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Public Law 119-21, Section 71120, requires states to charge more than $0 for some services for certain expansion adults above 100% of the poverty level starting October 1, 2028. The general ceiling is $35, with separate drug limits.
California ballot initiative 25-0008, analyzed by the Legislative Analyst's Office in February 2026, would require health centers to spend at least 90% of revenue on direct patient care and report their finances in full.
L.A. Care Health Plan, the nation's largest publicly operated health plan, filed a WARN notice for 225 layoffs effective March 13, 2026, citing federal funding cuts, Becker's Payer Issues reported.
At NACHC's Policy & Issues Forum, February 9-12, 2026, leaders called the $4.6 billion Community Health Center Fund the largest increase in a decade and warned it expires December 31, 2026 without reauthorization.
NACHC's workforce report, released in February 2026, finds 55% of community health centers face critical staffing shortages. Vacancy rates top 20% for physicians, nurses and behavioral health providers.
Santa Clara County is eliminating 365 full-time-equivalent positions across its health system as part of $183 million in cuts to address a $470 million county budget deficit. The cuts reach clinical, administrative and support staff.
California's SB 525 raises the health care minimum wage for health center workers in steps to $25 an hour by 2027, as of June 2025. It lifts pay floors for MAs, front desk and entry-level clinical staff.
Community health centers in California's San Joaquin Valley warn of a financial 'tsunami' as federal Medicaid cuts add to rising costs. Their patients are mostly Latino farmworkers who rely heavily on Medi-Cal.
The National Immigration Law Center says, as of February 2026, that providers have no federal duty to ask or report immigration status, and HIPAA generally limits disclosure, though exceptions and state rules can apply.
Section 71120 cost sharing starts October 1, 2028. Keep a dated list of primary sources, list the expansion products, services and sites that may be in scope, and approve bilingual scripts.
NACHC's funding page, as of February 2026, gives sector funding context. Before a board plan, confirm current fund authority and each local payer, grant and sliding-fee rule, then run downside scenarios with named assumptions.
A Kaufman Hall report in February 2026 found financial distress drove 43% of health care mergers and acquisitions in 2025, a record. Stressed hospitals and clinics being bought or closed push patients to the remaining community providers.
HRSA is aligning FY2026 health center grants with the administration's Make America Healthy Again initiative, as of February 2026, shifting priorities toward chronic disease prevention, nutrition and mental health.
Private equity-backed Prospect Medical Holdings kept closing facilities and selling assets in LA County as of February 2026, ElevenFlo reported. Advocates warn closures in under-served areas push more patients to health centers without more funding.
CHCF's San Joaquin Valley market report, cited in January 2026, says United Health Centers launched a for-profit independent practice association called United Physicians Network.