RAND: State Medicaid Budgets Will Decline by $665B Over Next Decade Under H.R. 1
Issue
A RAND Health analysis published by Stateline finds state Medicaid budgets will be reduced by a total of $665 billion over the next decade under H.R. 1. With FQHCs deriving ~43% of revenue from Medicaid, the projected decline signals sustained revenue compression for California's 213 community health centers.
CBO estimates 11.8M will directly lose coverage, plus 3.1M through marketplace plans.
Key points
- RAND: state Medicaid budgets reduced by $665 billion total over the next decade under H.R. 1
- FQHCs derive ~43% of revenue from Medicaid — sustained revenue compression ahead
- CBO estimates 11.8M will directly lose coverage + 3.1M through marketplace plans
- California's 213 FQHCs face among the largest state-level revenue impacts nationally
Sources for this story
Stateline / RAND HealthSources for your board packet
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Part of
- Medicaid financing and eligibility operations
Coverage-loss estimates
- ACA marketplace coverage and uninsured demand
FQHC Talent. (2026, March 4). RAND: State Medicaid Budgets Will Decline by $665B Over Next Decade Under H.R. 1. Source: Stateline / RAND Health. Retrieved October 6, 2026, from https://www.fqhctalent.com/intel/rand-665b-state-medicaid-decline-decade