Policy planning decisions can be characterized by conditions of high or low coordination. Holistic, deterministic and scientific traits are assumed under conditions of high coordination; incremental and pluralistic traits with low coordination. The latter may interfere with the achievement of program goals inherent in legislation, e.g., Title XIX. Identification of the nature and etiology of such interference is prerequisite to preventive or remedial efforts by an administrative agency. California Title XIX policy planning decisions were analyzed and classified. Findings were examined against the theoretical framework and against constraints imposed by federal policy decisions. Medi-Cal policy planning decisions were found to be incremental, remedial, serial and pluralistic. They were found to be the result of a disjointed political process, with three major interest groups vying with the responsible administrative agency. This resulted in a failure to include mandated service components and in preferential treatment for certain provider groups and program components.