State Policy
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- State Policy · NE
Cost of Living, Medicaid Work Rules Shape Nebraska Senate Race
Nebraska's U.S. Senate race between Republican incumbent Pete Ricketts and independent Dan Osborn is centering on cost-of-living concerns, with Medicaid policy entering the debate indirectly. Osborn has criticized the federal tax and spending law for cutting benefits while favoring wealthy taxpayers, pointing to new Medicaid work requirements included in that law as an offset for tax cuts. Ricketts defends the law's tax relief but has acknowledged voters are feeling economic strain from inflation, tariffs, and the Iran war's effect on fuel and fertilizer costs. The election is set for the 2026 midterms, with national Republicans in competitive races facing similar pressure over cost-of-living and administration policy fallout.
- State Policy · CT
Hayes, Shea clash over Medicaid cuts in CT-5 debate
U.S. Rep. Jahana Hayes and Republican challenger Chris Shea debated Tuesday night in Connecticut's competitive 5th Congressional District race, with sharp disagreement over federal tax-and-spending legislation known as H.R. 1. Hayes said she would push to rescind cuts to Medicaid and SNAP enacted through the law's new work requirements, noting nearly 63,000 Connecticut residents have already lost SNAP benefits due to eligibility changes. Shea countered that he wants the law's tax relief provisions strengthened or made permanent, criticizing Hayes's opposition to the bill. The debate, hosted by the League of Women Voters of Litchfield County, was likely the only face-off before the Nov. 3 election.
- State Policy · OH
Ohio Poll Shows Trump Disapproval Amid Medicaid Cuts, Close Races
New YouGov polling shows 57% of Ohio likely voters disapprove of President Trump's job performance, with Democrats Sherrod Brown and Amy Acton holding leads over Republicans Jon Husted and Vivek Ramaswamy in the state's Senate and governor's races. The article cites Trump's embrace of unpopular measures, including cutting federal food assistance and slashing Medicaid, alongside tax cuts for wealthy Americans, as factors dragging down Republican candidates. Early voting is underway in Ohio ahead of the November 3 election. Forecasters including Decision Desk HQ and Polymarket give Democrats strong odds of winning the U.S. House and a better-than-even chance at the Senate.
- State Policy · AR
Arkansas Governor Candidates Spar, Skip Medicaid Expansion Details
In a gubernatorial debate Tuesday, Democrat Fred Love and Libertarian Colt Shelby criticized Republican Gov. Sarah Huckabee Sanders' school voucher program, spending priorities and prison plans, but none of the three candidates offered specific plans for the future of Arkansas's Medicaid expansion program. The debate comes after Sanders' office said in July that the Trump administration rejected the state's request to renew its hybrid Medicaid expansion program, which purchases private insurance for low-income residents; the state has since requested a temporary two-year extension while it develops a replacement. Sanders is seeking reelection in November 2026 and is considered a heavy favorite. The lack of candidate detail on Medicaid leaves open questions about coverage for low-income Arkansans depending on the state's replacement plan.
- State Policy · OR
Kotek, Drazan Clash Over Medicaid Funding in Oregon Debate
Oregon Gov. Tina Kotek and Republican challenger Christine Drazan held their final gubernatorial debate in Bend, covering housing, homelessness and health care ahead of the election. Kotek said she has worked to protect the state's Medicaid program, the Oregon Health Plan, from federal cuts and criticized Drazan for voting against a state tax package that helps fund it. Drazan countered that she opposed the tax measure because it imposed new taxes, and argued Kotek has failed to deliver results for Oregonians over her term. The debate, hosted by KTVZ, also touched on rural representation, land use law and homelessness policy differences between the candidates.
- State Policy · ME
Maine Governor Candidates Clash Over MaineCare Fraud in Debate
Republican Bobby Charles and Democrat Hannah Pingree traded blame over Medicaid fraud during their third gubernatorial debate, hosted by WGME on October 13, 2026. Charles called Pingree "the poster child for fraud" and tied MaineCare fraud to the state's acceptance of Medicaid expansion, while also citing a $46 million federal audit finding on autism services as evidence, though the moderator noted that is not what the audit found. Independent candidate Rick Bennett proposed creating an inspector general position to investigate fraud complaints, while Pingree pledged to ensure healthcare dollars are spent on healthcare and blamed the Trump administration for making unfounded fraud allegations against Maine. The debate also covered a projected $1.3 billion state budget shortfall tied partly to rising healthcare costs.
- State Policy · CT
CT Voices for Children: State Poverty Rate Surpasses Pre-Pandemic Level
CT Voices for Children, a New Haven policy group, released a report Tuesday finding Connecticut's poverty rate rose to 10.6% in 2025, up from 7% in 2021 and above the 9.3% pre-pandemic level in 2019, as temporary pandemic-era benefit expansions expired. Child poverty saw the sharpest reversal, falling to 3.8% in 2021 before climbing back to 12.5% by 2025. The report warns that upcoming federal cuts, including new Medicaid work requirements and other eligibility rules taking effect in 2027, could remove roughly 110,000 adults from Medicaid and further increase poverty, alongside SNAP losses that have already affected about 63,000 residents. Women, Black and Hispanic residents, noncitizens, and children face disproportionate risk as these changes take hold.
- State Policy · WV
West Virginia Awards $2 Million in Rural Health Funds to Clinics
West Virginia Gov. Patrick Morrisey announced the state is distributing more than $2 million in Rural Health Transformation Program funds to community health centers. The West Virginia Primary Care Association will receive $1,656,432 to build a statewide clinically integrated network starting with 16 health center organizations across 40 counties, supporting shared care coordination, population health management and data analytics tools. The Monongahela Valley Association of Health Centers will receive $500,000 to modernize operations across its Fairmont, Shinnston and Mannington clinics. West Virginia received $199 million in federal Rural Health Transformation Program funds for 2026 under a five-year CMS program created by the One Big Beautiful Bill Act.
- State Policy · CA
California Ballot Measure Would Tax Billionaires for Health Funds
California's Proposition 40, backed by SEIU-UHW, would impose a one-time 5% wealth tax on roughly 200 residents worth at least $1 billion, directing 90% of revenue to a state healthcare fund and splitting the rest between food assistance and education. Supporters say it could raise up to $100 billion over five years to offset an estimated $30 billion in annual federal healthcare cuts from the One Big Beautiful Bill Act, which is projected to nearly double California's uninsured population. Critics, including the California Budget & Policy Center and California Medical Association, warn the measure's broad language gives the governor and legislature wide discretion over spending, could let lawmakers supplant rather than supplement existing state dollars, and wouldn't deliver funds for months even if approved. Voters decide the measure in November, with proceeds potentially directed toward Medi-Cal eligibility losses, provider reimbursement rates, or Covered California subsidies.
- State Policy · MI
Michigan SNAP Enrollment Drops 167,000 After New Work Rules
Michigan's SNAP enrollment fell by more than 167,000 people, including over 53,000 children, between June 2025 and August 2026, a nearly 12% decline, according to the Detroit Free Press. State officials and policy experts attribute much of the drop to new federal work requirements and added paperwork enacted under the 2025 federal tax law, which expanded work-and-reporting mandates to adults aged 18-64 without dependents under 14 and eliminated exemptions for homeless individuals, veterans, and former foster youth. Michigan's Department of Health and Human Services says confusion over new reporting duties, rather than reduced need, is driving people off the program, and the state must now also cover a larger share of program costs. Food pantries across the state report rising demand as former SNAP recipients lose benefits.
- State Policy · SD
South Dakota Groups Press Rhoden to Join Summer EBT Program
Thirty-four South Dakota organizations, led by Bread for the World South Dakota, sent Gov. Larry Rhoden a letter asking him to opt into the federally funded Summer Electronic Benefits Transfer program for 2027. The program provides $120 per eligible child in grocery benefits over summer months to families enrolled in SNAP, TANF, Medicaid, free or reduced-price lunch, or similar programs; South Dakota would qualify for $6.8 million covering 57,000 kids. The governor's deputy secretary of education says the administration is reconsidering after years of declining to participate, citing an estimated $500,000 to $700,000 setup cost plus IT and staffing needs, though the federal government covers half of ongoing administrative costs. South Dakota must decide by January 1 to participate in summer 2027; it is one of 11 states, all with Republican governors, not currently offering the program.
- State Policy
NASHP Details State Strategies to Align SUD Spending with Community Input
In a NASHP blog post, the organization shares lessons from AIR's MAAPPS Project, a multi-year effort that worked with Maryland and Oregon to help states incorporate community input into substance use disorder policy and funding decisions. The post outlines five strategies: inventorying existing data sources like Medicaid claims and SAMHSA's TEDS, meaningfully engaging people with lived experience, embedding community feedback into policy development, disseminating findings transparently, and building accountability mechanisms. It cites Maryland's Office of Overdose Response as an example, which used the MAAPPS framework to shape priorities for its 2027 Opioid Restitution Fund Grant Program. The piece targets state Medicaid and behavioral health agencies seeking to better align opioid settlement and SUD investments with community needs.
- State Policy · AL
Alabama Medicaid CIO Discusses IT Modernization Strategy, Governance
In a Q&A published by the National Association of Medicaid Directors, Alabama Medicaid CIO Mason Tanaka discusses the state's approach to system modernization. Tanaka emphasizes that modernization efforts should be driven by business needs rather than technology for its own sake, and that strong governance structures are essential to building systems that last. The interview covers how Alabama's governance foundation is positioning the agency to adopt new technologies going forward. No new rule, contract, or procurement action is announced in the piece.
- State Policy · CT
Trinity College Study Finds Cost Delays Abortion Access in Connecticut
Trinity College researchers, partnering with the REACH Fund of Connecticut, surveyed 969 people and found more than 80% delayed abortion care due to cost, including 83% of Medicaid patients and 76% of people with private insurance. Uninsured respondents almost universally reported delays for financial reasons, with some waits stretching a month or longer, raising procedure costs as delays push patients past the window for medication abortion. Though Connecticut Medicaid covers abortion services at in-state clinics, advocates note patients still face out-of-pocket costs for telehealth, travel, childcare and lost wages. The study calls for expanded funding for abortion access and related logistical costs, and advocates warn that more than 100,000 Connecticut residents could lose Medicaid coverage under new federal work requirements, compounding financial barriers to care.
- State Policy · MO
New Owners End Labor and Delivery at Missouri's Fitzgibbon Hospital
Fitzgibbon Hospital in Marshall, Missouri, ended labor and delivery services just nine days after new owners Strawberry Fields REIT and operator American Medical Administrators completed their purchase of the bankrupt hospital in early September. The hospital, renamed Missouri Valley Regional Medical Center, delivered 252 babies in 2025 and was one of few options for pregnant patients north of Interstate 70 in central Missouri. Patients will now travel 30 minutes to over an hour to Bothwell Regional Health Center or Western Missouri Medical Center to deliver, while prenatal and postpartum care continues locally through Marshall Women's Care. Fitzgibbon had sued the buyers to force the sale through after it missed its deadline, alleging the new owners planned to cut services despite earlier commitments to preserve care; the new operator says the hospital's finances made maintaining obstetric staffing unsustainable at under one birth per day.
- State Policy · CA
California Funds First Pharmacist Pipeline Program at UC San Diego
California has allocated $3.6 million to launch PRIME Rx at UC San Diego's Skaggs School of Pharmacy, the first PRIME program housed at a pharmacy school. The program will fund scholarships for roughly 10 PharmD students per year over the four-year degree, with clinical training in community-based settings aimed at underserved areas including the U.S.-Mexico border region. The one-time funding is expected to sustain the program for three years while the school seeks permanent state support. UC San Diego is also partnering with Southwestern College on a separately funded pharmacy technician associate degree program to address broader workforce shortages.
- State Policy · VT
Hartford School Leaders Argue Vermont Mandates Are Gutting District Budgets
In a VTDigger commentary, Hartford School District superintendent Caty Sutton, the Hartford School Board and district and union leadership argue that state legislative actions are devastating their school system. They cite a legislative reduction of the excess spending threshold from 118% to 115.5% as forcing an almost $5 million budget cut, potentially requiring a 25% staff reduction, alongside unfunded PCB testing mandates, a rushed transition to a new Medicaid reimbursement model, and a mandatory regional service-area realignment. The authors say they received no transition time for the Medicaid billing change and no evidence that these mandates will improve outcomes or save taxpayers money. They call on their legislative delegation to revisit the spending threshold cut, fund PCB remediation, and slow the regional restructuring process.
- State Policy · MI
Michigan's largest hospitals refuse to disclose facility fee revenue
Bridge Michigan asked the state's 10 largest health systems and three rural hospitals how much they collect annually in facility fees and what the money funds; none disclosed dollar amounts, though some described general uses like cybersecurity and emergency staffing. Only one rural hospital, Scheurer Health, shared a figure, expecting roughly $125,000 this year against a $125 million budget. State Rep. Curt VanderWall, who chairs the House Health Policy Committee, has introduced legislation to ban facility fees for routine outpatient care, certain outpatient services, and telemedicine visits, and says the industry's refusal to disclose figures undermines its claim that the fees are essential. Neither the hospital association nor the state currently tracks total facility fee collections statewide.
- State Policy · GA
Bottoms Pushes Medicaid Expansion as GOP Rival Skips Georgia Debate
Georgia Democratic gubernatorial nominee Keisha Lance Bottoms debated an empty podium Monday after GOP nominee Rick Jackson skipped the Atlanta Press Club's Loudermilk-Young debate, the first general-election gubernatorial candidate to do so since 1994. Jackson instead campaigned with Gov. Brian Kemp across the state, citing affordability and property taxes as voter priorities over debate appearances. Bottoms used the forum to promote her platform, including expanding Medicaid, fully funding pre-K, and creating an affordable housing fund, while also criticizing Georgia's six-week abortion ban. Early voting for the Nov. 3 general election begins Tuesday.
- State Policy · WY
Wyoming Task Force Drops BearCare Catastrophic Coverage Plan
In a WyoFile opinion column, Kerry Drake argues that Wyoming's Health Insurance Affordability Task Force should be extended another year after dropping its BearCare catastrophic coverage proposal and a state medical device purchasing plan. Legislative Service Office analysis found BearCare premiums would need to be fairly high to cover the risk pool, undercutting expected cost savings; the task force reached the same negative conclusion on the device purchasing idea. Drake notes the backdrop: over 9,000 Wyoming residents saw record premium spikes after Congress let enhanced ACA tax credits lapse, and some face increases over 400%. The task force is now exploring a health department proposal to designate "core" high-cost services for price regulation via a block grant and a utility-like commission, while leaving other services to market competition; Drake says the idea remains unfinished and raises funding concerns.