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Sen. Durazo Introduces Bill to Reverse 2026 Medi-Cal Undocumented Adult Coverage Rollback — Long-Shot Restoration Vehicle

California State Senator María Elena Durazo (D-Los Angeles) introduced legislation to reverse the Newsom administration's enrollment freeze (Jan 1, 2026), dental cuts (July 1, 2026), and $30/mo UIS p…

CalAIM 1115 Waiver Renewal Pending CMS Approval — $1.2B/yr ECM Funding on Dec 31, 2026 Cliff

California's CalAIM 1115 waiver renewal application comment period closed March 12, 2026, with the existing waiver expiring December 31, 2026. CMS approval is pending — the May 2026 to August 2026 wi…

LA Measure ER on June 2 Ballot — $1B/Year Sales Tax for FQHCs + Public Hospitals, Polling Shows 47% No / 45% Yes

LA County Measure ER — a half-cent sales tax raising the county rate to 10.25% — appears on the June 2, 2026 ballot. Projected revenue: $1B/year for Medi-Cal providers (FQHCs and public hospitals) th…

CPCA + Open Door File Federal Lawsuit to Block SEIU-UHW 90% Mission-Spend Ballot Measure — Federal Preemption Argument

The California Primary Care Association (representing 2,300+ clinics) and Open Door Community Health Centers (Humboldt/North Coast FQHC) filed a federal lawsuit on April 30, 2026 in the U.S. District…

AB 108 Signed — $25M Emergency Grants for Distressed Hospitals + Senate Proposes $200M Expansion (Precedent for FQHC Liquidity Grants)

Governor Newsom signed AB 108 in early May 2026, creating a $25M one-time emergency grant fund for distressed hospitals (eligibility: nonprofit/public, <10 days cash on hand, exhausted other options,…

Federal Government Appeals 340B Child Site Ruling — FQHC Site-Expansion Strategies Back in Legal Limbo

The federal government has appealed the March 3, 2026 district court ruling that struck down HRSA's 340B child site registration requirement. The original ruling let 340B child sites access discounts…

Hospitals File Emergency Court Order to Block 340B Rebate Pilot — Third Litigation Front Opens

Hospital plaintiffs filed an emergency motion in late April / early May 2026 seeking an injunction against HRSA's 340B Rebate Model Pilot Program, alleging irreparable harm. This is the third litigat…

Newsom May Revision Drops Mid-May 2026 — FQHC Watch Items: H.R. 1 Absorption, MCO Tax, Prop 35 Allocations, Worker Reqs Cost

California Governor Newsom's FY2026-27 May Revision is expected mid-May 2026, his last gubernatorial budget. The January proposed budget projected a $2.9B deficit and $1.1B in net Medi-Cal cost press…

CPCA + Open Door File Federal Lawsuit (N.D. Cal.) to Block SEIU-UHW 90% Mission-Spend Ballot — Federal Preemption Argument

California Primary Care Association (representing 2,300+ clinics) and Open Door Community Health Centers filed a federal lawsuit in the Northern District of California April 30, 2026, asking the cour…

California Senate Advances SB 915 + SB 1323 — ICE Restrictions in Hospital and FQHC Patient Rooms; Bills Clear Health and Judiciary Committees

SB 915 (Menjivar) prohibits 'blackout policies,' bars ICE agents from patient rooms without legal authorization, requires staff to document refusals, and bans agents from making medical or interpreta…

AHA Files En Banc Review Petition After 4th Circuit Blocks WV 340B Contract Pharmacy Law — Decision Expected Mid-May

American Hospital Association filed en banc review petition April 17 after 4th Circuit panel blocked West Virginia's S.B. 325 (which forced manufacturers to ship 340B drugs to contract pharmacies). C…

California Restored Adult Medi-Cal Vision Benefit Jan 1, 2020 — But Eyeglasses Coverage Varies by Managed Care Plan

California's adult Medi-Cal vision benefit was restored Jan 1, 2020 via the FY 2019-20 budget ($26M annual for optical services). Adults aged 21+ get comprehensive eye exam every 24 months, frames + …

CA AB 407 (2021) Massively Expanded Optometry Scope — Anterior Segment Treatment, Oral Rx, Immunizations Including COVID Vaccines

AB 407 (Salas, signed 2021, effective Jan 1, 2022) significantly expanded California optometry scope. Authorized: treatment of all non-cancerous anterior-segment conditions; topical and oral non-cont…

CA SB 776 Mobile Optometry Registry Effective Jan 1, 2026 — Enables Compliant Mobile Vision Vans for FQHC Partnerships

SB 776 (Cabaldon, 2025) signed Oct 13, 2025 — primary effective date Jan 1, 2026 for mobile optometric office registry. Establishes formal registration framework for mobile optometric offices, raised…

AB 2161 Medi-Cal Work/Community Engagement Requirements — 'Do Pass' Committee Recommendation

AB 2161 — directing DHCS to implement work/community engagement requirements for Medi-Cal applicants and beneficiaries under the 2025 federal law 'in ways that are least administratively burdensome' …

SEIU-UHW Submits Signatures for California Executive Pay Cap Ballot Initiative — Second Front on FQHC Compensation

SEIU-UHW submitted signatures April 3, 2026 for two parallel California ballot initiatives: the 90% mission-spend measure (already tracked) AND a NEW executive compensation cap targeting nonprofit cl…

Medicare Telehealth Distant-Site Flexibilities for FQHCs Extended Through Dec 31, 2027

The Consolidated Appropriations Act 2026 (H.R. 7148) extends FQHC/RHC ability to serve as Medicare distant-site telehealth providers for non-behavioral-health visits through December 31, 2027. This p…

HRSA 340B Rebate Model RFI — Comment Deadline April 20

HRSA's Request for Information on the 340B rebate model closes April 20, 2026. FQHCs have a narrow window to shape how manufacturer rebates, contract pharmacy oversight, and documentation requirement…

KFF: California Faces $3B Deficit While Implementing Work Requirements That Could Disenroll 1.4 Million

KFF publishes the most detailed analysis of California's work requirements implementation challenges. Key data: FY2027 deficit of $3B (growing to $22B by FY2028), $1.1B Medicaid cost from reconciliat…

California Billionaire Tax Act Proposed: $100B Revenue Source Could Offset H.R. 1 Healthcare Cuts

A proposed California Billionaire Tax Act would generate up to $100B in state revenue, explicitly framed as a response to H.R. 1 stripping $100B from CA healthcare over 5 years. If enacted, this coul…

SEIU-UHW Submits Ballot Signatures for 90% Patient Care Spending Mandate — CMA Opposes as 'Dangerous'

SEIU-UHW submitted ballot signatures for two California initiatives: one capping executive pay at healthcare companies and another requiring community health clinics to spend 90% of revenue on patien…

LAO: Counties Need 2,400+ New Eligibility Workers for H.R. 1 — Zero Funded, Creating Second Disenrollment Pathway

The CA Legislative Analyst's Office details the massive staffing gap counties face implementing H.R. 1. Counties estimate needing 2,000+ additional Medi-Cal eligibility workers and 400+ CalFresh work…

AB 2161: Bill to Block Work Requirements for State-Funded Undocumented Medi-Cal Coverage

Oakland Democrat Mia Bonta introduced AB 2161, which would prohibit California from imposing federal work requirements on individuals whose Medi-Cal coverage is entirely state-funded — including undo…

NACHC Recommends CHCs as Volunteer Sites to Fulfill Medicaid Work Requirements — CMS Rule Expected June 2026

NACHC issued updated guidance on Medicaid work requirements (80 hrs/month, effective Dec 31, 2026). Key recommendation: states should permit patients to volunteer at health centers to fulfill work re…

H.R. 1 Caps Medi-Cal Directed Payments — Provider Rates Will Edge Toward Medicare Levels by 2028

A distinct revenue threat beyond PPS elimination: H.R. 1 caps state-directed payments, ending California's ability to direct managed care plans to pay providers at commercial insurance rates. Provide…

Bipartisan Bill H.R. 7391 Would Exempt FQHCs from 340B Rebate Model — 35 Cosponsors

Reps. Auchincloss (D-MA) and Bergman (R-MI) introduced the Community Health Center Drug Pricing Protection Act to exempt FQHCs from HRSA's 340B Rebate Model Pilot Program. The bill mandates upfront c…

H.R. 1 Signed: Largest Medicaid Cuts in U.S. History

The 'One Big Beautiful Bill' includes $1 trillion in national Medicaid cuts over 10 years, with California projected to lose $30 billion annually. Work requirements, enrollment freezes, and PPS rate …

California Sues Federal Government Over $600M in Health Funding Cuts

California Attorney General files suit challenging federal clawback of $600 million in health funding, arguing the cuts violate federal spending agreements and disproportionately harm safety-net prov…

CHW Medi-Cal Billing Codes Now Active: Structural Shift for FQHC Hiring

Community Health Worker services are now a billable Medi-Cal benefit. FQHCs can bill for CHW encounters, creating a sustainable funding stream for positions previously dependent on grants. This is th…

SB 525: Healthcare Minimum Wage Rising to $25/hr by 2027 for FQHCs

California's phased healthcare minimum wage law reaches $25/hr for FQHC workers by 2027. This restructures compensation across the sector — raising floors for MAs, front desk, and entry-level clinica…

FQHC Transparency Ballot Initiative Filed — Could Appear on Nov 2026 Ballot

California ballot initiative #25-0008 proposes requiring FQHCs to spend at least 90% of revenue on direct patient care and services, with full financial transparency reporting. If it qualifies for th…

California Democrats Push to Restore Healthcare Benefits for Undocumented Immigrants

California Democratic legislators introduce measures to restore Medi-Cal benefits for undocumented adults that were frozen in January 2026, citing the public health and economic costs of coverage gap…

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 …

SD County Supervisors Vote to Overhaul Safety Net Program — 400K at Risk

San Diego County Board of Supervisors voted 4-1 to reform County Medical Services, the most restrictive safety-net program among large CA counties. H.R. 1 will strip Medi-Cal from an estimated 75,000…

CA Eliminates FQHC PPS Rates for Undocumented Patients July 2026 — $1B Annual Revenue Impact

Starting July 1, 2026, California's budget eliminates use of the Prospective Payment System for FQHC services to state-only-funded individuals with unsatisfactory immigration status (UIS). FQHCs will…

CalAIM Waiver Expires December 31, 2026 — $1.2B in ECM/Community Supports at Risk

California's CalAIM 1115 and 1915(b) waivers expire December 31, 2026. DHCS has indicated it will seek renewal, but no formal application has been submitted. If not renewed, $1.2 billion annually in …

AB 1460: California's 340B Contract Pharmacy Protection Bill Expected to Return in 2026

AB 1460 (Assemblymember Chris Rogers, D-Santa Rosa) would prohibit pharmaceutical manufacturers from restricting 340B contract pharmacy arrangements. The bill passed the Assembly in 2025 but stalled …

Health Net Commits $1M to Prepare 4.7M Medi-Cal Members for Work Requirements

Health Net (Centene subsidiary) launched 'Get Informed, Stay Covered' — the first managed care plan to begin formal member outreach for H.R. 1 work requirements taking effect January 2027. California…

Nebraska Becomes First State to Enforce Medicaid Work Requirements May 1

Nebraska will enforce 80-hour/month work requirements starting May 1, 2026 — 8 months ahead of the federal January 2027 mandate. This is the first real-world test of how work requirements affect comm…

HRSA 340B Rebate Model RFI: Comment Deadline April 20 — Possible Expansion to All IRA Drugs

After a Maine federal court vacated the original 340B rebate pilot program, HRSA is gathering stakeholder input with a 60-day comment window closing April 20. HRSA has signaled it may expand the reba…

HHS Shuts Down Minority Health Offices — CLAS Training Infrastructure at Risk for FQHCs

The CMS Office of Minority Health (~40 employees eliminated) and HHS Office of Minority Health have been restructured under federal cost-cutting. OMH sponsors Think Cultural Health and free CLAS Stan…

LAO: H.R. 1 Will Cost California $3.2B Through Provider Tax Restrictions and FMAP Cuts

The California Legislative Analyst’s Office published its April 6 fiscal analysis quantifying H.R. 1’s damage: $5.1B in provider tax revenue eliminated, administrative cost sharing drops to 25% feder…

LA County Medi-Cal Enrollment Crisis: Redeterminations + Asset Limits + Undocumented Cutoffs Converge

Three simultaneous Medi-Cal eligibility changes hit LA County in 2026: (1) asset limits reinstated Jan 1 ($130K individual), (2) undocumented adult enrollment frozen Jan 1, (3) H.R. 1 accelerated red…

Trump Administration Files Amicus Brief Siding with Pharma Against 340B in Louisiana Federal Case

The US government filed an amicus brief in a Louisiana federal 340B case siding with pharmaceutical manufacturers, arguing states cannot enforce 340B contract pharmacy protections. Combined with a Fo…

California DOJ Charges $267M Hospice Fraud Ring — Tightens Medi-Cal Program Integrity Scrutiny

'Operation Skip Trace' — CA DOJ charges 21 individuals in a $267M hospice fraud scheme involving 14 fraudulent hospice companies using stolen identities enrolled in Medi-Cal. While not FQHC-specific,…

KFF: California Faces $22B Deficit by FY2028 While Implementing Medicaid Work Requirements — 1.4M Disenrollments Expected

KFF's deep-dive shows California must implement Medicaid work requirements (affecting ~5M expansion enrollees) while managing a projected $3B deficit for FY2027 growing to $22B by FY2028. The state f…

CMS Interim Final Rule on Medicaid Work Requirements Due June 1 — Will Define Exemptions, Reporting, and Enforcement

CMS must issue an Interim Final Rule by June 1, 2026 defining critical work requirement implementation details: exemption criteria, reporting mechanisms, compliance verification, and non-compliance c…

Executive Order 14398 Bans DEI Activities by Federal Contractors — FQHCs as HRSA Grantees Face Compliance Risk

Trump signed EO 14398 prohibiting 'racially discriminatory DEI activities' by federal contractors and grantees. FQHCs receiving HRSA Section 330 grants face compliance deadlines: contract clauses (30…

PhRMA Sues Washington State Over 340B Contract Pharmacy Law — Ruling Will Set National Precedent for CA AB 1460

The pharmaceutical industry trade group PhRMA filed suit April 15 against Washington State's SB 5981, which requires drug manufacturers to reimburse 340B-covered entities when contract pharmacies are…

House Passes Budget Reconciliation Framework April 10 — Medicaid Cuts Now Move to Senate

The U.S. House passed a budget reconciliation framework on April 10, 2026 enabling the Senate to proceed with work requirements, per-capita caps, and FMAP reductions. NACHC calls it the most conseque…

Federal Register Rule Grants States Flexibility to Implement Medicaid Work Requirements Before January 2027 Deadline

An HHS rule published March 2, 2026 in the Federal Register (document 2026-04095) gives any state flexibility to implement Medicaid work requirements before the January 2027 federal statutory deadlin…

SB 1422 Committee Hearing April 20 — Bill to Restore Full Medi-Cal for Undocumented Adults Faces Critical Gate

Sen. Durazo's SB 1422 — which would restore full Medi-Cal eligibility for undocumented adults, reversing the January 2026 enrollment freeze — reaches its first committee hearing April 20, 2026. CPCA …

San Diego County Activates CalFresh and Medi-Cal Eligibility Restrictions — 400K+ Enrollees Affected

Effective April 1, 2026, lawfully present noncitizens in San Diego County lost CalFresh eligibility, with an 80-hour monthly work requirement for most CalFresh adults starting June 1 and Medi-Cal wor…

ACA Enhanced Premium Tax Credits Expired Jan 1 — Nearly 2 Million CHC Marketplace Patients Face Coverage Loss

ACA enhanced premium tax credits expired January 1, 2026, causing marketplace premiums to more than double (+114% on average). Geiger Gibson Center projects nearly 2 million CHC marketplace patients …

Cal Budget Center Publishes Definitive Bilingual Timeline of All Medi-Cal + CalFresh Cuts — Primary Planning Resource for FQHCs

The California Budget Center published a bilingual timeline mapping every eligibility deadline, enrollment freeze date, and administrative burden change to a calendar date — quantifying up to 2 milli…

SB 1422 Passes Senate Health Committee 9–2 — Durazo Bill to Restore Medi-Cal for Undocumented Adults Advances to Appropriations

SB 1422 passed the Senate Health Committee 9–2 on April 8, 2026 and was re-referred to Appropriations. The bill would reverse the January 2026 enrollment freeze for undocumented adults aged 19+, dire…

California AB 1113 Would Require Nonprofits to Spend 90% on Mission — FQHCs with Holding Companies or Pharmacy Subsidiaries Face Compliance Risk

AB 1113, advancing in the California Legislature, would require nonprofit health organizations to spend at least 90% of revenue on their stated mission, with penalties for excess executive compensati…

NACHC Warns Senate Finance: Reconciliation Bill Would Cut $7B from Community Health Centers Over 10 Years — 'The Most Significant Threat in 60 Years'

NACHC submitted formal testimony to the Senate Finance Committee warning that H.R. 1's combined Medicaid provisions — per-capita caps, work requirements, FMAP reductions, and Section 330 grant cuts —…