2026 in FQHCs

The stopgap signed September 2 sets a December 11 funding deadline — 20 days before the Community Health Center Fund expires

On Wednesday, September 2, 2026, the President signed H.R. 6500, the “Continuing Appropriations and Extensions Act, 2027,” a short-term continuing resolution providing fiscal year 2027 appropriations to federal agencies through December 11, 2026. The planning consequence for health centers is the calendar. The sector’s funding risk is no longer one date. It is now two, twenty days apart and both after the November 3 midterms: the CR lapses December 11, and the mandatory Community Health Center Fund expires December 31, 2026. That places both in the same lame-duck session. THE BILL ITSELF SAYS NOTHING ABOUT HEALTH CENTERS. Across all four divisions of the enrolled text, none of these terms appears: "health center," "section 330," "Community Health Center Fund," "National Health Service Corps," "teaching health center," or "Public Health Service Act." The divisions are Continuing Appropriations Act 2027; Authorizing Extensions; Surface Transportation Extension Act of 2026; and Department of Veterans Affairs Extenders. Division B extends seventeen authorities running from grain standards to passport fees; the only health provision anywhere in the bill is a Medicare Improvement Fund offset. What this does do for health centers is on the discretionary side: Division A continues funding under twelve FY2026 appropriations acts including "the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations Act, 2026," available until the first of an enacted FY2027 appropriation or "December 11, 2026." THE PRACTICAL READ, and it is a clean separation a CFO can plan against: DISCRETIONARY Section 330 keeps flowing at FY2026 levels through December 11, so the September 30 discretionary cliff is deferred rather than cured; the MANDATORY Community Health Center Fund is untouched and still expires December 31. Because the appropriations deadline now lands FIRST, a December omnibus or a second CR is the likeliest vehicle to carry any CHC Fund fix — and Congress has now had one clean opportunity to bridge that gap and used it to trim the Medicare Improvement Fund by $21 million instead.

FY2026 annual health-center funding reaches its September 30 boundary; FY2027 funding is not yet enacted

Health centers have two distinct federal grant-funding clocks. Public Law 119-75 provided $1,858,772,000 in FY2026 annual discretionary funding for primary health care. NACHC asks Congress to increase that amount by $300 million for FY2027, while the House Appropriations Committee's reported H.R. 9260 recommends $1,858,772,000 — flat to FY2026. As of August 26, H.R. 9260 is House-reported, not enacted, and the reported text reviewed contains no Community Health Center Fund extension. That separate mandatory authority currently provides $4.6 billion for FY2026 plus $1,159,452,055 for October 1 through December 31, 2026. If Congress enacts a continuing resolution, its duration, rate, terms, and anomalies control; do not assume it automatically repeats every FY2026 award term or extends the mandatory fund. September 30 alone does not prove that a particular center's award balance, staffing, or services stop. Finance leaders should check the center's current H80 Notice of Award, budget and project periods, any revised Notice of Award, enacted text, and current HRSA guidance before changing a forecast.

HRSA's revised 340B Rebate Model Pilot declines to exempt health centers from the entity-wide design

HRSA placed Notice 2026-15633 on public inspection July 31; official Federal Register publication is scheduled for August 3, and the pilot's effective date is January 1, 2027. Covered-entity commenters asked HRSA to exclude or phase in some entity types. HRSA declined, reasoning that differences between hospitals and FQHCs do not justify splitting the pilot and that duplicate-discount risk follows selected drugs across every covered-entity type. The notice reports $64.1B in disproportionate-share-hospital purchases (about 79% of total 340B purchases) versus $5.2B for FQHCs and Look-Alikes (about 6%). DEADLINE BOUNDARY: August 24 is the deadline for eligible manufacturers to submit plans, not a public-comment deadline. Approved plans must pay or deny rebates within 10 calendar days after a completed data submission. The 15-day grace period applies only to rebate requests for up to two unreplenished accumulated packages dispensed before the pilot's effective date; it is not a general implementation extension. HRSA predicts limited cash-flow harm while acknowledging cited modeling that financing burdens may be disproportionately larger for small entities. Those are agency positions and modeled estimates, not observed FQHC outcomes. No manufacturer approvals are named. The notice describes commenters generically, so this record does not attribute the exemption request to NACHC.

D.C. Circuit: drug makers can't force a 340B rebate model without HHS approval — the Secretary, not manufacturers, controls the program

On July 21, 2026 the U.S. Court of Appeals for the D.C. Circuit upheld a lower court and ruled that Section 340B does not permit manufacturers (Novartis and Johnson & Johnson) to unilaterally replace up-front 340B discounts with a post-purchase rebate model unless the HHS Secretary approves it — holding, in effect, that the statute puts the Secretary and not the manufacturers in control of the program. The decision preserves the up-front-discount structure that community health centers and their contract pharmacies depend on, while leaving open whether HHS could authorize a rebate model in the future. It is a defensive win, not a permanent fix: other manufacturer proposals and HHS's own rebate-pilot review remain live.

Eli Lilly's 340B Termination Turns Into Litigation and Congressional Pushback — Tampa General Sues in Federal Court, 72 House Members Demand HHS Act

Eli Lilly's June 1 five-day ultimatum escalated on June 18, 2026, when the manufacturer cut off 340B pricing for covered entities that refused to share in-house pharmacy claims data — Lilly directed wholesaler McKesson to end Tampa General Hospital's discounts after it missed the deadline, per the hospital's complaint. Tampa General sued Lilly on July 2 in the U.S. District Court for the Middle District of Florida, alleging the cutoff raised its average costs for Lilly medications 25-50% — losses the complaint pegs at roughly $24.7 million a year, including a 35.9% jump on Mounjaro. Separately, 72 bipartisan U.S. House members — led by Reps. Doris Matsui (D-CA) and Jack Bergman (R-MI) — signed an early-July letter to HHS Secretary Kennedy and HRSA Administrator Engels urging use of 'any enforcement mechanisms available' against Lilly's move and restoration of 340B pricing. Coverage so far documents hospitals as the entities cut off; no health-center termination has been confirmed, but FQHCs dispensing Lilly products face the same claims-data condition documented in the June 1 ultimatum item and should confirm their data-sharing posture now.