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 plans to submit the renewal application in 2026.
But the federal administration has withdrawn guidance supporting SDOH through Medicaid and won't approve new funding for rent assistance or medically tailored meals.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- Federal administration has withdrawn guidance supporting SDOH through Medicaid — renewal at risk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 StrategiesFQHC 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 June 12, 2026, from https://www.fqhctalent.com/intel/calaim-1115-waiver-renewal-2026
More in Legislation
Jun 10
The work-requirement map, 6 months out: 4 states going early, Nebraska's freeze is the preview, and Georgia's 5% enrollment rate is the warning
Jun 10
MACPAC's June report hands FQHCs two federal hooks: a work-requirement monitoring mandate and a human-review requirement for AI prior-auth denials
Jun 9
Washington's 340B protection law survives — and the national map now splits clean: 22 state laws, two circuits upholding, one blocking, DOJ siding with manufacturers
Jun 5
Becerra Tops the June 2 Governor Primary and Advances to November — Putting a Former HHS Secretary in Reach of the Office, but Not Until After the December Cliff