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The Record

The week on the record

82 records · 17 issues

Analysis

By issue

Medicaid financing and eligibility operations

Coverage is already falling before work requirements start: Michigan Medicaid has lost more than 80,000 people since January, and Texas's application backlog grew to more than 210,000 in August. Plan changes add to it: Healthy Blue leaves Louisiana Medicaid on December 31, moving more than 290,000 members on January 1. Comments on CMS's provider-tax implementation rule closed September 21 with no extension; the final rule is next. (as of )

11 more records

Medicaid work-requirement implementation

Enrollees and physician groups filed a second challenge, Taylor v. Kennedy, on September 18, aimed at the rule's medical-frailty provisions. CMS told states on September 8 to check frailty against claims, encounter and health information exchange data first. The federal rule is in effect and every state must apply it no later than January 1, 2027. A federal court denied preliminary relief in Massachusetts v. Oz without deciding the merits. Montana begins removals for noncompliance on October 1, and Kentucky's three-of-six-month lookback is already running. (as of )

Government · Michigan Department of Health and Human Services

MDHHS publishes work-requirement preparation notice and partner toolkit

Event:

MDHHS's July 23 release directs Healthy Michigan Plan members and partners to current preparation information and a partner toolkit. It correctly identifies Meghan Groen as MDHHS chief deputy director and points users to official state channels.

MISource

Manatt Health

Manatt models an average annual NC Medicaid enrollment reduction of 289,000 under CMS's interim work-rule approach, 64,000 beyond its statutory-baseline scenario

Event:

Manatt Health's July 16 primary analysis models North Carolina's average annual Medicaid enrollment reduction over federal fiscal years 2027–2034 at 225,000 (7% from baseline) under its H.R. 1 plain-language scenario and 289,000 (9%) under its CMS…

Medicaid financing and eligibility operationsNCSource

Safety-net workforce and capacity shifts

Layoffs are reaching health centers directly: SAC Health laid off 49 people and closed two San Bernardino clinics, and Maine's largest FQHC cut its entire enrollment team after warning it needed $3 million within 60 days. A Skid Row nonprofit filed 134 layoffs effective November 3, 117 of them on a campus a health center co-operates. Georgia's loan-repayment window for clinicians in rural counties is open until October 12. (as of )

ACA marketplace coverage and uninsured demand

Pennsylvania approved an average 15.97% increase for 2027 individual plans. The enhanced premium credits have expired and states are now approving 2027 rates: Washington approved an average 22.2% increase and Connecticut 11.3% for individual plans. In New York, nearly 192,000 of the roughly 450,000 people who lost expanded Essential Plan coverage had not enrolled in new coverage by July 31. (as of )

Research · Health Policy Institute of Ohio

Ohio posts the largest ACA marketplace decline in the nation

Event:

A Health Policy Institute of Ohio data snapshot published July 10, 2026 reports Ohio's effectuated ACA marketplace enrollment fell from 497,443 in February 2025 to 336,058 in February 2026 — "161,000 fewer Ohioans are enrolled in an ACA plan this year" — and…

OHSource

Health center openings, closures and mergers

Closures and openings are arriving together. Minnesota's largest health center closed two St. Paul clinics and Partnership Health Center will close its Seeley Lake clinic October 31, while Thrive Alabama plans a new Albertville site and two South Carolina health centers plan a merger into one 24-site organization, pending HRSA approval. North Hudson Community Action Corporation opened a Weehawken health center on September 18. (as of )

The $50 billion Rural Health Transformation Program

Delaware's round of nearly $23 million goes to its three federally qualified health centers. States are announcing awards and the health center share varies widely. Indiana's $112.4M in regional grants lists at least a dozen FQHCs as subrecipients, while Hawaii's first $58 million and Vermont's $11.7M round name no health center. In Maine, 100 lawmakers asked for $3 million to $6 million of the state's allocation to keep Penobscot Community Health Care open. State award lists often name more health centers than the press releases: New York's includes Refuah Health Center at $3.5 million, and South Carolina's funds at least ten health centers across 228 projects. (as of )

340B drug pricing

HRSA's revised rebate pilot is planned for January 2027 and does not exempt health centers; approvals of manufacturer plans are due September 24. In the states, a federal judge upheld Mississippi's contract-pharmacy law, the Fourth Circuit is rehearing the West Virginia and Maryland cases en banc, and Oregon's case is set for argument September 28. (as of )

News · Arkansas Advocate

Arkansas AG sues 13 drugmakers + a data firm over 340B

Event:

Arkansas Attorney General Tim Griffin filed suit July 22, 2026 in Polk County Circuit Court against 22 defendants — 13 drug manufacturers and related entities including Pfizer, Bristol Myers Squibb, AstraZeneca, Eli Lilly, Sanofi and Novo Nordisk…

Source

AI in care: law, oversight and adoption

OpenAI connected ChatGPT for Healthcare to Epic on September 1, with UCSF Health as pilot partner; no source says whether OCHIN Epic health centers can use it. All four California AI-in-healthcare bills are on the Governor's desk and each must be acted on by September 30. AAAHC's v45 accreditation standards add AI governance expectations for surveys on or after December 15, 2026. In a survey of 784 health center patients, 64% were uncomfortable with AI in their care and 70% want to be told when it is used. (as of )

Behavioral-health integration and capacity

California's acute psychiatric staffing ratios took effect June 1. Capacity is moving in both directions: Hillsboro Medical Center's 21-bed geriatric psychiatry service ended September 4, while nearly $14M in BHCIP Round 5 funding supports a new tribal health and wellness center in Jamestown. North Carolina won $5.2 million from SAMHSA to strengthen its 988 crisis line, plus mobile crisis funding for four northeastern counties. (as of )

Association · National Association of Community Health Centers

NACHC advocacy lands a 45-0 House Energy & Commerce vote advancing $750M for health-center behavioral health and nutrition

NACHC reported July 27, 2026 that the House Energy and Commerce Committee voted 45-0 to advance legislation providing $750 million in new funding for behavioral health and nutrition services at Community Health Centers — reported as $500M for behavioral…

Community Health Center Fund and federal appropriationsSource

Immigration enforcement, public charge and immigrant eligibility

Twenty-one states, Pennsylvania's governor and D.C. sued on September 14 to stop the new public charge rule. A separate federal change narrows which lawfully present immigrants qualify for Medicaid on October 1; Indiana, North Carolina and Michigan have each published how it will apply. The court has set an initial conference for October 9, and the rule remains in effect. In New Jersey, as many as 25,000 noncitizens could lose coverage on October 1. (as of )

Government · Washington State Health Care Authority

Washington narrows Apple Health for noncitizens on October 1

Event:

Washington HCA's H.R. 1 impact deck says that effective October 2026 Apple Health eligibility is limited to lawful permanent residents who have met or are exempt from the five-year bar, Compact of Free Association immigrants, and Cuban-Haitian entrants.

WASource

Community Health Center Fund and federal appropriations

The stopgap signed September 2 funds the government through December 11. The mandatory Community Health Center Fund expires December 31, 2026, 20 days later, and no enacted bill extends it. A House committee advanced a separate $750M health center package 45-0 in July; it has not become law. HRSA's NHSC loan repayment forms are open for public comment until October 27. (as of )

Association · National Association of Community Health Centers

NACHC advocacy lands a 45-0 House Energy & Commerce vote advancing $750M for health-center behavioral health and nutrition

NACHC reported July 27, 2026 that the House Energy and Commerce Committee voted 45-0 to advance legislation providing $750 million in new funding for behavioral health and nutrition services at Community Health Centers — reported as $500M for behavioral…

Behavioral-health integration and capacitySource

Healthcare access, language, and civil-rights implementation

A final rule takes effect October 13 barring federal Medicaid and CHIP payment for certain gender-related services for minors, and Open Door Community Health Centers has stopped starting hormone therapy for patients under 19. Separately, HHS removed disparate-impact liability from its Title VI regulations on July 24. On September 11, North Carolina and the Justice Department asked a court to end oversight of the 2012 community-housing settlement early. (as of )

Government · U.S. Department of Health and Human Services / Federal Register

HHS strips disparate-impact liability out of its Title VI regulations

HHS published a final rule July 24, 2026 (FR 2026-15000, RIN 0945-AA29) amending 45 CFR part 80 — its Title VI regulations — to remove provisions imposing liability based on unintentional disparate impact, conforming to Executive Order 14281.

Source

HRSA Health Center Program rules

HRSA extended funding for the 272 health centers in the FY2027 Service Area Competition through June 30 or July 31, 2027, while it makes new awards; each center must still compete. HRSA's New Access Points round is landing as $650,000 awards: two Texas look-alikes became Section 330 grantees, and Thrive Alabama plans a new Albertville site for mid-December. HRSA's 2025 UDS data is published by state. (as of )

Government · Federal Register / HRSA

HRSA reopens Form 5A and Form 5B

HRSA published an information collection request revision on July 30, 2026 (Federal Register document 2026-15419, 91 FR 48170) proposing to modify eight approved Health Center Program Forms and add three new ones, with comments due September 28, 2026.

Source

Medicare payment and value-based care

CMS proposes raising the FQHC PPS base rate to $212.91, a 2.5% increase, in the CY2027 physician fee schedule; comments closed September 14 and the final rule is pending. 66 House members asked CMS for telehealth payment parity at health centers and rural clinics. (as of )

CalAIM, Enhanced Care Management and Community Supports

California submitted its CalAIM 1115 renewal to CMS on May 11; no decision is posted. DHCS still lists its July Community Supports changes as proposed. Health Net is ending its Medi-Cal assisted living benefit for about 3,500 members at year-end. (as of )

Healthcare labor and organizing

Open NLRB matters at health centers include two charges at El Rio Community Health with no finding yet, a new SEIU Local 1021 charge at Community Medical Centers in Manteca, and a decertification election directed at Seattle Roots Community Health. (as of )

State health elections and ballot measures

California votes November 3. The official voter guide for Proposition 44 names nonprofit FQHCs and authorizes criminal charges; more than 100 health centers have joined the No campaign. South Dakota's ballot carries Amendment I, which puts a funding condition on its Medicaid expansion. In Georgia, the Republican nominee for governor pledges Medicaid expansion that keeps work requirements. (as of )

The next two weeks

Public dates in the 14 days after Aug 2, 2026.

Updated records

Records published earlier that changed this week: a correction, a new status or a replaced source.

Other records

11 records with no linked issue

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