Healthcare has been the throughline of my entire career in public service. I started as a legal advocate for people with mental illness who had no voice. I served twelve terms in Congress and on the Ways and Means Subcommittee on Health, fighting for every family to have the same assurance of care that my family  had growing up. As California’s Attorney General, I won a $575 million antitrust settlement against one of the largest health systems in the state, cracked down on pharmaceutical “pay-for-delay” schemes that kept generic drugs off the market, prosecuted Medi-Cal fraud, and led the three-year federal court fight that saved the Affordable Care Act for 133 million Americans with pre-existing conditions. As HHS Secretary, I negotiated drug price reductions of up to 79% on some of the most widely used medications in America, the first time the federal government had ever directly bargained with pharmaceutical companies on behalf of patients. Bringing costs down is not an aspiration for me. It is a record.

Now Washington is working to undo all of it. The Trump administration is targeting Medi-Cal, gutting the ACA, and abandoning the drug pricing reforms that were just beginning to deliver savings for families. With the federal government absent from this fight, California must be the firewall. I sued the Trump administration more than 120times as Attorney General and won, and I am ready to do it again. But fighting Washington is not enough. The next governor must do more than play defense. We need to protect coverage for every Californian today while building toward a system where universal access is not a promise deferred but a guarantee delivered.

The most effective way to lower healthcare costs is to keep people healthy in the first place. A family without a primary care doctor does not simply go without care. They end up in an emergency room, at far greater cost to the system and far greater harm to themselves. Primary care is the only part of the healthcare system where investment consistently produces longer lives, greater equity, and lower overall spending. As Governor, I will move California toward a system that does not just treat illness but prevents it, with community-based care, robust screening, and the kind of coordination that reaches the people who need it most.

None of this works without the people to deliver it. California cannot build toward universal coverage without the providers, nurses, and caregivers to make it real. We face serious shortages in primary care, behavioral health, and rural medicine, and those shortages fall hardest on the communities already carrying the heaviest health burden. I will invest in growing and retaining a healthcare workforce that reflects the full diversity of California and reaches every zip code, because coverage without access is not coverage at all.

GUIDING PRINCIPLES

Bring Healthcare Costs Down for All Californians. Lower the financial burden Californians face when accessing care, from premiums and out-of-pocket costs to prescription drug prices, using every tool of state purchasing power, regulation, and enforcement available.

Guarantee Access and Build Toward Universal Coverage. Protect existing coverage from federal rollbacks and chart a clear path to ensuring that no Californian is left without care, regardless of income, zip code or immigration status.

Increase Investment in Primary Care. Make prevention and early intervention the foundation of the system. It costs the state far less to give a family access to a doctor than to wait until a preventable condition lands them in the emergency room.

Build, Support, and Invest in a Stronger Healthcare Workforce. Grow and retain the providers, caregivers, and allied health professionals California needs, especially in rural communities, safety-net settings, and underserved specialties, so that coverage always comes with adequate networks and actual access to care.

POLICY AGENDA

1. Protect Healthcare and Keep Hospitals, Clinics, and Medical Practices Open

On Day One, I will issue an executive order directing state agencies to maintain coverage continuity for every Californian affected by federal cuts or Medi-Cal rollbacks. I will also direct state agencies to protect access to essential, medically appropriate health services from federal restrictions, including reproductive care and healthcare for immigrant communities, and ensure uninterrupted, equitable access to contraception, abortion, and maternal health support. I will immediately assess which rural hospitals, community clinics, and safety-net providers are most at risk and execute emergency state interventions to prevent cascading closures. And I will fight to fully implement Proposition 35, which California voters passed in November 2024 to dedicate MCO tax revenue exclusively to Medi-Cal, ensuring those funds go to stronger provider payments and expanded access to care, not federal clawbacks. State interventions will ensure that public dollars come with public obligations, including maintaining fair labor standards and respecting the representation rights of the healthcare workforce.

2. Cut Prescription Drug Costs Using State Purchasing Power

I negotiated drug price reductions of up to 79% as HHS Secretary, finalizing historic deals on ten high-cost medications including Eliquis, Jardiance, and Xarelto that will save Medicare billions of dollars every year. When I am Governor, California’s full purchasing power goes to work for patients on Day One. I will negotiate maximum reimbursement rates for drugs purchased through state employee health plans, Medi-Cal, and all state-administered programs, and direct agencies to prioritize lower-cost biosimilars and therapeutic alternatives wherever clinically appropriate.

3. Expand CalRx and Build Western States Drug Independence

California pioneered CalRx to produce and purchase essential medications at lower cost, and I will accelerate and expand it, moving urgently on high-impact medicines like insulin, inhalers, EpiPens, naloxone, and antibiotics. I will also forge joint purchasing arrangements with other Western states to maximize our collective buying power and build regional pharmaceutical independence, so that a hostile federal administration or a supply chain disruption can never hold California’s patients hostage.

4. Streamline Administrative Oversight to Reduce Waste and Improve Efficiency

Too much of what California spends on healthcare goes to paperwork, not patients. I will issue a directive requiring all healthcare oversight agencies to identify and eliminate duplicative requirements that add cost without improving care, produce a unified plan to modernize and consolidate oversight activities, and partner with health plans and providers to review outdated facility standards and operational rules that drive up costs and restrict innovation. Every dollar freed from administrative waste is a dollar that can go toward expanding access.

5. Launch “California Connected Care”: Universal Telehealth Access

As HHS Secretary, I oversaw the historic expansion of telehealth during the pandemic and saw firsthand how it saved lives in communities that had never had adequate access to specialists. As Governor, I will issue an executive order requiring all state-regulated payors to reimburse telehealth visits to the fullest extent permitted under law, prioritizing telehealth delivered by California-licensed health care professionals through local and regional providers to provide urgent care for conditions that do not require an in-person visit, and leverage California’s volunteer physician registry to open specialty telehealth access to communities that have never had it. I will also direct our oversight agencies to launch oversight and integrity programs to match the expansion of telehealth services. When a patient with a chronic condition connects online, they will be linked directly to a Federally Qualified Health Center for ongoing care.

6. Launch the “California Prevention First” Initiative

The most effective way to lower healthcare costs is to keep people healthy in the first place. I will invest in comprehensive community-based prevention programs targeting the chronic diseases that drive the highest costs, including diabetes, hypertension, cancer, substance use, and more, with community health workers, robust screening programs, and doula care. This initiative will prioritize Medi-Cal populations and disadvantaged communities that bear a disproportionate burden of chronic illness, and will invest in modern data systems that track patient needs and close gaps in care so that prevention is measurable, not just aspirational. As Governor, I will also strengthen public health infrastructure by restoring trust in science and expanding access to safe, effective vaccines, as I recognize immunization as one of the most powerful tools to prevent disease and protect public health. Building on California’s world-leading research institutions and innovation ecosystem, my administration will recommit to fact-based decision-making and double down on science and research to guide policy, improve outcomes, and prepare for emerging public health challenges.

7. Launch the California Healthcare Workforce Investment Fund

Coverage without providers is an empty promise. I will establish a long-term dedicated fund to grow the healthcare workforce where it is needed most, offering loan repayment and forgiveness programs, housing assistance in high-cost areas, and targeted incentives for primary care, behavioral health, women’s care, rural medicine, and dental providers. The fund will build lasting partnerships between health systems and California’s community colleges and universities to train the next generation of nurses, medical assistants, physicians, dentists, and allied health professionals, with incentives for health systems that invest in the workforce pipeline. I will also hold health plans accountable for building and maintaining adequate provider networks so patients can access timely, high-quality care when and where they need it. 

8. Center Affordability in Every Decision

Universal coverage, timely access, and a strong safety net must translate into real savings for real families. I will work with regulatory agencies to ensure that as waste and inefficiency are eliminated, the savings flow back to patients, not to shareholders. I will work with employers and other purchasers of care to drive down premiums and out-of-pocket costs across the board. The goal is a system where doing the right thing for patients is also the most financially sustainable path for providers, plans, and the state.

9. Stop Paying Twice for People Who Never Lost Eligibility

California loses hundreds of millions of dollars every year processing the same Medi-Cal cases twice, when eligible enrollees are dropped due to paperwork errors and then re-enroll weeks later. Children’s churn cases alone cost $120 million every three years. I will modernize Medi-Cal’s eligibility infrastructure with automated renewals that verify eligibility through existing state data, consolidate the fragmented county-by-county enrollment system, and ensure that a missed letter or a data entry error never becomes the reason an eligible Californian loses coverage.

10. Crack Down on Waste, Fraud, and Abuse

I prosecuted Medi-Cal fraud as California’s Attorney General, and California is still losing billions to fraudulent claims and misused benefits. I will create a dedicated healthcare fraud task force with the authority to hold funds, investigate bad actors, file charges, and see cases through to verdict. Services that are overutilized or delivered through the wrong system, including transportation and hospice abuse, home asthma remediation, and housing benefits that belong in social services will be reined in. Every dollar recovered is a dollar that can go to care for the patients who need it most.

11. Stop Large Employers From Shifting Costs onto Taxpayers

Some of California’s largest and most profitable corporations pay wages so low that their workers qualify for taxpayer-funded Medi-Cal, effectively subsidizing their labor costs with public money while disadvantaging competitors who do the right thing. I will pursue a fee on large employers who do not offer health coverage to their low-wage workers who qualify for Medi-Cal, so that corporations who shift their healthcare costs onto taxpayers pay their fair share. Profitable companies should not get to pass their obligations onto working families.

12. Modernize and Consolidate Medi-Cal Financing to Ensure Long-Term Stability

Medi-Cal’s current funding structure is a patchwork of supplemental payments, time-limited tools, and fragmented streams that obscures true costs, limits transparency, and makes long-term planning nearly impossible. I will pursue a unified financing strategy that consolidates duplicative payment structures, strengthens base rates, and ties funding to clear performance and accountability standards, so that Medi-Cal dollars go to access and quality, providers can plan with confidence, and California is no longer vulnerable to federal disruption of the mechanisms we rely on most.