Budget Act of 2019 – This is the Omnibus Health Trailer Bill for 2019-20. Among other things, the bill contains (1) Health Care Subsidies – Establishes a program of financial assistance to help low-income and middle-income Californians access affordable health care coverage through the California Health Benefit Exchange (Exchange). Authorizes this program to provide financial assistance to California residents with household incomes at or below 600 percent of the federal poverty level, and authorizes the Exchange to provide other appropriate subsidies designed to make health care coverage more accessible and affordable for individuals and households. (2) Individual Healthcare Mandate – Requires every California resident to be enrolled in, and maintain minimum essential coverage, for each month beginning on or after January 1, 2020. (3) Value-Based Payments – Establishes a program to provide payments to providers to incentivize quality improvements to behavioral health integration, prenatal and postpartum care, chronic disease management, and quality of managed care for children. (4) MCO Tax Extension. Establishes the intent of the Legislature to enact a managed care organization provider tax in California, contingent on federal approval. (5) Medi-Cal Pharmacy Carve-Out Executive Order. Requires the Department of Health Care Services to convene an advisory group to receive feedback on changes, modifications and operational timeframes regarding the implementation of pharmacy benefits offered in Medi-Cal.