Federal RuleAug 21
62
DOL Rewrites Disability Rules for 'Merit-Based Opportunity' Push
RuleLabor DepartmentFederal Contract Compliance Programs OfficeSignificant Wallet
119-hr-10640119th CongressWALLET
Urban Health Transformation Act of 2026
Sponsored By: Representative Waters, Maxine [D-CA-43]
Introduced
Summary
Federal funding to transform urban health care systems would create a new Urban Health Transformation Program that gives states grants to improve access, outcomes, prevention, and financial stability for urban hospitals and related providers. The program focuses on chronic disease management, technology-driven care, workforce recruitment, and supporting substance use and mental health services.
Show full summary
- Families and patients: Would expand access to prevention, chronic disease management, and consumer-facing tech in large urban areas, and support more opioid use disorder and mental health services.
- Urban hospitals and providers: Would provide targeted payments and support to help stabilize at-risk standalone hospitals, fund training and technology, and recruit clinical staff with five-year service commitments. States would not need to provide a matching payment.
- States and territories: States would apply for allotments and get funds split 50% equally and 50% by need factors. The bill would fund $10.0 billion per year for FY2027–FY2031, with an additional $200 million for FY2026 implementation.
*Would increase federal spending by $50.0 billion over FY2027–FY2031 plus $200 million for FY2026 implementation.*
Personalized for You
How does this bill affect your finances?
Personalize government policy and PRIA will tell you what this bill means for your household, plus every other piece of legislation we track. PRIA reads each provision against your financial profile to show you exactly what matters to your wallet.
Bill Overview
Analyzed Economic Effects
5 provisions identified: 1 benefits, 0 costs, 4 mixed.
Federal $10B yearly grants for cities
If enacted, this bill would provide $10 billion each year for fiscal years 2027 through 2031 to support urban health transformation. For each year, CMS would split funds: 50% divided equally among States with approved applications and 50% awarded under a formula that considers a State’s urban population and its share of urban health facilities. CMS would have to ensure at least one-quarter of States get formula money. CMS would review unused prior-year funds by March 31, 2029, and annually through March 31, 2033, and could redistribute those amounts. Any program money still unexpended or unobligated on October 1, 2033, would be returned to the U.S. Treasury.
State rules for using urban health grants
If enacted, this bill would require each approved State to use its allotment for at least three listed activities. Allowed activities include prevention and chronic disease management, payments to urban providers, consumer-facing technology, clinician recruitment and training (with recruited clinicians committing to five years of urban service), expanding behavioral health and substance use disorder care, and developing value-based payment models. A State could not be required to provide matching funds to receive its allotment. The Administrator would limit State administrative spending to not more than 10% of each year’s allotment and would require annual reports on fund use.
CMS power to recover misused grants
If enacted, this bill would let the CMS Administrator withhold, reduce, or recover payments to a State if the Administrator finds the State is not using allotted or redistributed amounts consistently with its approved application. Any amounts withheld, remaining after a reduction, or recovered would be returned to the U.S. Treasury. This authority would apply to State payments under the Urban Health Transformation Program.
CMS setup funds and state deadline
If enacted, this bill would appropriate $200 million for CMS in fiscal year 2026 to implement the program and would allow those funds to remain available until expended. States would have to submit applications during a period ending no later than December 31, 2026, and CMS would have to approve or deny all applications by that date. Approved States would be eligible for allotments for fiscal years 2027 through 2031. Applications would have to certify that Program funds would not be used for intergovernmental transfers, certified public expenditures, or to finance the non‑Federal share for Medicaid, CHIP, or waivers.
Who and where counts as urban providers
If enacted, this bill would define an "urban area" as a metropolitan statistical area with at least 1,000,000 people. It would define eligible health care providers as suppliers enrolled under Medicare (Title XVIII), Medicaid (Title XIX), or CHIP (Title XXI). For counting facilities in allocations, CMS would include disproportionate share hospitals, hospitals with approved residency programs, certain subsection (d) hospitals in the 75th percentile for inpatient services to dual eligibles or subsidy-eligible people, Federally Qualified Health Centers, community mental health centers, Section 330 health centers, urban opioid and SUD treatment programs, and certified community behavioral health clinics.
Sponsors & CoSponsors
Sponsor
Waters, Maxine [D-CA-43]
CA • D
Cosponsors
Rep. Bell, Wesley [D-MO-1]
MO • D
Sponsored 10/1/2026
Rep. Carson, André [D-IN-7]
IN • D
Sponsored 10/1/2026
Rep. Clarke, Yvette D. [D-NY-9]
NY • D
Sponsored 10/1/2026
Rep. Correa, J. Luis [D-CA-46]
CA • D
Sponsored 10/1/2026
Rep. Costa, Jim [D-CA-21]
CA • D
Sponsored 10/1/2026
Rep. Davis, Danny K. [D-IL-7]
IL • D
Sponsored 10/1/2026
Rep. Garcia, Sylvia R. [D-TX-29]
TX • D
Sponsored 10/1/2026
Rep. Jackson, Jonathan L. [D-IL-1]
IL • D
Sponsored 10/1/2026
Rep. Kelly, Robin L. [D-IL-2]
IL • D
Sponsored 10/1/2026
Rep. Lynch, Stephen F. [D-MA-8]
MA • D
Sponsored 10/1/2026
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 10/1/2026
Rep. Ramirez, Delia C. [D-IL-3]
IL • D
Sponsored 10/1/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov