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The Buildout · Week of April 6–12, 2026

Published April 6, 2026. Auto-generated from The Buildout's pipeline; not edited.

U.S. federal spending, week ending 2026-04-12.

The Department of Health and Human Services obligated $210.3 billion in Medicaid entitlements to five states this week, with California alone receiving $80.2 billion for fiscal 2026 coverage. The four largest awards—to California, New York, Texas, and Pennsylvania—account for the bulk of the week's spending and reflect the routine quarterly distribution of federal matching funds to state programs. Ten contracts crossed the wire total; the Federal Register saw modest activity with notices on NIH closed meetings and a continuation of the Somalia emergency declaration.

Context. $655,138,056,315 is the largest weekly total in the trailing 8 weeks — versus an average of $55,704,379,204.

This week's biggest contracts

$80,226,900,892 · Department of Health and Human Services → HEALTH CARE SERVICES, CALIFORNIA DEPARTMENT OF

MEDICAID ENTITLEMENT FOR 7 - FY 2026 - T19

$45,939,696,597 · Department of Health and Human Services → NYS DEPARTMENT OF HEALTH

MEDICAID ENTITLEMENT FOR 42 - FY 2026 - T19

$29,031,104,531 · Department of Health and Human Services → HEALTH & HUMAN SVC COMMN TX

MEDICAID ENTITLEMENT FOR 54 - FY 2026 - T19

Also this week:

DateRecipientAgencyAmountSector
2026-04-06PA DEPARTMENT OF HUMAN SERVICESDepartment of Health and Human Servi$29,024,953,484
2026-04-06OHIO DEPARTMENT OF MEDICAIDDepartment of Health and Human Servi$26,062,737,878
2026-04-06PA DEPARTMENT OF HUMAN SERVICESDepartment of Health and Human Servi$24,655,483,126
2026-04-06FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATIONDepartment of Health and Human Servi$21,945,445,030
2026-04-06NORTH CAROLINA DEPARTMENT OF HEALTH & HUMAN SERVDepartment of Health and Human Servi$18,399,629,835
2026-04-06FLORIDA AGENCY FOR HEALTH CARE ADMINISTRATIONDepartment of Health and Human Servi$15,780,010,182
2026-04-06HEALTH SERVICES KENTUCKY CABINET FORDepartment of Health and Human Servi$15,593,085,025

From the Federal Register

Proposed rules

Notices and other

On the record

Verbatim from agencies' own Federal Register filings this week.

Notice is hereby given that on April 7, 2026, the presiding administrative law judge ("ALJ") issued an Initial Determination on Violation of Section 337.

International Trade Commission, notice, 2026-04-10

Pursuant to the Department of the Treasury (Treasury) and FinCEN's efforts to modernize the Bank Secrecy Act (BSA) and to implement provisions of the Anti-Money Laundering Act of 2020 (AML Act), FinCEN is proposing a rule to fundamentally r

Treasury Department, proposed_rule, 2026-04-10

The Environmental Technologies Trade Advisory Committee (ETTAC) will hold an in-person meeting on Tuesday, April 28, 2026.

Commerce Department, notice, 2026-04-10

What to watch

Concrete things to look for in the next two weeks — re-bids opening up, rules taking effect, and funding windows closing.

Coming up for re-bid

Rules taking effect


The Buildout · Issue covering 2026-04-06 – 2026-04-12. Generated 2026-05-14. Data: USAspending.gov, Federal Register, Grants.gov, agency RSS. Subscribe · Archive · Methodology.