Community Multi-Share Coverage Program Act of 2026

This bill directs the Secretary of Health and Human Services to award between three and five grants for Community Multi-Share Coverage programs. These programs aim to provide affordable health coverage and integrated health-related social services to small business workers and qualifying individuals, thereby reducing the number of uninsured, promoting workforce development, and supporting small business economic recovery, particularly for those hesitant to lose Medicaid eligibility.

Each program must maintain a physical presence and offer comprehensive health coverage, including physician, hospital, behavioral health, and prescription drug services, with no deductibles and limited co-payments. They are required to collaborate with existing community-based entities to align health, human service, and workforce-related services, ensuring coordinated care and efficient resource utilization.

A core component involves providing integrated continuous health improvement services, which include regular community assessments, individualized enrollee assessments for psycho-social barriers, and personalized plans for health and economic self-sufficiency through coaching, classes, and training. The program's funding structure mandates shared financial responsibility among the public sector, local healthcare providers, enrollees, and employers, aiming for long-term sustainability through diverse funding sources.

Qualifying individuals must meet specific income criteria (between Medicaid eligibility and 400% FPL), not be enrolled in other qualified health plans, and work for small employers not offering affordable health coverage. Grant applicants, which must be non-profit entities, must secure commitments from local hospitals and small employers, certifying no pre-existing condition exclusions and a focus on individuals with limited income. The bill authorizes appropriations totaling $36 million over four fiscal years.