves the data‑exchange framework to HCAI and directs a legislative report, and AB 1312 tightens hospital fair‑billing practices by adopting a presumptive eligibility approach tied to programs such as CalFresh and CalWORKs. She also summarized SB 40 and SB 41 as complementary efforts to lower insulin costs and reform pharmacy benefit manager practices.

On the federal front, Landsberg previewed California’s application for the Rural Health Transformation Program created by HR1, a five‑year federal initiative with $50 billion in funding. The state plans three priorities for its application: (1) a transformative hub‑and‑spoke care model to keep specialty services connected to rural spokes; (2) investments in technology, interoperability and cybersecurity, including a technical assistance center and shared purchasing; and (3) workforce development with local "grow your own" pipelines, community health workers and behavioral‑health training for primary‑care providers.

Landsberg also reported on a Los Angeles medical‑debt summit that framed debt as a public‑health problem and highlighted coalition efforts to reduce collection harms. She closed by noting that most of OCA’s expected submitters had provided 2025 data; Pagani later said 48 of 50 submitters had submitted and passed validations.

What’s next: Landsberg said HCAI will continue tribal engagement and finalize the state’s Rural Health Transformation Program application, which is due in the coming days. The board also discussed enforcement and data priorities later in the meeting.