CalAIM 1115 Waiver Expires Dec 2026 — Renewal at Risk Under Restrictive Federal Posture
California's CalAIM 1115 waiver expires December 31, 2026. Since launching in January 2022, 326,000+ members have enrolled in ECM and 368,000+ in Community Supports. DHCS released a concept paper in July 2025 and formally submitted the renewal application to CMS on May 11, 2026 (CMS issued its completeness letter May 26; a decision is expected near the December 31 expiration).
But the federal administration has withdrawn guidance supporting SDOH through Medicaid and won't approve new funding for rent assistance or medically tailored meals.
For FQHCs: ECM revenue (the fastest-growing revenue stream for many centers) depends on this renewal.
Build ECM volume NOW while the waiver is active, and prepare contingency plans if renewal is delayed or narrowed.
Key takeaways
- CalAIM 1115 waiver expires December 31, 2026 — ECM revenue depends on this renewal
- Since Jan 2022: 326,000+ members enrolled in ECM and 368,000+ in Community Supports
- Federal administration has withdrawn guidance supporting SDOH through Medicaid — renewal at risk
- Build ECM volume NOW while the waiver is active, and prepare contingency plans if renewal is delayed or narrowed
Primary source
Center for Health Care StrategiesSource packet
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FQHC Talent. (2026, March 4). CalAIM 1115 Waiver Expires Dec 2026 — Renewal at Risk Under Restrictive Federal Posture. Primary source: Center for Health Care Strategies. Retrieved July 28, 2026, from https://www.fqhctalent.com/intel/calaim-1115-waiver-renewal-2026
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