Advocacy Watch

Tracking legislation, ballot initiatives, coalition actions, and legal rulings protecting FQHC funding. Follow-up dates, outcomes, and tools to take action.

Updated: 2026-07-04

Actions tracked

Active now

Pending votes

Upcoming follow-ups

Upcoming follow-up dates

days

Comment period closes July 6

HHS OCR Issues Interim Final Rule Extending Section 504...

Jul 6, 2026·Federal Register notice 2...AHA News coverage

days

Resolved

DOJ Extends ADA Title II 1 Year — But HHS Section 504 M...

Jul 6, 2026·DOJ Federal Register Titl...Converge Accessibility Re...

days

Confirm the Governor's signature and effective date; track whether manufacturers challenge the law as in Washington and the 4th Circuit states.

Illinois Passes Dual 340B Protection Bills (HB 2371 + H...

Jul 10, 2026·WCBU (NPR Peoria)

days

Application deadline July 15, 2026 at 3:00 PM

HCAI's Behavioral-Health Recruitment & Retention Progra...

Jul 15, 2026·MBH-RRP program page

days

Watch for a North Dakota appeal to the 8th Circuit + any read-through cited in AB 1460's Senate analysis.

Federal Judge Strikes Down North Dakota's 340B Contract...

Jul 15, 2026·North Dakota Monitor

days

Track Assembly Health Committee hearing + floor vote (June–August 2026).

SB 903 (AI in Mental Health) Passes CA Senate 39-0 — NU...

Jul 15, 2026·California Senate District 18

95 actions

ActiveFederal ActionFederal

Senate HELP Chair Cassidy Unveils Comprehensive 340B Reform Discussion Draft

Sep 1, 2026(59 days)— Watch for formal introduction and whether the health-center '340C' carve-out gains traction as the draft advances through summer 2026.

ActiveBallot InitiativeCalifornia

Last-Minute Ballot Deal Withdraws Two Healthcare Measures — but SEIU-UHW's 90% Clinic-Spending Mandate (Measure 1986) Stays on the November Ballot

Nov 3, 2026(122 days)— November 3, 2026 — the 90% clinic-spending mandate (Measure 1986) goes to voters. Track the CPCA / Open Door federal preemption suit (N.D. Cal.) for any pre-election ruling, plus campaign spending and polling on Measure 1986.

June 25, 2026: Measure 1985 ($450K hospital-exec-pay cap) and the CHA union-political-spending measure (#25-0021) were withdrawn by mutual deal; Measure 1986 (90% clinic-spending mandate) and the 5% billionaire-wealth-tax measure remain on the November 3 ballot.

Pending VoteBallot InitiativeCalifornia

SEIU-UHW Billionaire Tax QUALIFIES for November 2026 Ballot (June 17) — Newsom Rejects Union's Scaled-Back 2% Compromise

Nov 3, 2026(122 days)— RESOLVED at the June 25 deadline: NO deal on the billionaire tax. Newsom rejected the union's 2% legislative alternative, no 2% bill was enacted, and the union did NOT withdraw — so the 5% wealth tax IS on the November 3, 2026 ballot (one of 14 statewide measures). The separate June 24 SEIU-UHW/CHA mutual-disarmament deal withdrew only the exec-pay cap (#25-0009) and CHA's counter-measure (#25-0021); it did NOT touch this measure or the #25-0008 90% clinic-spending measure. Next milestone: the November 3 vote.

On the November 3, 2026 ballot — no withdrawal deal reached by the June 25 deadline.

ActivePublic StatementCalifornia

CPCA Advocates Endorses Xavier Becerra for California Governor — the FQHC Sector's First Gubernatorial Pick of the 2026 Cycle

Nov 3, 2026(122 days)— November 3, 2026 general election — Becerra vs. the second-place finisher. Track whether a Becerra win materially changes the post-cliff Medi-Cal/FQHC funding posture for the January 2027 transition.

Pending VoteLegislationFederal

House Committee Advances School-Based Health Centers Reauthorization (H.R. 8209) with NACHC Backing

Sep 15, 2026(73 days)— Check for the House floor vote and any Senate companion introduction.

PassedLegislationIllinois

Illinois Passes Dual 340B Protection Bills (HB 2371 + HB 4327) — Barring Manufacturer Contract-Pharmacy Restrictions and Mandating a State Audit

Jul 10, 2026(6 days)— Confirm the Governor's signature and effective date; track whether manufacturers challenge the law as in Washington and the 4th Circuit states.

ActiveBallot InitiativeCalifornia

Hospital Industry's Union-Spending Counter-Measure (#25-0021) Misses November Ballot While SEIU-UHW Clinic Measure Proceeds

Nov 3, 2026(122 days)— November 3, 2026 election — Measure 1986 remains on the statewide ballot; watch campaign spending, court challenges, and voter-guide arguments.

June 25 withdrawal deadline passed; the Secretary of State's qualified-measures list includes Measure 1986 but not the CHA union-spending countermeasure.

FailedBallot InitiativeContra Costa County

Contra Costa's Measure B FAILS (~42%-58%) — a ~$150M/Year County Medicaid-Backfill Tax Rejected by Voters

FAILED ~42.1% yes / ~57.9% no (June 5 count) — no local backstop for Contra Costa Health as H.R. 1 lands and signed-budget UIS/PPS risk moves into a July 1, 2027 planning horizon.

ActiveCoalition ActionTexas

TACHC Leaders Testify at Texas Capitol on Rural Health Transformation Funding and 340B

Sep 1, 2026(59 days)— Watch for the interim-charge report and any RHTP allocation guidance affecting FQHC eligibility.

ActiveFederal ActionFederal

NACHC Presses Congress for a Multi-Year Community Health Center Fund Reauthorization Before the Dec 31, 2026 Cliff

Sep 30, 2026(88 days)— FY2027 discretionary funding also expires Sept 30; a CHCF/NHSC extension is most likely to ride a year-end CR or reconciliation vehicle — track for an introduced bill.

ActiveLocal FundingCalifornia

HCAI's Behavioral-Health Recruitment & Retention Program Opens June 1 — FQHCs Eligible for Up to $20K Recruitment + $35K/Yr Supervision + $50K Student Support

Jul 15, 2026(11 days)— Application deadline July 15, 2026 at 3:00 PM — FQHCs should apply for BH recruitment/retention/supervision awards

In CourtLegal ActionFederal

Full 4th Circuit Grants En Banc Rehearing of West Virginia & Maryland 340B Contract-Pharmacy Rulings — a National Safety-Net Pharmacy Test

Aug 15, 2026(42 days)— Watch for oral-argument scheduling and the en banc decision; a ruling upholding state 340B laws would sharpen the circuit split heading toward the Supreme Court.

ActiveLegislationCalifornia

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

Pending VoteLegislationCalifornia

SB 903 (AI in Mental Health) Passes CA Senate 39-0 — NUHW-Co-Sponsored Guardrails on AI Therapy

Jul 15, 2026(11 days)— Track Assembly Health Committee hearing + floor vote (June–August 2026).

Pending VoteLegislationCalifornia

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

ActiveLegislationCalifornia

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

In CourtLegal ActionFederal

Three Health Systems Sue CVS/Caremark for ~$250M in Alleged 340B Savings Diversion (Federal RICO) — Precedent Watch for FQHC Clawbacks

Dec 1, 2026(150 days)— Watch for motions to dismiss in late 2026 and any class expansion that could reach FQHCs/340B covered entities.

ActiveCoalition ActionCalifornia

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

ActiveBallot InitiativeCalifornia

SEIU-UHW 90% Patient-Care Initiative QUALIFIES for Nov 3, 2026 California Ballot

Nov 3, 2026(122 days)— November 3, 2026 statewide vote — watch final title/summary language, voter-guide arguments, court challenges, and campaign spending.

Measure 1986 qualified for the November 3, 2026 statewide ballot after the 131st-day withdrawal deadline passed.

FailedLegislationMinnesota (precedent for California)

Minnesota 340B Hospital Protection Bill DIES on House Floor — PhRMA Lobby Outmaneuvers Senate 42-24 Passage

Sep 1, 2026(59 days)— CPCA 2027 session prep — track whether MN failure energizes CA 340B legislation

Bill failed to reach House floor vote before session-end deadline despite Senate passage 42-24

PassedLegislationMinnesota (precedent for California)

Minnesota Becomes First State to Impose 340B Covered-Entity Reporting Requirements — National Template Created

Sep 30, 2026(88 days)— Track whether CA copycat 340B reporting legislation emerges from 2027 session prep or SEIU-UHW supplemental ballot

Law passed and signed — first-in-nation 340B covered-entity reporting requirement

ActiveFederal ActionFederal

NACHC June 2-3 Hill Days Target Dec 2026 CHCF Cliff — Registration Closes May 22

Sep 30, 2026(88 days)— Fly-In concluded — the live question is now CHC Fund reauthorization beyond the Dec 31, 2026 cliff; watch FY2027 appropriations (discretionary CHC funding lapses Sept 30) for any multi-year extension

The June 2-3, 2026 Fly-In took place as scheduled — CA and national CHC advocates held hundreds of congressional meetings pressing for CHC Fund reauthorization. The ~$4.6B Community Health Center Fund was funded for FY2026 via the Consolidated Appropriations Act, 2026 (NACHC called it the largest mandatory CHC Fund increase in a decade), but a multi-year reauthorization beyond the December 31, 2026 cliff remains UNENACTED — the fight has shifted to FY2027 appropriations.

ActiveCoalition ActionCalifornia

CSAC + CWDA Counties Demand $6.4B from State to Backfill May Revise Cost-Shift

ActiveCoalition ActionCalifornia

Health4All Coalition Mobilizes Against Newsom May Revise $1.1B Additional Immigrant Medi-Cal Cuts

ActiveCoalition ActionFederal

NACHC + ACH Set Aside 340B Differences — Joint Lobby for Health Center Funding Cliff

Sep 30, 2026(88 days)— FY27 appropriations deadline — track whether unity holds through reconciliation negotiations

ActiveFederal ActionFederal

NACHC Opens Second 2026 In-District Lobby Window — May 24 to June 1

Sep 30, 2026(88 days)— In-district window and the June 2-3 DC Fly-In are done — watch FY2027 appropriations and any CHC Fund extension ahead of the Dec 31, 2026 mandatory-funding cliff

The May 24–June 1 in-district lobby window closed and was followed by NACHC's June 2-3 Washington DC Fly-In. No 2026 reconciliation cuts to health centers advanced — Senate Finance received no reconciliation instructions — but CHC Fund reauthorization beyond the December 31, 2026 cliff is still unresolved.

PassedFederal ActionFederal

HHS OCR Issues Interim Final Rule Extending Section 504 / WCAG 2.1 AA Compliance Deadline by One Year

Jul 6, 2026(2 days)— Comment period closes July 6 — CCALAC/CPCA should submit FQHC-specific comments shaping final rule

Interim Final Rule effective May 7, 2026 — 1-year extension granted; deadlines now May 11, 2027 (15+) / May 10, 2028 (<15)

ActiveLegislationCalifornia

CA Assembly Democrats Draw 'Line in the Sand' on Safety Net Cuts in 2026-27 Budget Road Map — Bicameral Counter-Position Ahead of May Revise

Newsom's May 14 May Revision did NOT honor the Assembly's 'line in the sand' — it retained the UIS Medi-Cal enrollment freeze, the July 1, 2026 UIS adult dental elimination, the ~$1B Medi-Cal Dental supplemental-payment cut, and proposed RAISING the UIS premium from $30 to $50/month. The Assembly and Senate kept pushing back, and the budget signed June 29, 2026 LARGELY honored the line. Per the Assembly Budget Committee's June 11 Floor Report, it 'delays most clinic cuts by 12 months' and appropriates $1,034,000,000 General Fund in 2026-27 to maintain clinics' PPS reimbursements for state-only Medi-Cal populations — delaying the ~$1B UIS-PPS health-center cut from July 1, 2026 to July 1, 2027 — and it also delays the UIS adult dental elimination and the Prop 56 Medi-Cal Dental supplemental-rate elimination to July 1, 2027, renews the MCO tax (dropping the Senate's $285/employee fee), and defers the enrollment-freeze pause + $30→$50 premium + $2,000 asset limit to July 2027. The caveat: it is a one-year reprieve, not a permanent repeal (all of it returns July 1, 2027 unless the next budget extends it, and the next governor inherits that).

ActiveBallot InitiativeCalifornia

100+ Organizations Formally Join CalChamber 'Affordable California' Coalition — Counter-Ballot Mobilization Phase

ActiveCoalition ActionCalifornia

Health Consumer Coalition Releases 'Medi-Cal 2030' Principles — Person-Centered Framework as Counterweight to H.R. 1 Cuts

Newsom's May 14 May Revision did NOT adopt the coalition's 'Medi-Cal 2030' principles — it maintained the January 2026 UIS enrollment freeze, kept the then-proposed July 1, 2026 UIS adult dental elimination, and proposed raising the UIS premium from $30 to $50/month. The June 29 signed budget later changed the live posture: UIS adult dental and major clinic PPS cuts were delayed to July 1, 2027, making this item historical context for the next budget fight rather than current-law July 2026 guidance.

ActiveCoalition ActionCalifornia

CCALAC + CHC Coalition Issue Public Statement Against May Revision Medi-Cal Cuts and UIS PPS Elimination

The May 14 May Revision retained the proposals CCALAC's coalition opposed — the UIS Medi-Cal enrollment freeze, the then-proposed July 1, 2026 UIS adult dental elimination, and the State-Only PPS-to-non-PPS reimbursement change. Signed-budget outcome: the June 29 budget later delayed the major UIS/PPS and UIS adult dental cuts to July 1, 2027, so the live planning posture is a one-year reprieve, not a July 2026 cut.

In CourtLegal ActionCalifornia

CHA + Community Clinic Employers File Lawsuit to Block SEIU-UHW 90% Patient Care Ballot Measure

ActiveCoalition ActionCalifornia

FY2026-27 May Revision Advocacy Window Opens — CPCA / Health4All / CCALAC Coordinated Push for FQHC-Friendly Restorations

PassedLegal ActionFederal

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

Sep 30, 2026(88 days)— Rebate pilot is vacated/remanded and not operating — watch HRSA's rebate-model RFI process; HRSA committed to at least 90 days' notice before any relaunch

Resolved in FQHCs' favor: the 340B Rebate Model Pilot was vacated and remanded to HRSA (the U.S. District Court for the District of Maine granted the parties' joint motion Feb 10, 2026, after the First Circuit denied the government's stay Jan 8), so upfront 340B discounts remain in place. HRSA reopened a notice-and-comment RFI and committed to at least 90 days' notice before any relaunch — so as of June 2026 no rebate model is operating and the emergency-injunction fight was overtaken by the vacatur.

ProposedFederal ActionFederal

H.R. 8629 — Bipartisan Bill to Build the FQHC Workforce Pipeline (NHSC Priority, Loan Repayment, CHW & BH Hiring)

Sep 1, 2026(59 days)— Track House Energy & Commerce / Ways & Means committee action; watch companion H.R. 7289.

In CourtLegal ActionCalifornia

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

PassedCoalition ActionCalifornia

CPCA Day at the Capitol Convened California CHC Advocates in Sacramento

Event held; current UIS/PPS posture should be checked against signed-budget and DHCS sources.

FailedLegal ActionNorth Dakota (federal precedent)

Federal Judge Strikes Down North Dakota's 340B Contract-Pharmacy Law — A Cautionary Precedent for CA's AB 1460

Jul 15, 2026(11 days)— Watch for a North Dakota appeal to the 8th Circuit + any read-through cited in AB 1460's Senate analysis.

H.B. 1473 struck down as unconstitutional (Supremacy + Commerce Clause); permanent injunction against enforcement.

ActiveBallot InitiativeCalifornia

CalChamber 'Affordable California' Files ~1M Signatures for November 2026 Ballot — Counter to SEIU-UHW 90% Spend Initiative

Pending VoteLegislationCalifornia

SB 1422 Placed on Senate Appropriations Suspense File April 20 — UIS Restoration Bill Now At-Risk

SB 1422 was RELEASED from the Senate Appropriations suspense file — on May 14, 2026 the committee voted 'do pass as amended' 5-2; it was read a second time and amended (May 18) and now sits at Senate Third Reading awaiting a floor vote. The bill did not die on suspense; it remains alive on the Senate floor as of June 8.

ActivePublic StatementFederal

Washington Hospital Association Files Formal Opposition to HRSA 340B Rebate Pilot — Joins AHA, ASHP, NACHC in Coalition Pressure

Sep 30, 2026(88 days)— HRSA Q3 2026 decision; track whether coalition opposition shapes pilot scope or kills it

PassedFederal ActionFederal

DOJ Extends ADA Title II 1 Year — But HHS Section 504 May 11 Deadline UNCHANGED (Confusion Risk)

Jul 6, 2026(2 days)— Resolved — HHS matched the extension; the new deadline is May 11, 2027 (15+ employees). Comment period on the HHS IFR closes July 6, 2026

The confusion was resolved in FQHCs' favor: on May 7, 2026 — four days before the May 11 cliff — HHS OCR issued its own Interim Final Rule (Fed. Reg. 2026-09266) extending the Section 504 / WCAG 2.1 AA deadline by one year, to May 11, 2027 (15+ employees) and May 10, 2028 (<15), so HHS did match the DOJ Title II extension after all. Section 504 itself remains enforceable since July 8, 2024, so the underlying obligation (and private right of action) is unchanged.

ActiveFederal ActionFederal

AHA Files Formal RFI Opposition to HRSA 340B Rebate Model — Unified FQHC/Hospital Front

Sep 30, 2026(88 days)— HRSA RFI synthesis expected Q3 2026 — track whether opposition alters rebate model design

In CourtLegal ActionFederal

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

Sep 30, 2026(88 days)— En banc GRANTED — watch for en banc argument scheduling and the full-court merits decision on the WV + MD contract-pharmacy laws

On May 28, 2026 the full Fourth Circuit GRANTED en banc rehearing of the challenges to both West Virginia's S.B. 325 and Maryland's 340B contract-pharmacy law — the opposite of a denial, so no Supreme Court petition followed. The panel decisions that had sided with drugmakers will be reheard by the full court; a merits decision is pending. Favorable for preserving state-level 340B protections (and the circuit-split posture relevant to CA AB 1460).

ActiveBallot InitiativeCalifornia

April 17 Signature Sample Check: SEIU-UHW 90% and Exec Pay Cap Initiatives at Critical Procedural Gate

ActiveFederal ActionFederal

NACHC Senate Finance Testimony: Reconciliation Would Cut $7B, Close 1 in 5 Health Centers, Displace 7.6M Patients

Sep 30, 2026(88 days)— No 2026 reconciliation markup occurred — Senate Finance got no reconciliation instructions; the health-center funding fight has moved to FY2027 appropriations and the Dec 31 CHC Fund cliff

The anticipated mid-May 2026 Senate Finance reconciliation markup did NOT occur — Senate Republican leadership pursued a narrow reconciliation package with no reconciliation instructions to the Senate Finance Committee, so no NEW health-center cuts advanced via reconciliation. NACHC's $7B / 7.6M-patients / 1-in-5-closures figures remain its standing estimate of the already-enacted H.R. 1's 10-year impact; the live federal funding threat is now FY2027 appropriations and the December 31, 2026 CHC Fund cliff.

ActiveLegislationCalifornia

NACHC State 340B Legislation Tracker — 37 States Now Protect CHC 340B Savings, California Lacks Parallel Statute

Sep 1, 2026(59 days)— Watch CPCA legislative agenda for CA-specific 340B contract pharmacy bill in 2027 session

ActiveCoalition ActionCalifornia

Health4All Coalition Mobilizes Against UIS Adult Dental Cut + $30 Premium — Distinct From SB 1422 Enrollment Defense

May Revision held the line on neither at the proposal stage: it kept the then-proposed July 1, 2026 elimination of full-scope UIS adult dental and proposed RAISING the UIS premium from $30 to $50/month. Signed-budget outcome: the June 29 budget delayed UIS adult dental to July 1, 2027, making this a historical advocacy record for the next budget cycle.

ActivePublic StatementCalifornia

Medi-Cal Optometry Rate Has Been ~$47 for 25 Years — California Optometric Association + CalMatters Push for Rate Update

Dec 31, 2026(180 days)— Track DHCS rate review schedule, CA budget cycle vision provisions, COA legislative priorities for 2027 session.

PassedFederal ActionFederal

HRSA 340B Rebate Pilot ICR Comment Window CLOSED April 27 — AHA/ASHP/NACHC/WHA All Filed Formal Opposition

Jul 15, 2026(11 days)— HRSA synthesis expected 30-60 days post-deadline

Both comment windows closed; AHA/ASHP/NACHC/WHA filed formal opposition arguing >$1B/year cost

In CourtLegal ActionFederal

PhRMA Sues Washington State Over 340B Contract Pharmacy Law — National Precedent for CA AB 1460 Hinges on Outcome

ActiveFederal ActionFederal

Eli Lilly & Novo Nordisk Activate 340B Claims-Data Mandates — FQHCs Face Operational Compliance Burden

Jul 15, 2026(11 days)— Still unresolved — HRSA has issued NO guidance allowing or barring the mandates. Lilly's June 1 letter set a June 8 cutoff to pull 340B pricing from non-compliant entities (~70% complied, ~1,000 holdouts); 9 manufacturers now require data. Watch for HRSA action and any fallout from the June 8 cutoff

In CourtLegal ActionFederal

AstraZeneca Sues Vermont Over 340B Contract Pharmacy Law — Argues Rebate Pilot Preclusion

Sep 1, 2026(59 days)— Monitor for circuit ruling by Q3 2026. Outcome shapes which state-law model (Vermont, Washington, Maine) provides the strongest precedent for any future CA AB 1460-style 340B contract pharmacy access legislation.

ActiveFederal ActionFederal

CMS Published the Medicaid Work-Requirements Interim Final Rule (CMS-2454-IFC) on June 1 — Exemption Scope Drives FQHC Patient Impact

Jul 31, 2026(27 days)— Comment period closes July 31; states begin member outreach by Aug 31 — track exemption criteria

Published June 1, 2026 as CMS-2454-IFC: 80-hour/month community-engagement requirement, effective July 31 2026, full state implementation by Jan 1 2027; comment period closes July 31.

PassedCoalition ActionFederal

NACHC In-District Advocacy Week April 14–25 — WINDOW CLOSED, NACHC P&I Forum April 28-29 Up Next

In-district advocacy window concluded April 25, 2026. Engagement metrics pending NACHC P&I Forum reporting.

ActiveCoalition ActionLos Angeles, Orange County

CCALAC + CoalitionOC Hold Joint FQHC Advocacy Summit — Unified Front on H.R. 1 Medi-Cal Cuts

In CourtLegal ActionCalifornia

California AG Opposes FQHC 340B Preliminary Injunction — State vs. Community Health Tension

PassedCoalition ActionCalifornia

MAJOR WIN: SEIU 1021 + Alameda Health System Workers Ratify New Contract — Layoff Crisis Resolved

Contract ratified. New CEO + new Director of Labor Relations + new governance model. Wage increases retroactive. Layoffs averted.

PassedCoalition ActionNational

NACHC April 14-25 In-District Advocacy Push — Window Closed, NACHC P&I Forum April 28-29 Next

In-district window concluded April 25, 2026. Engagement metrics pending NACHC P&I Forum reporting.

In CourtLegal ActionFederal

AbbVie Files Landmark 340B Lawsuit — 'Most Consequential Manufacturer Challenge to Date'

ActiveBallot InitiativeCalifornia

California Hospital Association Files Counter-Initiative Requiring Union Member Approval for Ballot Spending

ActiveFederal ActionFederal

CMS Opens $100M MAHA ELEVATE Model — FQHCs Eligible for Lifestyle Medicine Grants

Oct 1, 2026(89 days)— Check award announcements

Pending VoteBallot InitiativeCalifornia

SEIU-UHW Submits Signatures for California Executive Pay Cap Ballot Initiative — Second Front Against FQHC Leadership Comp

ActiveBallot InitiativeCalifornia

SEIU-UHW Submits 1M+ Signatures (~83% Buffer) for 90% Mission Spend + $450K Exec Pay Cap — Near-Certain November Qualification

ActiveBallot InitiativeCalifornia

CCALAC & FHCSD Lead 'Protect Access to Healthcare' Counter-Initiative — Signatures Submitted for November Ballot

FailedCoalition ActionCalifornia

CPCA + No-on-AB-1113 Coalition Mounts Legislative Opposition to SEIU-UHW 90% Mission-Spend Mandate

AB 1113 DIED on January 31, 2026 as a two-year bill (Calif. Const. Art. IV §10(c)) — it cleared an Assembly policy committee 11-1 (May 2025) but stalled on the Appropriations suspense file and never reached the Assembly floor. The SEIU-UHW 90% mission-spend effort now runs solely through the qualified ballot measure (Initiative #25-0008 / Measure 1986, Nov 3, 2026), which CPCA and Open Door Community Health Centers are suing in federal court to block. CPCA's opposition has shifted entirely from the bill to the ballot and the lawsuit.

PassedLegal ActionFederal

D.C. District Court Vacates HRSA's 2013 340B GPO Prohibition Policy — APA Win Weakens HRSA Regulatory Footing

Sep 30, 2026(88 days)— HRSA expected to issue revised GPO guidance Q3 2026 — track whether replacement rule narrows or expands FQHC 340B exposure

GPO Prohibition vacated; child site registration requirement also vacated. Remanded to HRSA for revised rulemaking.

ActivePublic StatementCalifornia

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

ActiveBallot InitiativeCalifornia

California Billionaire Tax Act: $100B Healthcare Funding Ballot Measure Gains Momentum

Aug 1, 2026(28 days)— Check if sufficient signatures collected for November ballot

FailedLegal ActionFederal

4th Circuit Blocks West Virginia's 340B Contract Pharmacy Law — First Federal Appeals Win for Drugmakers, Weakens CA AB 1460 Path

State 340B contract pharmacy law blocked — state/FQHC side lost; manufacturer side won

In CourtLegal ActionFederal

Novartis and AbbVie Sue Washington Over Its New 340B Contract-Pharmacy Protection Law — a Direct Precedent Watch for California's AB 1460

Sep 1, 2026(59 days)— Injunction DENIED June 9; law in effect June 10. Litigation continues on the merits — watch for appeal to the 9th Circuit and any Supreme Court cert petition consolidating the WV/MS circuit split. Read alongside CA AB 1460 (pending in Senate Health; no confirmed 2026 hearing date).

Preliminary injunction denied June 9, 2026 (Judge Estudillo); SB 5981 took effect June 10, 2026 with $5,000/day penalties. Merits litigation continues.

In CourtLegal ActionFederal (Washington)

AbbVie + Novartis File Federal Lawsuit Against WA 340B Transparency Law — Precedent Risk for CA AB 1460

Sep 30, 2026(88 days)— Track district court ruling; precedent for CA AB 1460

In CourtLegal ActionFederal

Third Circuit Revives False Claims Suit Against AbbVie, Novartis, AstraZeneca, Sanofi for 340B Pricing Fraud

Sep 1, 2026(59 days)— Monitor district court remand proceedings through Q3 2026. Discovery filings could surface evidence usable in California AB 1460-style legislation. NACHC and 340B Health are coordinating amicus briefs.

ActiveFederal ActionFederal

EO 14398 FAR Guidance Deadline May 25 — FQHCs Must Review HR Policies for DEI Compliance

Jul 24, 2026(20 days)— FAR guidance issued — but it binds procurement contractors, not Section 330 grantees; watch the July 24 agency contract-modification effort and any HHS/OMB grant-side DEI conditions

The FAR Council issued the EO 14398 implementation guidance EARLY — on April 17, 2026, ahead of the ~May 25 deadline — creating FAR clause 52.222-90 (required in new solicitations from April 24; a certification that the contractor will not engage in 'racially discriminatory DEI activities,' material to payment under the False Claims Act). Key nuance for FQHCs: the clause covers PROCUREMENT CONTRACTORS, not federal grantees, so HRSA Section 330 grants are generally OUTSIDE it — any DEI-grant risk for FQHCs would flow from separate HHS/OMB grant terms (e.g., MAHA's DEI deprioritization), not FAR 52.222-90. Agency contract-modification effort is due ~July 24.

PassedLegal ActionFederal

Ninth Circuit Rules FQHCs Can Sue Drug Makers for 340B Overcharges Under False Claims Act

Sep 1, 2026(59 days)— Watch for manufacturer appeals or settlements

Ruling issued March 17 — FCA suits may proceed for 340B overcharges

In CourtLegal ActionCalifornia

NLRB Seeks Forced Union Recognition at Innercare — ALJ Hearing Underway in San Diego

ActiveLegislationCalifornia

Sen. Durazo Introduces SB 1422 to Reverse the UIS Medi-Cal Enrollment Freeze

Newsom's May 14 May Revision did NOT soften the UIS cuts at the proposal stage — the enrollment freeze, then-proposed July 1, 2026 dental elimination, and premium increase were retained. The June 29 signed budget later delayed the major UIS/PPS and UIS adult dental cuts to July 1, 2027, so Durazo's SB 1422 remains restoration context rather than a July 2026 bridge.

PassedLocal FundingSanta Barbara County

SB Neighborhood Clinics Receives $5M Wyatt Family Donation — Largest in History

$5M donation received. Capacity expansion to 28K patients underway.

ActiveLocal FundingAlameda County

Alameda Health System Creates $91.7M Working Group — 183 Layoffs Deferred

ProposedBallot InitiativeSan Diego County

San Diego County Exploring $360M Community Health Tax Ballot Measure

Aug 1, 2026(28 days)— Check if measure qualifies for ballot

PassedBallot InitiativeLos Angeles County

Measure ER (Essential Services Restoration Act): LA County Half-Cent Health Tax on June 2 Ballot — $1B/Year for Community Health

Passed — official final count 1,013,747 yes (50.64%) to 987,977 no (49.36%); takes effect Oct 1, 2026 (~$1B/yr).

ActiveFederal ActionFederal

H.R. 7391: 340B FQHC Protection Act — 35 Congressional Cosponsors

ActiveCoalition ActionCalifornia

CPCA-PCDC Partnership for Expanded Healthcare Access in Underserved Communities

Sep 1, 2026(59 days)— Check partnership progress and outcomes

ActiveFederal ActionFederal

NACHC P&I Forum: $7B Federal Advocacy Push for Community Health Center Funding

Dec 1, 2026(150 days)— Track CHCF reauthorization progress before December expiry

Pending VoteLegislationCalifornia

SB 1422 (Durazo) Clears Senate Appropriations 5-2 (May 14), Now at Senate Third Reading

SB 1422 cleared Senate Appropriations 5-2 ('do pass as amended') on May 14, 2026 — corrected from the earlier '7-0 on April 20' framing (April 20 was only its placement on the suspense file). It was read a second time and amended (May 18) and now sits at Senate Third Reading, awaiting a Senate floor vote before it can cross to the Assembly. The bill remains alive as of June 8 but still faces the budget deficit; it would restore full-scope Medi-Cal effective Jan 1, 2027.

PassedFederal ActionFederal

HRSA 340B Rebate Model RFI — Comment Deadline April 20 for FQHC Stakeholders

RFI comment period closed April 20, 2026. NACHC, CPCA, and FQHC coalition filed coordinated responses pushing upfront ceiling-price model over rebate burden. HRSA next steps pending.

ActiveLegislationCalifornia

AB 2161: California Bill to Implement Medi-Cal Work Requirements in Least-Burdensome Way (Do Pass April 7)

PassedLegal ActionFederal

Federal Courts Block 340B Rebate Pilot — 1st Circuit Upholds Halt, HRSA Pauses Program

340B rebate pilot vacated by federal court; HRSA paused program

PassedLegal ActionFederal

HHS Withdraws 340B Rebate Pilot Appeal — Program Effectively Vacated (FQHC Win)

Sep 1, 2026(59 days)— Track potential HRSA new rulemaking + WA state pharma lawsuit (AbbVie+Novartis)

HHS withdrew appeal; program effectively vacated. Pharma's rebate model dead in current form.

ActiveFederal ActionFederal

AOA Lobbying for NHSC Improvement Act (HR 920 / S. 1445) — Add Optometrists to NHSC Loan Repayment Eligible Disciplines

Sep 30, 2026(88 days)— Check HR 920 / S. 1445 markup status and co-sponsor count by end of Q3 2026. Track HHS interpretive authority statements.

ActiveCoalition ActionCalifornia

70+ Organizations Form 'Save Our Dental Care' Coalition Against $1B Medi-Cal Dental Cut

The May 14 May Revision RETAINED the Medi-Cal Dental cut at the proposal stage, eliminating dental supplemental payments (including Proposition 56 supplemental payments) effective July 1, 2026. Signed-budget outcome: the June 29 budget delayed the dental supplemental-payment cut to July 1, 2027, so this coalition record should be read as historical pressure that helped create the one-year reprieve.

In CourtLegal ActionFederal

New Mexico's First-in-Nation 340B Contract-Pharmacy Law for Health Centers Takes Effect — PhRMA Sues, 8 Drugmakers Exempt NM Centers

Sep 1, 2026(59 days)— Track PhRMA & AbbVie federal suits in New Mexico — the bellwether for CA AB 1460's constitutional viability

ActiveCoalition ActionCalifornia

SEIU-Community Clinics Labor Management Partnership: 3,000+ Workers Trained via High-Road Model

In CourtLegal ActionFederal

AHA + Maine Hospital Association + 4 Safety-Net Hospitals Sue HHS Over 340B Rebate Model in U.S. District Court for Maine

PassedBallot InitiativeSanta Clara County

Santa Clara County Measure A Passes — $330M/Year Local Health Tax Takes Effect April 1

Oct 1, 2026(89 days)— Check first 6-month revenue report and allocation

Tax took effect April 1, 2026. First revenue collection underway.

Funding Impact

Policy timeline and revenue strategies

View

Layoff Tracker

Layoff events and displaced workers

View

Executive Guides

Case studies and strategic frameworks

View

Advocacy Watch

Tracking legislation, ballot initiatives, coalition actions, and legal rulings protecting FQHC funding. Follow-up dates, outcomes, and tools to take action.

Updated: 2026-07-04

Actions tracked

Active now

Pending votes

Upcoming follow-ups

Upcoming follow-up dates

days

Comment period closes July 6

HHS OCR Issues Interim Final Rule Extending Section 504...

Jul 6, 2026·Federal Register notice 2...AHA News coverage

days

Resolved

DOJ Extends ADA Title II 1 Year — But HHS Section 504 M...

Jul 6, 2026·DOJ Federal Register Titl...Converge Accessibility Re...

days

Confirm the Governor's signature and effective date; track whether manufacturers challenge the law as in Washington and the 4th Circuit states.

Illinois Passes Dual 340B Protection Bills (HB 2371 + H...

Jul 10, 2026·WCBU (NPR Peoria)

days

Application deadline July 15, 2026 at 3:00 PM

HCAI's Behavioral-Health Recruitment & Retention Progra...

Jul 15, 2026·MBH-RRP program page

days

Watch for a North Dakota appeal to the 8th Circuit + any read-through cited in AB 1460's Senate analysis.

Federal Judge Strikes Down North Dakota's 340B Contract...

Jul 15, 2026·North Dakota Monitor

days

Track Assembly Health Committee hearing + floor vote (June–August 2026).

SB 903 (AI in Mental Health) Passes CA Senate 39-0 — NU...

Jul 15, 2026·California Senate District 18

95 actions

ActiveFederal ActionFederal

Senate HELP Chair Cassidy Unveils Comprehensive 340B Reform Discussion Draft

Sep 1, 2026(59 days)— Watch for formal introduction and whether the health-center '340C' carve-out gains traction as the draft advances through summer 2026.

ActiveBallot InitiativeCalifornia

Last-Minute Ballot Deal Withdraws Two Healthcare Measures — but SEIU-UHW's 90% Clinic-Spending Mandate (Measure 1986) Stays on the November Ballot

Pending VoteBallot InitiativeCalifornia

SEIU-UHW Billionaire Tax QUALIFIES for November 2026 Ballot (June 17) — Newsom Rejects Union's Scaled-Back 2% Compromise

On the November 3, 2026 ballot — no withdrawal deal reached by the June 25 deadline.

ActivePublic StatementCalifornia

CPCA Advocates Endorses Xavier Becerra for California Governor — the FQHC Sector's First Gubernatorial Pick of the 2026 Cycle

Pending VoteLegislationFederal

House Committee Advances School-Based Health Centers Reauthorization (H.R. 8209) with NACHC Backing

Sep 15, 2026(73 days)— Check for the House floor vote and any Senate companion introduction.

PassedLegislationIllinois

Illinois Passes Dual 340B Protection Bills (HB 2371 + HB 4327) — Barring Manufacturer Contract-Pharmacy Restrictions and Mandating a State Audit

Jul 10, 2026(6 days)— Confirm the Governor's signature and effective date; track whether manufacturers challenge the law as in Washington and the 4th Circuit states.

ActiveBallot InitiativeCalifornia

Hospital Industry's Union-Spending Counter-Measure (#25-0021) Misses November Ballot While SEIU-UHW Clinic Measure Proceeds

Nov 3, 2026(122 days)— November 3, 2026 election — Measure 1986 remains on the statewide ballot; watch campaign spending, court challenges, and voter-guide arguments.

June 25 withdrawal deadline passed; the Secretary of State's qualified-measures list includes Measure 1986 but not the CHA union-spending countermeasure.

FailedBallot InitiativeContra Costa County

Contra Costa's Measure B FAILS (~42%-58%) — a ~$150M/Year County Medicaid-Backfill Tax Rejected by Voters

FAILED ~42.1% yes / ~57.9% no (June 5 count) — no local backstop for Contra Costa Health as H.R. 1 lands and signed-budget UIS/PPS risk moves into a July 1, 2027 planning horizon.

ActiveCoalition ActionTexas

TACHC Leaders Testify at Texas Capitol on Rural Health Transformation Funding and 340B

Sep 1, 2026(59 days)— Watch for the interim-charge report and any RHTP allocation guidance affecting FQHC eligibility.

ActiveFederal ActionFederal

NACHC Presses Congress for a Multi-Year Community Health Center Fund Reauthorization Before the Dec 31, 2026 Cliff

Sep 30, 2026(88 days)— FY2027 discretionary funding also expires Sept 30; a CHCF/NHSC extension is most likely to ride a year-end CR or reconciliation vehicle — track for an introduced bill.

ActiveLocal FundingCalifornia

HCAI's Behavioral-Health Recruitment & Retention Program Opens June 1 — FQHCs Eligible for Up to $20K Recruitment + $35K/Yr Supervision + $50K Student Support

Jul 15, 2026(11 days)— Application deadline July 15, 2026 at 3:00 PM — FQHCs should apply for BH recruitment/retention/supervision awards

In CourtLegal ActionFederal

Full 4th Circuit Grants En Banc Rehearing of West Virginia & Maryland 340B Contract-Pharmacy Rulings — a National Safety-Net Pharmacy Test

Aug 15, 2026(42 days)— Watch for oral-argument scheduling and the en banc decision; a ruling upholding state 340B laws would sharpen the circuit split heading toward the Supreme Court.

ActiveLegislationCalifornia

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

Pending VoteLegislationCalifornia

SB 903 (AI in Mental Health) Passes CA Senate 39-0 — NUHW-Co-Sponsored Guardrails on AI Therapy

Jul 15, 2026(11 days)— Track Assembly Health Committee hearing + floor vote (June–August 2026).

Pending VoteLegislationCalifornia

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

ActiveLegislationCalifornia

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

In CourtLegal ActionFederal

Three Health Systems Sue CVS/Caremark for ~$250M in Alleged 340B Savings Diversion (Federal RICO) — Precedent Watch for FQHC Clawbacks

Dec 1, 2026(150 days)— Watch for motions to dismiss in late 2026 and any class expansion that could reach FQHCs/340B covered entities.

ActiveCoalition ActionCalifornia

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

ActiveBallot InitiativeCalifornia

SEIU-UHW 90% Patient-Care Initiative QUALIFIES for Nov 3, 2026 California Ballot

Nov 3, 2026(122 days)— November 3, 2026 statewide vote — watch final title/summary language, voter-guide arguments, court challenges, and campaign spending.

Measure 1986 qualified for the November 3, 2026 statewide ballot after the 131st-day withdrawal deadline passed.

FailedLegislationMinnesota (precedent for California)

Minnesota 340B Hospital Protection Bill DIES on House Floor — PhRMA Lobby Outmaneuvers Senate 42-24 Passage

Sep 1, 2026(59 days)— CPCA 2027 session prep — track whether MN failure energizes CA 340B legislation

Bill failed to reach House floor vote before session-end deadline despite Senate passage 42-24

PassedLegislationMinnesota (precedent for California)

Minnesota Becomes First State to Impose 340B Covered-Entity Reporting Requirements — National Template Created

Sep 30, 2026(88 days)— Track whether CA copycat 340B reporting legislation emerges from 2027 session prep or SEIU-UHW supplemental ballot

Law passed and signed — first-in-nation 340B covered-entity reporting requirement

ActiveFederal ActionFederal

NACHC June 2-3 Hill Days Target Dec 2026 CHCF Cliff — Registration Closes May 22

ActiveCoalition ActionCalifornia

CSAC + CWDA Counties Demand $6.4B from State to Backfill May Revise Cost-Shift

ActiveCoalition ActionCalifornia

Health4All Coalition Mobilizes Against Newsom May Revise $1.1B Additional Immigrant Medi-Cal Cuts

ActiveCoalition ActionFederal

NACHC + ACH Set Aside 340B Differences — Joint Lobby for Health Center Funding Cliff

Sep 30, 2026(88 days)— FY27 appropriations deadline — track whether unity holds through reconciliation negotiations

ActiveFederal ActionFederal

NACHC Opens Second 2026 In-District Lobby Window — May 24 to June 1

Sep 30, 2026(88 days)— In-district window and the June 2-3 DC Fly-In are done — watch FY2027 appropriations and any CHC Fund extension ahead of the Dec 31, 2026 mandatory-funding cliff

PassedFederal ActionFederal

HHS OCR Issues Interim Final Rule Extending Section 504 / WCAG 2.1 AA Compliance Deadline by One Year

Jul 6, 2026(2 days)— Comment period closes July 6 — CCALAC/CPCA should submit FQHC-specific comments shaping final rule

Interim Final Rule effective May 7, 2026 — 1-year extension granted; deadlines now May 11, 2027 (15+) / May 10, 2028 (<15)

ActiveLegislationCalifornia

CA Assembly Democrats Draw 'Line in the Sand' on Safety Net Cuts in 2026-27 Budget Road Map — Bicameral Counter-Position Ahead of May Revise

ActiveBallot InitiativeCalifornia

100+ Organizations Formally Join CalChamber 'Affordable California' Coalition — Counter-Ballot Mobilization Phase

ActiveCoalition ActionCalifornia

Health Consumer Coalition Releases 'Medi-Cal 2030' Principles — Person-Centered Framework as Counterweight to H.R. 1 Cuts

ActiveCoalition ActionCalifornia

CCALAC + CHC Coalition Issue Public Statement Against May Revision Medi-Cal Cuts and UIS PPS Elimination

In CourtLegal ActionCalifornia

CHA + Community Clinic Employers File Lawsuit to Block SEIU-UHW 90% Patient Care Ballot Measure

ActiveCoalition ActionCalifornia

FY2026-27 May Revision Advocacy Window Opens — CPCA / Health4All / CCALAC Coordinated Push for FQHC-Friendly Restorations

PassedLegal ActionFederal

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

Sep 30, 2026(88 days)— Rebate pilot is vacated/remanded and not operating — watch HRSA's rebate-model RFI process; HRSA committed to at least 90 days' notice before any relaunch

ProposedFederal ActionFederal

H.R. 8629 — Bipartisan Bill to Build the FQHC Workforce Pipeline (NHSC Priority, Loan Repayment, CHW & BH Hiring)

Sep 1, 2026(59 days)— Track House Energy & Commerce / Ways & Means committee action; watch companion H.R. 7289.

In CourtLegal ActionCalifornia

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

PassedCoalition ActionCalifornia

CPCA Day at the Capitol Convened California CHC Advocates in Sacramento

Event held; current UIS/PPS posture should be checked against signed-budget and DHCS sources.

FailedLegal ActionNorth Dakota (federal precedent)

Federal Judge Strikes Down North Dakota's 340B Contract-Pharmacy Law — A Cautionary Precedent for CA's AB 1460

Jul 15, 2026(11 days)— Watch for a North Dakota appeal to the 8th Circuit + any read-through cited in AB 1460's Senate analysis.

H.B. 1473 struck down as unconstitutional (Supremacy + Commerce Clause); permanent injunction against enforcement.

ActiveBallot InitiativeCalifornia

CalChamber 'Affordable California' Files ~1M Signatures for November 2026 Ballot — Counter to SEIU-UHW 90% Spend Initiative

Pending VoteLegislationCalifornia

SB 1422 Placed on Senate Appropriations Suspense File April 20 — UIS Restoration Bill Now At-Risk

ActivePublic StatementFederal

Washington Hospital Association Files Formal Opposition to HRSA 340B Rebate Pilot — Joins AHA, ASHP, NACHC in Coalition Pressure

Sep 30, 2026(88 days)— HRSA Q3 2026 decision; track whether coalition opposition shapes pilot scope or kills it

PassedFederal ActionFederal

DOJ Extends ADA Title II 1 Year — But HHS Section 504 May 11 Deadline UNCHANGED (Confusion Risk)

Jul 6, 2026(2 days)— Resolved — HHS matched the extension; the new deadline is May 11, 2027 (15+ employees). Comment period on the HHS IFR closes July 6, 2026

ActiveFederal ActionFederal

AHA Files Formal RFI Opposition to HRSA 340B Rebate Model — Unified FQHC/Hospital Front

Sep 30, 2026(88 days)— HRSA RFI synthesis expected Q3 2026 — track whether opposition alters rebate model design

In CourtLegal ActionFederal

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

Sep 30, 2026(88 days)— En banc GRANTED — watch for en banc argument scheduling and the full-court merits decision on the WV + MD contract-pharmacy laws

ActiveBallot InitiativeCalifornia

April 17 Signature Sample Check: SEIU-UHW 90% and Exec Pay Cap Initiatives at Critical Procedural Gate

ActiveFederal ActionFederal

NACHC Senate Finance Testimony: Reconciliation Would Cut $7B, Close 1 in 5 Health Centers, Displace 7.6M Patients

ActiveLegislationCalifornia

NACHC State 340B Legislation Tracker — 37 States Now Protect CHC 340B Savings, California Lacks Parallel Statute

Sep 1, 2026(59 days)— Watch CPCA legislative agenda for CA-specific 340B contract pharmacy bill in 2027 session

ActiveCoalition ActionCalifornia

Health4All Coalition Mobilizes Against UIS Adult Dental Cut + $30 Premium — Distinct From SB 1422 Enrollment Defense

ActivePublic StatementCalifornia

Medi-Cal Optometry Rate Has Been ~$47 for 25 Years — California Optometric Association + CalMatters Push for Rate Update

Dec 31, 2026(180 days)— Track DHCS rate review schedule, CA budget cycle vision provisions, COA legislative priorities for 2027 session.

PassedFederal ActionFederal

HRSA 340B Rebate Pilot ICR Comment Window CLOSED April 27 — AHA/ASHP/NACHC/WHA All Filed Formal Opposition

Jul 15, 2026(11 days)— HRSA synthesis expected 30-60 days post-deadline

Both comment windows closed; AHA/ASHP/NACHC/WHA filed formal opposition arguing >$1B/year cost

In CourtLegal ActionFederal

PhRMA Sues Washington State Over 340B Contract Pharmacy Law — National Precedent for CA AB 1460 Hinges on Outcome

ActiveFederal ActionFederal

Eli Lilly & Novo Nordisk Activate 340B Claims-Data Mandates — FQHCs Face Operational Compliance Burden

In CourtLegal ActionFederal

AstraZeneca Sues Vermont Over 340B Contract Pharmacy Law — Argues Rebate Pilot Preclusion

ActiveFederal ActionFederal

CMS Published the Medicaid Work-Requirements Interim Final Rule (CMS-2454-IFC) on June 1 — Exemption Scope Drives FQHC Patient Impact

Jul 31, 2026(27 days)— Comment period closes July 31; states begin member outreach by Aug 31 — track exemption criteria

Published June 1, 2026 as CMS-2454-IFC: 80-hour/month community-engagement requirement, effective July 31 2026, full state implementation by Jan 1 2027; comment period closes July 31.

PassedCoalition ActionFederal

NACHC In-District Advocacy Week April 14–25 — WINDOW CLOSED, NACHC P&I Forum April 28-29 Up Next

In-district advocacy window concluded April 25, 2026. Engagement metrics pending NACHC P&I Forum reporting.

ActiveCoalition ActionLos Angeles, Orange County

CCALAC + CoalitionOC Hold Joint FQHC Advocacy Summit — Unified Front on H.R. 1 Medi-Cal Cuts

In CourtLegal ActionCalifornia

California AG Opposes FQHC 340B Preliminary Injunction — State vs. Community Health Tension

PassedCoalition ActionCalifornia

MAJOR WIN: SEIU 1021 + Alameda Health System Workers Ratify New Contract — Layoff Crisis Resolved

Contract ratified. New CEO + new Director of Labor Relations + new governance model. Wage increases retroactive. Layoffs averted.

PassedCoalition ActionNational

NACHC April 14-25 In-District Advocacy Push — Window Closed, NACHC P&I Forum April 28-29 Next

In-district window concluded April 25, 2026. Engagement metrics pending NACHC P&I Forum reporting.

In CourtLegal ActionFederal

AbbVie Files Landmark 340B Lawsuit — 'Most Consequential Manufacturer Challenge to Date'

ActiveBallot InitiativeCalifornia

California Hospital Association Files Counter-Initiative Requiring Union Member Approval for Ballot Spending

ActiveFederal ActionFederal

CMS Opens $100M MAHA ELEVATE Model — FQHCs Eligible for Lifestyle Medicine Grants

Oct 1, 2026(89 days)— Check award announcements

Pending VoteBallot InitiativeCalifornia

SEIU-UHW Submits Signatures for California Executive Pay Cap Ballot Initiative — Second Front Against FQHC Leadership Comp

ActiveBallot InitiativeCalifornia

SEIU-UHW Submits 1M+ Signatures (~83% Buffer) for 90% Mission Spend + $450K Exec Pay Cap — Near-Certain November Qualification

ActiveBallot InitiativeCalifornia

CCALAC & FHCSD Lead 'Protect Access to Healthcare' Counter-Initiative — Signatures Submitted for November Ballot

FailedCoalition ActionCalifornia

CPCA + No-on-AB-1113 Coalition Mounts Legislative Opposition to SEIU-UHW 90% Mission-Spend Mandate

PassedLegal ActionFederal

D.C. District Court Vacates HRSA's 2013 340B GPO Prohibition Policy — APA Win Weakens HRSA Regulatory Footing

Sep 30, 2026(88 days)— HRSA expected to issue revised GPO guidance Q3 2026 — track whether replacement rule narrows or expands FQHC 340B exposure

GPO Prohibition vacated; child site registration requirement also vacated. Remanded to HRSA for revised rulemaking.

ActivePublic StatementCalifornia

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

ActiveBallot InitiativeCalifornia

California Billionaire Tax Act: $100B Healthcare Funding Ballot Measure Gains Momentum

Aug 1, 2026(28 days)— Check if sufficient signatures collected for November ballot

FailedLegal ActionFederal

4th Circuit Blocks West Virginia's 340B Contract Pharmacy Law — First Federal Appeals Win for Drugmakers, Weakens CA AB 1460 Path

State 340B contract pharmacy law blocked — state/FQHC side lost; manufacturer side won

In CourtLegal ActionFederal

Novartis and AbbVie Sue Washington Over Its New 340B Contract-Pharmacy Protection Law — a Direct Precedent Watch for California's AB 1460

Preliminary injunction denied June 9, 2026 (Judge Estudillo); SB 5981 took effect June 10, 2026 with $5,000/day penalties. Merits litigation continues.

In CourtLegal ActionFederal (Washington)

AbbVie + Novartis File Federal Lawsuit Against WA 340B Transparency Law — Precedent Risk for CA AB 1460

Sep 30, 2026(88 days)— Track district court ruling; precedent for CA AB 1460

In CourtLegal ActionFederal

Third Circuit Revives False Claims Suit Against AbbVie, Novartis, AstraZeneca, Sanofi for 340B Pricing Fraud

ActiveFederal ActionFederal

EO 14398 FAR Guidance Deadline May 25 — FQHCs Must Review HR Policies for DEI Compliance

PassedLegal ActionFederal

Ninth Circuit Rules FQHCs Can Sue Drug Makers for 340B Overcharges Under False Claims Act

Sep 1, 2026(59 days)— Watch for manufacturer appeals or settlements

Ruling issued March 17 — FCA suits may proceed for 340B overcharges

In CourtLegal ActionCalifornia

NLRB Seeks Forced Union Recognition at Innercare — ALJ Hearing Underway in San Diego

ActiveLegislationCalifornia

Sen. Durazo Introduces SB 1422 to Reverse the UIS Medi-Cal Enrollment Freeze

PassedLocal FundingSanta Barbara County

SB Neighborhood Clinics Receives $5M Wyatt Family Donation — Largest in History

$5M donation received. Capacity expansion to 28K patients underway.

ActiveLocal FundingAlameda County

Alameda Health System Creates $91.7M Working Group — 183 Layoffs Deferred

ProposedBallot InitiativeSan Diego County

San Diego County Exploring $360M Community Health Tax Ballot Measure

Aug 1, 2026(28 days)— Check if measure qualifies for ballot

PassedBallot InitiativeLos Angeles County

Measure ER (Essential Services Restoration Act): LA County Half-Cent Health Tax on June 2 Ballot — $1B/Year for Community Health

Passed — official final count 1,013,747 yes (50.64%) to 987,977 no (49.36%); takes effect Oct 1, 2026 (~$1B/yr).

ActiveFederal ActionFederal

H.R. 7391: 340B FQHC Protection Act — 35 Congressional Cosponsors

ActiveCoalition ActionCalifornia

CPCA-PCDC Partnership for Expanded Healthcare Access in Underserved Communities

Sep 1, 2026(59 days)— Check partnership progress and outcomes

ActiveFederal ActionFederal

NACHC P&I Forum: $7B Federal Advocacy Push for Community Health Center Funding

Dec 1, 2026(150 days)— Track CHCF reauthorization progress before December expiry

Pending VoteLegislationCalifornia

SB 1422 (Durazo) Clears Senate Appropriations 5-2 (May 14), Now at Senate Third Reading

PassedFederal ActionFederal

HRSA 340B Rebate Model RFI — Comment Deadline April 20 for FQHC Stakeholders

RFI comment period closed April 20, 2026. NACHC, CPCA, and FQHC coalition filed coordinated responses pushing upfront ceiling-price model over rebate burden. HRSA next steps pending.

ActiveLegislationCalifornia

AB 2161: California Bill to Implement Medi-Cal Work Requirements in Least-Burdensome Way (Do Pass April 7)

PassedLegal ActionFederal

Federal Courts Block 340B Rebate Pilot — 1st Circuit Upholds Halt, HRSA Pauses Program

340B rebate pilot vacated by federal court; HRSA paused program

PassedLegal ActionFederal

HHS Withdraws 340B Rebate Pilot Appeal — Program Effectively Vacated (FQHC Win)

Sep 1, 2026(59 days)— Track potential HRSA new rulemaking + WA state pharma lawsuit (AbbVie+Novartis)

HHS withdrew appeal; program effectively vacated. Pharma's rebate model dead in current form.

ActiveFederal ActionFederal

AOA Lobbying for NHSC Improvement Act (HR 920 / S. 1445) — Add Optometrists to NHSC Loan Repayment Eligible Disciplines

Sep 30, 2026(88 days)— Check HR 920 / S. 1445 markup status and co-sponsor count by end of Q3 2026. Track HHS interpretive authority statements.