Pennsylvania lawmakers passed a $50.8 billion state budget on on July 12, 2026, utilizing a “cycle roll” accounting maneuver to balance the books without dipping into the state’s rainy-day fund. This tactic involved delaying approximately $2.6 billion in payments to the state’s Medicaid managed care organizations – which manage health care for the majority of Pennsylvania’s Medicaid recipients – over a two-year period.
While House Appropriations Chair Jordan Harris, D-Philadelphia, maintained that the delayed payments would not impact services, Independent Fiscal Office head, Matthew Knittel, warned of potential cash flow issues for the managed care organizations and noted that the move does not resolve the state’s underlying problem of spending more than it earns.
The Primary Care Practitioner Program (PCPP) was flat funded in the state budget at $8.35 million. PCPP funds the state loan repayment program, the Pennsylvania Primary Care Career Center, the Pennsylvania Office of Rural Health, and other programs.