Back to School-related
Kindergarten Vaccination Rates Continue to Decline
https://www.kff.org/medicaid/kindergarten-routine-vaccination-rates-continue-to-decline/
August 21, 2026
As measles cases rise across the U.S., children’s routine vaccination rates continue to decline while exemptions from school vaccination requirements, particularly non-medical exemptions, have increased. (…) Department of Health and Human Services (HHS) Secretary Kennedy and the Trump administration have also made significant changes to federal vaccine policy, including several attempts to change childhood vaccine recommendations and dropping Medicaid vaccine reporting requirements. Due to recent federal actions, most states have announced that they are no longer following federal recommendations as their benchmark for some or all childhood vaccines. As the school year begins, these changes along with changes to school vaccine exemption requirements in some states may increase confusion for families and could further drive down vaccination rates among children. This issue brief provides an update on the latest trends in kindergarten children’s routine vaccination and exemption rates as state and federal vaccination policy continues to evolve.
Proposed Changes to Childhood Vaccination Schedule
Childhood Vaccine Recommendations Executive Order: What It Includes, What It Means, and What Happens Next
https://publichealth.jhu.edu/2026/what-does-the-executive-order-on-childhood-vaccines-say
August 18, 2026
The Trump administration’s guidance calls for reduced immunizations for children and separated measles, mumps, and rubella vaccines. As part of a push toward “gold standard childhood vaccine recommendations,” the Trump administration is calling for American children to receive fewer routine vaccinations. A new executive order signed by President Trump on August 10 recommends vaccinating children against 11 diseases rather than the currently recommended 17. The order also calls for splitting the MMR vaccine into three shots, which experts say would not only come with logistical hurdles but also lacks a scientific basis.
What Does the Executive Order Mean for Childhood Vaccines?
The president has issued an executive order, and it covers a few different topics. It asserts that the vaccine schedule should be what the Department of Health and Human Services had announced back in January before the court stopped them. They also had this interesting statement that the MMR vaccine—the measles, mumps, and rubella vaccine—should be given as three different shots over time, and that it should be the policy of the government to work toward that. There was some very misleading information on different issues at the press conference for the executive order. One of them was that the United States is this huge outlier that does so many more shots than other countries. That's not true. The U.S. vaccinates against 17 diseases. There are other countries that do that, while others vaccinate against 15 or 16 diseases. Denmark is down at 10, so Denmark is the outlier.
Has the MMR Vaccine Ever Been Separated Into Individual Vaccines Before?
There’s no country on Earth that does that. It’s not even possible because those vaccines aren’t typically made in the quantities to be able to do that. There’s no study that backs it.
It came from an assertion that was made more than 25 years ago by the author of a paper published in The Lancet that was retracted because it was scientifically invalid. That author had a patent on a competing product that would benefit from the paper’s recommendations. Twenty-five years later, not a single reputable scientific organization supports separating the MMR vaccine. With this executive order, it is now the policy of the United States to try to make it happen.
Affordable Care Act
https://kffhealthnews.org/medicaid/aca-fraud-crackdown-skyrocketing-prices-enrollment-decline/
August 3, 2026
Enrollment in Affordable Care Act plans fell by nearly 3 million this year to about 19.2 million, following steep premium increases by insurers and the Republican-led Congress’ unwillingness to extend more generous premium subsidies. On average, ACA customers pay $178 a month in premium payments this year, a 58% increase from 2025, according to KFF, while their deductibles — the amount consumers must pay annually before insurers pick up their share — have climbed 37% to nearly $3,800 a year.
Medicaid Work Requirements
https://www.kff.org/medicaid/what-could-medicaid-work-requirements-mean-for-ssi-applicants/
July 29, 2026
The 2025 reconciliation law requires 44 states to condition Medicaid eligibility for adults in the Affordable Care Act (ACA) Medicaid expansion group and enrollees in certain waiver programs, on meeting work requirements starting January 1, 2027, or sooner at state option. While the law specifies mandatory exclusions, including for individuals who are “medically frail,” the approach to determining medical frailty specified in the June 2026 interim final rule could make it difficult for some people to qualify for this exclusion. Medicaid expansion provides coverage to many adults with significant health care needs, including some with disabilities who are applying for the Supplemental Security Income Program (SSI). This coverage could be at risk for some because of the planned approach to defining medical frailty.
SSI is a means-tested federal program administered by the Social Security Administration (SSA) that pays monthly cash assistance to people with limited resources who are unable to work because of a disability and generally qualifies people to receive health coverage through Medicaid. Once approved for SSI, Medicaid enrollees would not be subject to work requirements, but the application for SSI can be a lengthy and complicated process, spanning months, if not years, during which time applicants may be at risk of uninsurance because they are unable to work. Medicaid can fill coverage gaps during the SSI application period, particularly in states that have adopted the Medicaid expansion.
This issue brief finds that the percent of new SSI enrollees ages 19 through 64 with Medicaid prior to SSI entitlement is twice as high in ACA expansion states as it is in non-expansion states, and in 2023, over 100,000 new SSI enrollees had ACA Medicaid coverage prior to their SSI entitlement. It also describes the lengthy SSA process for determining SSI eligibility, particularly assessing ability to work, and how the current approach to determining medical frailty could cause some SSI applicants to undergo concurrent assessments of their ability to work using different processes and criteria. The new documentation requirements and processes could cause some people with disabilities to lose Medicaid coverage or be denied Medicaid enrollment while they are waiting on their SSI determination.
How Can Medicaid Provide Coverage While Someone Is Applying for SSI?
Medicaid provides coverage for many people with disabilities, including those who are applying for SSI. One in five Medicaid enrollees have a disability, including 43% of adults ages 50-64, but only one-third of these individuals receive SSI income, generally qualifying for Medicaid for that reason. The remaining people with disabilities are covered through different Medicaid eligibility pathways, including the ACA Medicaid expansion. Because of the lengthy process for obtaining an SSI determination and the fact that people who are applying for SSI are unable to work, many people applying for SSI rely on Medicaid to avoid going uninsured.
In 2023, 223,000 SSI applicants ages 19 through 64 had Medicaid while they were waiting for an SSI determination, including over 106,000 with coverage through the ACA expansion. KFF analyzed detailed Medicaid administrative data to identify people who were ages 19 through 64 and became eligible for Medicaid because of SSI during the calendar year 2023 and whether those enrollees had Medicaid coverage in the months prior to their SSI-based eligibility (see Methods). Among the 337,000 people who started SSI during the calendar year, over 200,000 had prior Medicaid coverage through a different eligibility pathway, with roughly half receiving that coverage through the ACA expansion.
In ACA expansion states, 76% of new SSI enrollees ages 19 through 64 had Medicaid coverage through a different eligibility pathway prior to their disability determination (including 42% who were covered through the Medicaid expansion) compared with only 33% in non-expansion states (Figure 1). In both expansion and non-expansion states, roughly 1 in 3 new SSI enrollees ages 19 through 64 were enrolled in non-ACA Medicaid coverage (such as coverage for parents and caretakers) prior to becoming eligible for SSI. However, in expansion states, an additional 42% of new SSI enrollees were enrolled in Medicaid through the expansion, covering over 100,000 people in 2023. New SSI enrollees who were not covered by Medicaid prior to their SSI approval were likely uninsured because of their low income and inability to work.
State
California Considers Penalties for Healthcare Providers That Fail to Control Costs
August 24, 2026
California is weighing stiff penalties for hospitals and other healthcare entities that don’t stay under state spending limits, potentially levying hundreds of millions of dollars in fines if these providers don’t take steps to rein in rising healthcare costs.
If the state Office of Health Care Affordability adopts the fines next week, hospitals, medical groups, insurers, and others could face penalties that amount to as much as 125% of the total they spend above the state’s annual growth targets. (…)
Meanwhile, hospitals are warning there’s a risk of more closures. According to Yale University’s Health Care Affordability Lab, 17 hospitals have closed in the state since 2016, compared with only six openings.
Hospitals and other healthcare providers have said the proposed multimillion-dollar penalties are too steep and could destabilize their operations at a time when they’re facing funding challenges, including massive federal cuts to Medicaid, the end of enhanced federal subsidies for Affordable Care Act plans, and a sharp rise in uninsured patients. The One Big Beautiful Bill Act, passed by congressional Republicans and signed by President Donald Trump last summer, is expected to reduce federal Medicaid spending by more than $900 billion — including by $30 billion in California — and increase the rolls of the uninsured in the U.S. by 10 million people over a decade.
August 13 was a major deadline at the California State Capitol. The Assembly and Senate Appropriations Committees decided which bills that would have a cost to the state could continue moving through the Legislature. Bills that passed are now one step closer to the Governor’s desk. Bills that were “held under submission” will not move forward this year.
For The Arc & UCP California Collaboration, there was some good news.
Several bills we support made it through Appropriations:
AB 2526 (Muratsuchi) – More Resources for Special Education
AB 2526 would change how certain special education funding is calculated and would provide additional resources to support students with significant disabilities.
AB 2081 (Stefani) – Expanding Home and Community-Based Services
AB 2081 would expand California’s Home and Community-Based Alternatives (HCBA) Waiver, which helps people who might otherwise need institutional care receive services in their homes and communities. Beginning in 2027, the bill would require California to increase the number of available waiver slots by 10,000, in addition to other planned increases. This is a bill that Assembly Member Stefani has repeatedly introduced over a number of years, and has been supported by the Arc of California each time.
AB 2233 (Ta) – Protecting Access to Autism Treatment
AB 2233 would give families more flexibility in using authorized behavioral health treatment hours. If treatment hours are approved as part of a six-month treatment plan, health plans and insurers generally could not restrict when those hours are used during that authorization period, as long as their use remains consistent with the treatment plan and clinical guidelines.
AB 2414 (Nguyen) – Recognizing Direct Support Professionals
AB 2414 takes an important step toward recognizing the professionalism and value of this workforce. By establishing a clear statutory definition of a Direct Support Professional and directing DDS to develop billing guidance to facilitate training-related pay differentials, this bill supports workforce development, promotes consistency across the developmental services system, and helps lay the foundation for improved recruitment and retention efforts. The bill also ensures that DSPs are appropriately recognized within future DDS rate model reviews, which is the first step toward increasing DSP pay.
SB 974 (Seyarto) – Special Needs Trusts and Family Homes
The bill would recognize qualifying special needs trusts as an eligible way to transfer certain family property for purposes of California’s applicable property tax exclusion. This could mean that some families will pay less property tax when transferring their family home to their disabled loved one through a Special Needs trust.
SB 1349 (Gonzalez) – Reviewing California Tax Breaks
SB 1349 would require the Legislative Analyst’s Office to review major state tax expenditures, including whether they are a cost-effective use of public resources and whether savings could be achieved by reducing or limiting them.
AB 880 (Bennett) – Prompt Payments for Nonprofits
AB 880 recognizes that nonprofit organizations providing public services to people with disabilities should be afforded the same basic expectation of timely payment as other entities doing business with the state. The nonprofit status of an organization does not eliminate payroll obligations, operating expenses, or the need for predictable cash flow. If anything, many community-based nonprofits have fewer financial reserves and less access to capital to withstand substantial payment delays. By expanding the Prompt Payment Act’s definition of “grant” to include agreements between state agencies and nonprofit organizations, AB 880 would help establish greater accountability and fairness in the state’s payment practices to non-profits that are paid via Medi-Cal.
Some Important Bills Failed to Advance
Unfortunately, several bills supported by The Arc & UCP California Collaboration were held in Appropriations and will not move forward this session. These include AB 1925 (Gonzalez), which proposed studying a statewide permanent disability certification that could potentially reduce the need for people with lifelong disabilities to repeatedly prove their disability; AB 2191 (Quirk-Silva), which would have supported statewide resources for alternate pathways to a high school diploma for students with disabilities; AB 2208 (Stefani), which addressed upcoming federal changes to Medi-Cal; and AB 2360 (Arambula), which would have strengthened plain-language requirements for state government documents.
SB 1202 (Weber Pierson), which would have required California to publicly track Medi-Cal enrollment, disenrollment, work requirements, and exemptions through a new data dashboard, was also held. SB 363 (Wiener), which sought greater accountability around health insurance treatment denials and independent medical reviews, did not advance either.
One Harmful Bill Advanced Through the Appropriations Process
AB 2490 (Valencia) – Lowering Experience Requirements for Long-Term Substitute Teachers
Unfortunately, AB 2490 also passed the Senate Appropriations Committee and will continue moving through the Legislature. The Arc & UCP California Collaboration opposes this bill because of its potential impact on students with disabilities.
AB 2490 would allow substitute teachers to spend more than one-third of the school year in a general or special education classroom, with only minimal training and unspecified support.
Staffing classrooms with untrained teachers is a solution for districts, not students. Students with disabilities deserve qualified and well-prepared educators who understand their individual needs and can implement their Individualized Education Programs (IEPs). The Arc will continue opposing the bill as it moves through the final weeks of the legislative session.
The California Policy Center for Intellectual and Developmental Disabilities (CPCIDD) is a non-partisan, non-profit policy center established to identify best practices that inform, support, and improve upon statewide policies that impact the lives of people with intellectual and developmental disabilities. The Center’s focus is to identify priorities within the IDD community and provide policy recommendations based on objective, evidence-based research, data, and policy analysis to help inform the community, as well as the policymaking process.
There is an immense amount of policy – housing, employment, transportation, workforce, rate reform, access to dental care, access to health care, education, state budget, public safety, and the list goes on – that directly impacts the IDD community. CPCIDD will serve as an important conduit between individuals with IDD, families, advocates, experts, stakeholders, and the various branches of California’s Government for trusted policy insights and the impacts of these policies on the IDD community.
Focus Areas
Direct Support Professional (DSP) Workforce
CPCIDD will address the complexities of the DSP workforce shortages, such as recruitment, retention, training, compensation, and recognition, and provide policy recommendations to improve the quality and availability of DSPs for people with IDD.
CPCIDD will assist with gathering accurate data on the projected need and availability of housing for people with IDD, and identify the various factors that impact housing, such as affordability, accessibility, choice, and community integration.
CPCIDD will identify the barriers and facilitators to employment of people with IDD, such as funding, incentives, expectations, and supports.
CPCIDD will study the issue of children in foster care who may not be able to access or benefit from Early Start services, which are designed to enhance the development of infants and toddlers with disabilities.
Past events:
https://www.cpcidd.org/invisible-no-more-advancing-californias-direct-support-profession/
https://www.cpcidd.org/unraveling-myths-about-benefits-and-work/
The Little Hoover Commission
FOR IMMEDIATE RELEASE
August 05, 2026
For Additional Information Contact:
Tamar Foster
Deputy Executive Director
(916) 445-0939
Tamar.Foster@lhc.ca.gov
Little Hoover Commission Backs 22 Bills as California Legislature Returns to Sacramento
SACRAMENTO – The Little Hoover Commission is supporting 22 bills as the California Legislature returns from summer recess. The bills would implement recommendations from the Commission's independent studies to improve state government and better serve Californians.
The Commission's legislative package reflects recommendations developed through extensive public hearings, stakeholder engagement, and bipartisan deliberation. The bills address issues ranging from housing and electricity affordability to nonprofit contracting, developmental disabilities, labor trafficking, intimate partner violence, education, and government accountability.
"The Legislature's return marks an important stage in the policymaking process," said Commission Chair Pedro Nava. "We appreciate the legislators who have authored these measures and look forward to working with them as the bills move through the final weeks of session."
The Commission's recommendations have long served as a resource for lawmakers seeking evidence-based policy solutions. During the current 2025–2026 Legislative Session, legislators from both parties have introduced measures reflecting findings from Commission reports and issue briefs.
Among the Commission's legislative priorities this year are bills that would:
The Commission's current legislative positions, including bill summaries and status updates, are available on the Little Hoover Commission website.
The Little Hoover Commission is California's independent oversight agency. Since 1962, the Commission has investigated state government operations, conducted public hearings, and developed bipartisan recommendations to improve efficiency, effectiveness, and accountability in government. Many of its recommendations have been enacted into law, improving programs and services for Californians.