October 02, 2025
What You Need to Know: Prop. 35 implementation is finally beginning in four areas: reproductive health, GME residency positions, emergency department care, and emergency transport. CMA will continue pushing to ensure all voter-approved dollars are directed to patient care and addressing workforce issues.
After months of delay, California has finally begun moving forward with implementation of Proposition 35, the voter-approved measure to increase Medi-Cal payments and expand access to care. While the 2025-26 state budget included budget allocations that were contrary to those required under Proposition 35, California Medical Association (CMA) advocacy and sustained pressure are now beginning to yield progress across four key areas, with the expectation of more to come.
Emergency Department Physician Payments
On September 30, the California Department of Health Care Services (DHCS) submitted a State Plan Amendment (SPA) to CMS seeking approval to use Prop 35 funds for supplemental payments to emergency department physicians who treat Medi-Cal patients. The supplemental payments will be for four E/M billing codes (99282-99285) and be retroactive to July 1, 2025.
Family Planning and Abortion Services
The state has begun distributing $90 million in Prop 35 funding for family planning and abortion care through grants administered by the California Department of Health Care Access and Information (HCAI). With federal funding for providers such as Planned Parenthood under attack in Washington, these state resources will help sustain critical reproductive health services.
Graduate Medical Education Expansion
In early September, the Newsom Administration confirmed that $75 million in Prop 35 funds for graduate medical education is available now. These dollars are being distributed through the state’s CalMedForce GME program, administered in a partnership between Physicians for a Healthy California and the University of California. CalMedForce/CalMedForce+ are currently accepting applications for residency and fellowship slots in primary care, as well as specialty and subspecialty training programs. The application window closes October 8.
Emergency Transportation Services
DHCS also submitted a SPA to CMS to support supplemental payments for ground emergency medical transportation for Medi-Cal enrollees. This change, too, would be retroactive to July 1, 2025.
Looking Ahead
CMA will continue to hold state leaders accountable to fully implement Proposition 35 as voters intended. Physicians and patients fought hard to pass this historic measure, and CMA will keep pressing to ensure that every voter-approved dollar is invested in strengthening the Medi-Cal program and improving access to care across California.