California: the record

AB 1460 (CA 340B Contract Pharmacy Protection) Clears Assembly, Amended in Senate to Add Reporting

AB 1460 would bar drug manufacturers from restricting 340B contract-pharmacy arrangements for California covered entities — closing a gap NACHC's tracker flags: California's SB 786 (2023) protects 340B savings from PBM discrimination…

SB 903 (AI in Mental Health) is on the governor's desk

Event: May 26

SB 903, the Wellness and Oversight for Psychological Resources Act (Sen. Steve Padilla, D-18), passed the California Senate 39-0 and advanced to the Assembly.

May Revision Proposes MCO Tax Renewal

Event: May 14

Governor Newsom's 2026-27 May Revision proposed renewing the Managed Care Organization (MCO) tax — which expires Dec 31, 2026 and is one leg of the December 'triple cliff' already tracked — as a novel two-component structure: one component 'substantially…

Monterey County Relaunches 'Esperanza Care' July 1, County-Funded Coverage for 500 Undocumented Adults Losing Medi-Cal

Event: May 27

Monterey County's Board of Supervisors voted in late May 2026 to relaunch 'Esperanza Care' effective July 1 — a county-funded program covering up to 500 undocumented adults at ≤100% FPL who lose Medi-Cal under the H.R. 1 / UIS-freeze coverage rollbacks.

CHCF Publishes 2026 California Community Clinics Almanac

The California Health Care Foundation released its 2026 California Community Clinics Almanac on May 28 — the authoritative annual dataset on the state's community health center sector.

Alameda County's $6.7B FY2026-27 Budget Closes a $91.4M Gap Without Layoffs

Alameda County's recommended FY2026-27 budget, presented to supervisors May 28, closes a $91.4 million spending gap without layoffs or major service cuts — buoyed in part by the Measure W sales tax.

SLO County Closes Paso Robles Health Clinic While Balancing a $38.5M Deficit, Patients Redirect to an FQHC

San Luis Obispo County is closing its Paso Robles county health clinic at the end of May 2026 as part of balancing a $38.5 million budget deficit that eliminates a range of public-health services; budget hearings continue in June.

California Submits CalAIM 1115 Renewal to CMS, ECM + Community Supports Framework Pitched Through 2031

Event: May 11

DHCS formally submitted its CalAIM Section 1115 demonstration renewal application to CMS on May 11, 2026, requesting a five-year term (Jan 1, 2027 – Dec 31, 2031).

California's 4-Bill H.R. 1 Mitigation Package Clears Appropriations + Floor Votes, Advocacy Coalition Pushes Cost-Sharing, Retroactive Coverage, Renewal Automation, Transparency

A four-bill California package designed to blunt H.R. 1's Medi-Cal damage advanced through Appropriations (May 14) and onto floor votes the week of May 22-26, co-sponsored by Western Center on Law & Poverty, Justice in Aging, the National Health Law Program…

California's 4-Bill H.R. 1 Mitigation Package Advances, Cost-Sharing Cap, Retroactive Coverage, Renewal Automation, Disenrollment Dashboard

UPDATE (Aug 18, 2026) — three of the four are dead. At the Aug 13 suspense hearing AB 2208, AB 2201 and SB 1202 were all held in committee; only AB 2161 survived (as amended).

LA County DHS Launches 'Save Our Safety Net', Consolidates 3 Health Centers + System-Wide Hiring Freeze as Federal Cuts Hit $700M by 2029

LA County Department of Health Services (DHS — the public hospital/clinic system, distinct from DPH) announced 'Save Our Safety Net' (SOS) on May 28, 2026, relocating Antelope Valley, Torrance…

Santa Clara's Public Hospital System Faces +$231M State May-Revise Hit on Top of Federal Cuts, FQHC Referral Backstop Strained

Event: May 25

California's May Revision layers an additional $231M (FY26-27), rising to $322M (FY27-28), in losses onto Santa Clara Valley Medical Center — the state's 2nd-largest public hospital system — on top of federal H.R. 1 cuts.

FQHC Dental Readiness for July 2027: Separate Benefit Scope, Emergency Coverage, Eligibility Exceptions, and Revenue Scenarios

Event: Jul 1

DHCS's current provider-facing dental page makes the July 1, 2027 change operationally narrower than the earlier “two million immigrants lose dental” shorthand. Full dental continues through June 30, 2027.

Public Health Watch calculated an 86,000 January-February enrollment change

KVPR republished a Public Health Watch analysis that calculated more than 86,000 people without legal status left or were denied Medi-Cal in January and February 2026, using California Health and Human Services Adult Expansion data…

CalFresh Federal Work Requirements Take Effect June 1, FQHC SDOH Spillover Imminent

Event: May 22

New federal CalFresh (SNAP) work requirements under H.R. 1 take effect June 1, 2026 — 4 days from this update.

California Hospital Association Warns FQHC Closures Will Drive Up ED Visits, First Time Hospital Lobby Publicly Backs FQHC Sustainability

Event: May 22

California Hospital Association VP of Policy Sheree Lowe publicly warned that FQHC closures will drive up emergency department visits and emergency-response strain…

San Bernardino County Releases $10.9B FY2026-27 Recommended Budget, Board Adoption June 9

Event: May 21

On May 21, 2026 San Bernardino County released its $10.9B FY2026-27 recommended budget. CEO Luther Snoke noted spending decreased $26.1M vs. Mid-year (one-time funding obligations from 2025-26 rolling off).

San Diego County Releases $9.1B FY2026-27 Recommended Budget With Explicit H.R. 1 Safety-Net Protection, Public Hearing June 1

Event: May 18

On May 18, 2026 San Diego County released its $9.1B FY2026-27 recommended budget (6% increase over 2025-26) with explicit language that it 'supports health and safety-net services impacted by federal policy changes of H.R. 1.' Key allocations: $3.5B for HHSA…

SF Mayor Lurie Commits $34M + 154 HSA Staff to Absorb H.R. 1 Medi-Cal/CalFresh Paperwork

Event: May 21

SF Mayor Daniel Lurie's proposed FY26-27 budget allocates $34M from the city's federal-funding reserve to hire 154 new Human Services Agency staff dedicated to processing Medi-Cal and CalFresh paperwork, eligibility verification, employment-training referrals…

SEIU 1021 + AHS Workers Lead Statewide "Fight For Our Health" Rally Day at Capitol, Third Coalition Pressure Point on May Revise

Event: May 21

On May 21, 2026, SEIU 1021 members from Alameda Health System and Alameda County joined community members across California for a coordinated 'Fight For Our Health' rally day…

Venice Family Clinic CEO Discloses Hiring Freeze + 20% Budget Loss Anticipating Medi-Cal Cuts, First Named FQHC Freeze in 2026

Event: Apr 29

Venice Family Clinic CEO Dr. Mitesh Popat publicly confirmed instituting a hiring freeze and 'significant operational efficiencies' in anticipation of losing ~20% of the clinic's annual budget to combined state and federal Medi-Cal cuts.

AB 403, CHW/Promotora Medi-Cal Services Transparency Act Advances

AB 403 (Asm. Liz Ortega, D-20) would require DHCS, beginning July 1, 2027, to publish an annual analysis of Community Health Worker / Promotora / Representative Medi-Cal benefit utilization, reimbursements, and CHW/beneficiary demographics.

AB 403 Would Force DHCS to Publicly Report CHW/Promotora Medi-Cal Use, After Fewer Than 6,000 of 15M Beneficiaries Accessed the Benefit

AB 403 (Asm. Liz Ortega, D-20) — the Community Health Worker/Promotora/Representative Medi-Cal Services Transparency Act — would require DHCS, beginning July 1, 2027, to publish an annual analysis of CHW Medi-Cal benefit utilization, reimbursements…

OCHIN + C3 Launch a National Medicare ACO Built for OCHIN Epic FQHCs

Event: Mar 17

Community Care Cooperative (C3), a nonprofit FQHC-governed accountable care organization, partnered with OCHIN (announced March 17, 2026) to launch a national Medicare ACO purpose-built for OCHIN Epic health centers.

SEIU 721 WINS Certification at Bartz-Altadonna Community Health Center (96-19), Largest CA Community-Clinic Election Win of 2026

What began as a union-sourced organizing report is now an NLRB-certified election win.

San Diego County's $9.1B FY2026-27 Budget Explicitly Backstops Safety Net vs. H.R. 1, 60-Day Reform Clock Starts at Adoption

Event: May 18

San Diego County released a $9.1B recommended FY2026-27 budget on May 18 (a 6% increase) that explicitly 'supports health and safety-net services impacted by H.R. 1' and expands behavioral health capacity.

Santa Clara County's $787M Deficit Triggers Deep Safety-Net Cuts, Compounding February's $183M Health-System Reduction

Event: May 5

Santa Clara County's May 5 budget makes steep cuts across social safety-net programs to close a $787M deficit — layering on top of the $183M health-system reduction from February.

California AB 2756 is now law, Chapter 309 creates public Medi-Cal vision performance reporting, with no FQHC payment change

Event: Sep 18

AB 2756 was signed and chaptered on September 18, 2026. The official California Legislative Information history records “Approved by the Governor.” And “Chaptered by Secretary of State - Chapter 309, Statutes of 2026.”

LA Measure ER on June 2 Ballot, 'Essential Services Restoration Act' Polling 45/47 Against, 12 Days to ~$1B/yr Safety-Net Backfill Vote

Los Angeles County Measure ER — officially the 'Essential Services Restoration Act for Los Angeles County' — heads to voters June 2, 2026 with polling showing 47% opposed vs. 45% in favor.

Historical May Revision Baseline: DHCS Proposed Moving About 2 Million UIS Members to Fee-for-Service January 1, 2027

Event: May 14

This record preserves what DHCS published in the May 14, 2026 May Revision: a proposal to move approximately 2 million members with unsatisfactory immigration status from Medi-Cal managed care to fee-for-service effective January 1, 2027…

Santa Barbara County Issues 84 Layoff Notices (47 from Public Health) + Public Health Pharmacy Closures, Largest Central Coast Safety-Net Cut of 2026

Event: May 13

Santa Barbara County issued layoff notices May 10-13 for 84 positions effective June 30, 2026: 47 from Public Health, 31 from Social Services, 5 Sheriff's, 1 Fire.

Kheir reported 60–100 daily resource visits and a 25–30% staffing response in May

American Community Media reported on May 19 that Kheir Clinic was assisting an average of 60–100 people per day in person with a combined set of Medi-Cal enrollment, eligibility-loss, DPSS food-assistance, and other resource needs.

Clinicas del Camino Real + Mexican Consulate Oxnard Launch 'Ventanilla de Salud', Replicable Consular-FQHC Model for Chilling-Effect Response

Event: May 15

Clínicas del Camino Real (16 health centers + 2 CAREPLUS urgent care across Ventura County since 1971) signed MOU with the Mexican Consulate of Oxnard for a 'Ventanilla de Salud' (Health Window) program — free preventive medicine delivered directly at the…

Santa Barbara County (Public Health + Social Services + Sheriff + Fire), 84 positions

Event: May 13

Santa Barbara County issued 84 layoff notices May 10-13, 2026 — 47 from Public Health, 31 Social Services, 5 Sheriff, 1 Fire — effective June 30, 2026 unless budget reversal.