Funding & Budget

Santa Clara County expands uninsured care as Valley Care

On October 21, 2026, the Mercury News reported that Santa Clara County supervisors approved a larger uninsured care program on October 20, renamed Valley Care. Santa Clara Valley Healthcare expects to add up to 10,000 people in 2027. Between 25,000 and 70,000 county residents are estimated to lose Medi-Cal coverage next year.

Contra Costa supervisors expand Basic Health Care for the uninsured

On October 20, 2026, Contra Costa County supervisors approved changes to the Basic Health Care Program for residents without other coverage. It will cover incomes from 0% to 300% of the federal poverty level, drop annual fees and expect 6,000 participants, up from about 3,100. The $13.5 million annual cost needs $6 million in new funding.

California collects $2.9 billion more than forecast in September

On October 20, 2026, the Governor’s office reported that California’s September revenue came in $2.9 billion, or 14.9 percent, above forecast. Personal income tax collections ran $1.1 billion over and corporation tax collections $1.3 billion over. The release names no health program.

CMS expects to announce state rural health award amounts October 31

On October 20, 2026, America’s Essential Hospitals reported that CMS expects to announce state award amounts for the Rural Health Transformation Program on October 31. Amounts will depend on each state’s compliance with its transformation plan. States that miss their checkpoints may see future funds reduced, or in extreme cases rescinded.

Imperial Valley Healthcare District adds El Centro hospital, seeks parcel tax

On October 19, 2026, the San Diego Union-Tribune reported that El Centro Regional Medical Center joined the Imperial Valley Healthcare District. Measure N on the November ballot would levy a $111 parcel tax per property countywide and needs supermajority support. The district is said to represent more than 180,000 residents.

Torrance starts $17.4 million health center with Venice Family Clinic

On October 16, 2026, Los Angeles County and Torrance broke ground on a $17.4 million renovation of a vacant county building at 2300 West Carson Street, the Daily Breeze reported. Venice Family Clinic will operate the health center on the ground floor. Construction is expected to finish by July.

Central California Alliance expects to keep 44,700 of 78,500 Medi-Cal members

On October 16, 2026, the Pajaronian reported that Central California Alliance for Health expects to retain 44,700 of its 78,500 Medi-Cal members once federal cuts take full effect. Its CEO said hospitals and federally qualified health centers such as Salud Para La Gente will likely become the main providers for uninsured and underinsured people.

CMS rural health report shows $0 obligated in New York, West Virginia

CMS’s Year 1 Rural Health Transformation obligated funds report covers December 29, 2025 through July 31, 2026. New York and West Virginia list $0 put to work, while Georgia lists its full $218.9 million award. CMS calls the report not a full view of state progress and will refresh it after the November 30, 2026 quarterly report.

HRSA awards $12.7 million for produce prescriptions in pregnancy

On October 13, 2026, HRSA announced $12.7 million in first-year Maternal Produce Prescription Program awards to 27 recipients. Grants pay for fruit and vegetable prescriptions or vouchers and nutrition education for pregnant and postpartum women. Recipients include Westside Family Healthcare in Delaware and Community Health Centers of Pinellas in Florida.

San Diego's Measure B sales tax targets federal health and food cuts

On October 9, 2026, Voice of San Diego detailed Measure B, a countywide citizens' initiative on the November ballot. It would raise the sales tax a half cent with no end date, an estimated $400 million to $450 million a year. Up to 60% would go to health care, nutrition and family programs facing federal cuts.

KFF maps 2026 marketplace enrollment and losses by congressional district

On October 8, 2026, KFF estimated 2026 ACA Marketplace enrollment by congressional district after effectuated enrollment fell 12%, from 21.8 million to 19.2 million. Republican-held districts hold 55% of enrollees and 67% of the decline. Enrollment equals 16% of Florida's population and 10% of Texas's. A KFF survey found 1 in 10 of 2025 enrollees said they became uninsured.

CMS lets states cover behavioral health clinics without the demonstration's PPS

On October 6, 2026, CMS told state Medicaid directors how to add Certified Community Behavioral Health Clinic services to their state plans. Unlike the demonstration, states need not pay a PPS rate and get no enhanced federal match. Clinics must keep care coordination agreements with FQHCs and, where relevant, rural health clinics.

CMS lets health centers bill ACCESS co-management codes from October 1

As of its October 5, 2026 update, CMS's ACCESS billing guidance says every Medicare-enrolled FQHC and RHC can bill the co-management payment for services from October 1. Health centers file G0676, G0677 or G0678 on institutional claims, type of bill 77X. Each claim needs a review of the patient's ACCESS care update and one coordination task, 5 minutes in all.

KFF says Medicaid is a third of rural health center revenue

KFF reported on October 5, 2026 that rural health centers served 10.2 million patients in 2025, 31% of all health center patients. Medicaid made up 32% of rural health center revenue versus 49% for urban centers, while Medicare made up 19% versus 9%. KFF says it is unclear how far Rural Health Transformation funds will offset revenue losses.

CMS finalizes GLOBE drug rebate model and excludes 340B units

CMS published the final GLOBE Model rule on October 2, 2026, a mandatory Medicare Part B drug rebate test that takes effect November 30. Claims billed with the 340B modifier are left out of GLOBE rebates, and CMS says the model may indirectly move 340B ceiling prices. The first performance year begins April 1, 2027.

HRSA approves ten drugmakers' 340B rebate plans starting January 1

HRSA posted approved 340B rebate plans from ten drugmakers, covering 21 drugs such as Eliquis and Jardiance, on October 1, 2026. Rebates start January 1, 2027, and Merck, Pfizer and AstraZeneca apply them to every covered entity type. Sites send claims to the Beacon platform within 45 days, and drugmakers must pay or deny within 10 days.

Santa Clara's Measure A money stays on hold until two lawsuits end

On September 30, 2026, San José Spotlight reported that Measure A revenue, an estimated $330 million a year for Santa Clara County's public health system, is tied up until two lawsuits are resolved. An appeals court rejected one challenge on September 23. A second, from the Silicon Valley Taxpayers Association, goes to Superior Court on October 16.

Treasury mails $500 refund checks to 950,000 HealthCare.gov enrollees

On September 30, 2026, the Treasury Department began mailing $500 checks to 950,000 HealthCare.gov enrollees in 30 states, an administration official told ABC News. The administration calls them refunds of marketplace user fee overcharges. Primary recipients have incomes above 400% of the poverty level. Texas and Florida have the most recipients. The enhanced subsidies have yet to be renewed.

Health centers can apply for Medi-Cal navigator grants due October 30

On September 29, 2026, CPCA and DHCS posted two Medi-Cal navigator grants for health centers, due October 30. A $3.165 million track serves adult expansion members facing work rules and needs past AB 102 or SB 154 navigator experience. A $7.12 million track serves UIS members moving to fee-for-service.

Lawsuit sends LA County's Measure ER health tax money into escrow

On September 29, 2026, Los Angeles County's chief executive told supervisors that an August lawsuit forces all Measure ER revenue into escrow until the case ends. The final budget counts no Measure ER money this year, and LA Health Services will use $784.5 million in reserves. Clinics expecting Measure ER contracts should plan without that money for now.

Berkeley poll shows California voters split on Prop 40

On September 25, 2026, the Berkeley IGS Poll reported that 45% of likely voters back Proposition 40, the one-time billionaire tax, and 42% oppose it. Proposition 3, which would make an existing high-income tax permanent, led 54% to 34%. The poll surveyed 4,512 likely voters from September 15 to 20.

SAMHSA awards $247.9 million for addiction treatment and mental health

SAMHSA announced $247.9 million in grants on September 25, 2026, for addiction treatment, overdose prevention and mental health services. The largest pieces are $69.4 million to widen access to medications for opioid use disorder and $54.9 million for school mental health through Project AWARE. Health centers that offer this treatment can ask local grantees about referral partnerships.

HRSA awards $89.3 million for rural addiction treatment in 45 states

On September 25, 2026, HRSA announced $89.3 million through the Rural Communities Opioid Response Program for rural communities in 45 states and one territory. The largest piece is $62.7 million for RCORP-Impact to expand substance use disorder treatment and recovery services. Rural health centers can check the award lists for local network partners.

CMS stops Basic Health Program funding for many lawfully present immigrants

On September 25, 2026, CMS said Basic Health Program payments will stop counting many lawfully present immigrants starting January 1, 2027. Permanent residents, Cuban and Haitian entrants and COFA migrants still count. CMS will not act against states that stop covering the others from 2027 through 2029.

KFF tracker shows Medicaid enrollment fell 5.1 million in a year

KFF's enrollment tracker, updated September 25, 2026, shows Medicaid enrollment fell by 5.1 million, or 6%, from June 2025 to June 2026. Total Medicaid and CHIP enrollment dropped in 49 states and DC, from a gain under 1% in Iowa to a 19% drop in Indiana, leaving 73.2 million people enrolled.