Initiatives

Gender Affirming Care and Reproductive Health Programs

Important Update:

Providers who are currently treating a patient under age 18 with Medi-Cal or age 19 with CHIP who has gender affirming care surgical interventions or puberty blocker administration already scheduled on or after October 13, 2026, should contact HCAI via email at genderaffirmingcare@hcai.ca.gov to discuss how to access state funding for these services. Please do not include any identifiable patient information in your email.

Gender Affirming Care Services for Youth

Background
Federal policies and actions in recent years have targeted access to gender affirming health care, in particular for children and youth. A series of Executive Orders, proposed rules, statements from high-ranking government officials, federal agency clinical and policy guidance changes, and investigations and subpoenas of providers, have had a chilling effect on and affected the availability and delivery of gender affirming care. Most recently, in August 2026, the Centers for Medicare & Medicaid Services (CMS) released a final rule that prohibits federal Medicaid and CHIP funds from paying for certain gender affirming care, including puberty blockers, hormone therapy, and surgical interventions, for children and youth (under age 18 for Medicaid and age 19 for CHIP).

California law contains many provisions designed to ensure access to high-quality, equitable, and clinically appropriate gender affirming care and reproductive health services. However, in the current federal environment, California providers and patients face more challenges than ever before in delivering and accessing these services. For providers, there is a considerable amount of uncertainty, which can create complexities related to the continued provision of care and compliance concerns. Similarly, for patients, there can be many different barriers to accessing care (e.g., geographic limitations, limited provider availability, lack of insurance coverage, and/or safety concerns, etc.). In response to these challenges, state investments in uncompensated care and provider capacity building, and changes to how certain kinds of care are funded by the state, will help bolster access and strengthen the network of providers delivering services.

California is committed to maintaining access to gender affirming care, particularly for impacted minors. To support providers and patients, the state has established new funding programs that help ensure continued access to gender affirming care and strengthen provider capacity.

The 2026-27 Budget Act appropriated $66 million to HCAI across three funding allocations to support continued access to care:

  1. Uncompensated Care Program ($30 million): This program provides grants to health care providers to support uncompensated care for eligible patients who are at or below 400% of the federal poverty line (FPL) and do not have coverage for abortion, abortion-related, family planning, family planning-related, and gender affirming care services under Medi-Cal or Family PACT.
  2. Gender Affirming Care Services for Children and Youth ($10 million): This funding supports the delivery of high-quality, equitable, and clinically appropriate gender affirming care services for youth (under age 18 for Medicaid and under age 19 for CHIP), including medical and pharmacy services that are no longer eligible for federal Medicaid and CHIP funding as of October 13, 2026.
  3. Gender Affirming Care Provider Network and Capacity Fund ($26 million): This fund ($10 million in FY 26-27 and $8 million each in the subsequent two fiscal years, subject to appropriations) provides grants to organizations to maintain and develop capacity to provide gender affirming care. Funding is intended to strengthen the provider network and address clinical and operational capacity needs that may limit access to care.

Request for Information (RFI) – Now Open

HCAI has released a Request for Information (RFI) to identify a potential organization or organizations to establish, administer, and manage one or more of the three grant programs listed above. The funds may be administered independently or in combination.

Download the RFI Here

Application Dates

• Opens September 22, 2026, 12:00 p.m.
• Closes October 6, 2026, 5:00 p.m.

Contact Us

Email: genderaffirmingcare@hcai.ca.gov

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Reproductive Health Care Access Initiative

After the overturn of Roe v. Wade on June 24, 2022, California reaffirmed its status as a reproductive freedom state. In its 2022-23 budget, the State of California appropriated $120 million to the California Department of Health Care Access and Information (HCAI) to establish and administer five programs designed to support and expand abortion, abortion-related care, and reproductive health services across the State. 

Clinical Infrastructure

Through the Clinical Infrastructure program, HCAI awarded scholarships and loan repayments to support a broad spectrum of healthcare providers offering abortion-related care and reproductive health services.

Funding for the Reproductive Health–specific scholarship and loan repayment programs has ended at this time. However, additional funding opportunities remain available through other HCAI scholarship and loan repayment programs.

Reproductive Health Hotline (ReproHH)

The Reproductive Health Hotline (ReproHH) is a free and confidential clinician-to-clinician consultation service operated by the University of California, San Francisco (UCSF) through a contract with HCAI.

ReproHH provides real-time guidance to all health care providers, including Medi-Cal providers, who have questions about sexual and reproductive health. Calls are answered by physicians with specialized expertise to help minimize unnecessary referrals, reduce treatment delays, and improve patient outcomes.

Hotline Details
1-844-ReproHH (1-844-737-7644)
Available on-demand from 8 a.m. to 4 p.m. PDT, Monday through Friday, excluding holidays.

Learn More

Capital Infrastructure

HCAI, in partnership with the California Governor’s Office of Emergency Services (Cal OES), implemented the Physical and Digital Infrastructure Security (PDIS) Grant Program to strengthen the safety and security of healthcare facilities and practitioners providing abortion-related care and reproductive health services across California.

Funding was awarded to providers across two grant cycles. The PDIS Grant Program has now concluded and is no longer accepting applications.

Resources

For More Information

Uncompensated Care Fund and Abortion Practical Support Fund

In 2023, HCAI has contracted with Essential Access Health (Essential Access) to administer the Uncompensated Care and Abortion Practical Support Funds. Essential Access has a long history of supporting individuals who face barriers to accessing reproductive health services. Essential Access is responsible for distributing $60 million in grants to expand access to abortions, abortion-related services, and general reproductive health care.

  • The Uncompensated Care Fund provides grants to healthcare providers who participate in the Medi-Cal program and who deliver abortion and abortion-related care to individuals without coverage for such services and with an income below 400 percent of the federal poverty level.
  • The Abortion Practical Support Fund provides grants to non-profit organizations to help individuals seeking abortion care with the supports necessary to access abortion-related care. Practical support can include travel, lodging, childcare, food, and other ancillary supports.

As of September 2026, Uncompensated Care funding has been fully awarded to non-profit organizations across three cycles, while Abortion Practical Support funding has been awarded across four cycles. Refer to the resources below for additional details   

Resources

California Reproductive Health Service Corps

The Reproductive Health Service Corps (“Corps”) will recruit, train, retain, and financially support a diverse workforce of health care professionals who commit to providing reproductive health services, including abortion care, for at least three years. 

HCAI has partnered with Training in Early Abortion for Comprehensive Healthcare (TEACH) and Birth Control Pharmacist to administer the Reproductive Health Service Corps (RHSC). The program will address critical gaps in access to abortion care, diversify the reproductive health care workforce, and empower pharmacists to provide comprehensive reproductive health services.

Resources

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Join the Reproductive Health Programs Update mailing list by clicking below to Subscribe to program announcements. Scroll down to Healthcare Workforce and select Reproductive Health Access Programs to receive program announcements.

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