California Governor Gavin Newsom signed an executive order Monday that seeks to change the way that the state pays for and acquires prescription drugs.

The order directs state officials to set up what Newsom said would become the nation’s largest single-purchaser system for prescriptions. It directs California’s Medicaid system to negotiate drug prices for all of its recipients. The state would create a list of drugs to purchase in bulk or target for price negotiations.

The order also seeks to allow other governmental agencies and private companies to participate in negotiation of drug prices and creates a new government position by naming the first ever Surgeon General of California.

Newsom has hired numerous health care advocates to serve as aides and is expected to focus heavily on healthcare issues as his administration moves forward. He is expected to propose, as part of the state’s budget plan later this week, that the legislature allow all undocumented immigrants under the age of 26 to participate in California’s Medicaid program. The proposal will also contain a plan to increase ACA subsidies and reinstate the mandate to purchase health care.

Assemblyman David Chiu, a Democrat from San Francisco, stated that “it’s about time” in response to Newsom’s plan for pharmaceutical negotiations. “The drug pricing crisis is something that should be dealt with nationally. But the failure of Washington to act means that we—California—have to act.”