Community Multi-Share Coverage Program Act of 2026
Sponsored By: Representative Moolenaar, John R. [R-MI-2]
Introduced
Summary
Community Multi-Share Coverage Programs would create locally run, shared-funded health plans that give small-business employees with incomes above Medicaid but below 400 percent of the federal poverty level access to low-cost medical care and social supports. The bill would have Health and Human Services (HHS) award 3 to 5 planning grants and set rules for benefits, provider partnerships, and a multi-year shared funding model.
Show full summary
- Families and workers: Offers coverage with no deductible and limited in-network copays, and benefits that include physician care, hospital services, behavioral health, and prescription drugs to reduce barriers to care.
- Small employers and workforce: Helps small businesses hire competitively by pairing affordable coverage with workforce development, individualized plans, and services that address psycho-social barriers to employment.
- Hospitals and communities: Requires nonprofit-led hospital–community partnerships, a physical community presence, shared cost contributions, and formal evaluation of impacts on health, employment, and self-sufficiency. Grants run up to four years and prioritize local coordination.
*Would authorize federal funding of $4.8 million for FY2026, $7.2 million for FY2027, and $12.0 million for each of FY2028 and FY2029, increasing federal outlays.*
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 3 benefits, 0 costs, 2 mixed.
What CMSCP plans must cover
If enacted, CMSCP plans would be required to cover many core services when provided by network providers or community resources. That list includes doctor visits; inpatient and outpatient hospital care; mental health and substance use services; preventive care; lab tests and x-rays; prescription drugs; emergency ground ambulance rides; emergency services under federal law; and community population-health services. CMSCP plans could not charge any deductible for covered services, and in-network copays must be limited so they do not block access to care.
Who can get CMSCP coverage
If enacted, the program would let people who live or work in a partner hospital area enroll if their household income is above their State's Medicaid limit but at or below 400% of the federal poverty guideline. You must not have had a qualified health plan in the prior 180 days unless that coverage ended for a qualifying event. You must be ineligible for federal health programs like IHS or VA. You may qualify only if you work for a small employer that does not offer affordable coverage (the statute compares combined premium plus deductible to 7% of household income). The Secretary could add other rules.
How CMSCPs must be funded
If enacted, CMSCPs would have to share direct program costs among the public sector, local hospitals and providers, enrollees, and enrollees' employers or trade groups. Programs must plan a multi-year move away from reliance on a single funding source and show progress toward getting state, local, and hospital community benefit money to supplement federal grants. That means some local employers and enrollees would be expected to contribute to ongoing costs.
Personal coaching and enrollment rules
If enacted, CMSCPs would give regular community and individual assessments of factors that affect your health and work. Each enrollee would get an individualized plan with a health domain score, coaching, group classes, and links to local training and work supports. If demand is higher than capacity, programs must publish a written enrollment priority policy. Programs could end someone's participation for sustained failure to meet minimum engagement or personal-growth steps, but those steps must be participatory (not health-contingent) and include reasonable alternatives in the person's plan. Programs must also evaluate effects on employment, health, and income.
Grants, applicants, and local partnerships
If enacted, HHS would award 3 to 5 grants within 180 days to start Community Multi-Share Coverage Programs. The bill would authorize $4.8 million for FY2026, $7.2 million for FY2027, and $12 million for each of FY2028 and FY2029. Grants would last four years and at least one award must go to a program already operating. Applicants must be nonprofits with written commitments from local hospitals and small employers. They must certify no preexisting-condition exclusions, show a sufficient provider network, plan to enroll low-income households, pick an administrator for billing and eligibility, submit annual reports, and work with local hospital and community partnerships.
Sponsors & CoSponsors
Sponsor
Moolenaar, John R. [R-MI-2]
MI • R
Cosponsors
Rep. Huizenga, Bill [R-MI-4]
MI • R
Sponsored 4/29/2026
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov