State Policy
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- State Policy · SD
South Dakota Factions Clash Over Ad Claims in Amendment L Fight
Backers and opponents of South Dakota's Amendment L traded accusations this week over campaign ads linking the measure to "out-of-state billionaires." Amendment L, on the Nov. 3 general election ballot, would require 60% voter approval for future constitutional amendments, though it would not change thresholds for citizen-initiated laws or referendums. Supporter Rep. John Hughes sent a cease-and-desist letter to media outlets airing opposition ads, calling them defamatory, while opponents say the ads illustrate how costly ballot campaigns would become under a higher threshold. The measure is the third such attempt in South Dakota since 2018, following past efforts that included constitutional ballot measures on Medicaid expansion and marijuana legalization.
- State Policy · MS
Mississippi Budget Committee Begins Hearings on $32B Spending Plan
Mississippi's Joint Legislative Budget Committee held two days of public hearings last week, starting the formal process of building a recommendation for the state's fiscal year 2027 budget, currently running at over $32 billion including $13.11 billion in federal funds. The committee will develop a budget recommendation before the legislative session begins January 5, 2027, which then serves as a starting point for lawmakers. Federal funds make up a significant share of spending for agencies including Medicaid, Human Services, Environmental Quality and Transportation, while the general fund and state-support funds ($9.22 billion) are the portion legislators have the most discretion over. The article describes the ongoing, largely behind-the-scenes annual budgeting cycle rather than a specific new policy decision.
- State Policy · CO
Colorado Voters to Decide Medicaid Ban on Youth Gender Surgeries
Colorado's November ballot includes Proposition 135, which would prohibit health care professionals from performing gender-affirming surgeries on minors and bar state and federal funding, including Medicaid, from covering such procedures. The measure, backed by Protect Kids Colorado, is opposed by a coalition of LGBTQ+ advocacy groups, Democratic officials, and the Colorado Medical Society, whose board says the measure's vague language around a minor's "perception of sex or gender" could make care delivery too legally uncertain for providers to administer. Gender-affirming surgeries for minors are rare nationally and already unavailable at Colorado's two major pediatric hospital systems, which halted such care in 2025 amid federal pressure. The measure goes before voters in November 2026.
- State Policy · ID
NAMI Idaho to Honor Providers Who Reversed Medicaid Mental Health Cuts
The National Alliance on Mental Illness of Idaho plans to award clinic owners Laura Scuri and Ric Boyce its Kathie Garrett Impact Award for advocacy that led the Idaho Legislature to restore funding for Assertive Community Treatment and peer support services. The programs, administered through the state's Medicaid behavioral health contractor Magellan, had been cut following a gubernatorial executive order reducing the vendor's payment; four patients died after the mobile treatment service was eliminated. Gov. Brad Little signed legislation on the final day of the session temporarily restoring the funding after the two providers built relationships with lawmakers and engaged journalists. The award will be presented October 9 at a Boise gala, as Idaho continues moving toward privatized management of all Medicaid benefits.
- State Policy · WI
Wisconsin Governor Candidates Clash Over BadgerCare, Healthcare Cost Plans
Wisconsin's gubernatorial candidates, Democrat David Crowley and Republican Tom Tiffany, have released competing healthcare affordability plans ahead of the 2026 election. Crowley proposes opening BadgerCare (Wisconsin's Medicaid program) to any household, with income-based premiums, subsidies for small businesses and gig workers, and expanded coverage for dental, vision and mental health. Tiffany's plan focuses on price transparency requirements for hospitals and insurers, a direct-pay subscription model for primary care, and increased oversight of pharmacy benefit managers. The debate comes as a Forward Analytics report shows Wisconsin hospital prices among the highest in the nation, with hospital costs up 274 percent since 2000 versus 90 percent income growth, and as federal Medicaid work requirements for childless adult BadgerCare members are set to begin in 2027.
- State Policy · WY
Wyoming Committee Advances Bill to Raise Medicaid Nursing Home Limits
Wyoming's Joint Labor, Health and Social Services Committee directed staff to draft legislation raising the personal needs allowance for Medicaid nursing home residents from $50 to $100 monthly and the asset limit from $2,000 to $5,000. The current limits date to 2001 and 1989 respectively and have not kept pace with inflation, according to hospital association and ombudsman testimony. Supporters, including the Wyoming Hospital Association and the Long-Term Care Ombudsman, say the low thresholds cause residents to lose coverage over small asset fluctuations and create uncompensated care burdens for facilities. The change is estimated to cost the state $1.3 million annually; the committee will consider the draft bill at its November meeting.
- State Policy · NC
NC Lawmakers Probe Claims Officials Falsified Medicaid Tech Funding Bids
GOP lawmakers in North Carolina say they are investigating allegations that state health officials used false information to obtain federal funding for a Medicaid technology overhaul. The allegations originated in a lawsuit that has since been dismissed, but the state auditor has revived a separate audit into the project. The scope and timeline of the legislative inquiry remain unclear, and no findings have been released. The matter raises questions about oversight of federal funding requests tied to the state's Medicaid IT modernization efforts.
- State Policy · MS
Mississippi Medicaid Requests $179M State Funding Increase
Mississippi's Division of Medicaid asked lawmakers for a roughly $179 million state funding increase for the fiscal year beginning July 2027, a 15% rise but far smaller than last year's nearly $390 million initial request. The agency also anticipates a $34 million shortfall in the current fiscal year. Executive Director Cindy Bradshaw told the Joint Legislative Budget Committee the figure will likely change, noting a slight federal matching-rate increase is expected to reduce the request by about $25 million. The agency's total projected budget, including federal funds, is $9.4 billion; cost-containment efforts include contractor and long-term care audits, prior authorization reviews, and reduced managed care profit margins. Lawmakers will issue budget recommendations in December ahead of the 2027 legislative session.
- State Policy · AR
Arkansas Families Press Lawmakers to Speed Disability Waiver Waitlist Fix
Families of Arkansans with disabilities testified before House and Senate committees urging faster relief for nearly 2,500 people on the Community and Employment Services Medicaid waiver waitlist, saying the state's planned 2027 timeline is too slow. Gov. Sarah Huckabee Sanders and DHS announced in September a roughly $17 million plan to have the managed-care Medicaid program begin covering non-medical in-home supportive living services by January, one of four services currently excluded for waitlisted families. DHS officials said the waitlist has ballooned because the agency's IT systems cannot keep pace with 400-500 annual applications, and the state must show CMS that home-based care saves money versus institutionalization. DHS plans to seek legislative approval this month for a customer-service vendor contract to streamline beneficiary access.
- State Policy · MO
Missouri Forgoes Optional Hardship Exemptions From Medicaid Work Rules
Missouri's Department of Social Services will not adopt optional federal "short-term hardship" exemptions from Medicaid work requirements, covering hospitalization, medical travel, disaster areas, and high-unemployment regions, that states may use under the federal law requiring 80-hour monthly work, school, or volunteer activity for expansion adults starting Jan. 1, 2027. The department says it will instead rely on mandatory caregiver and "medically frail" exemptions to limit bureaucratic complexity, and will verify compliance based on just one month within each six-month reporting period. Advocates, including Legal Services of Eastern Missouri and the American Cancer Society Cancer Action Network, warn the mandatory exemptions require more verification and may not cover people with short-term acute conditions like cancer treatment or hospital stays. As of Sept. 25, 344,669 Missourians were enrolled in the adult expansion group subject to the new requirements.
- State Policy · TN
Tennessee Faces $220M SNAP Cost Shift Under Federal Law
New federal cost-sharing rules under the One Big Beautiful Bill Act could force Tennessee to cover an estimated $220 million in additional SNAP costs next year, according to state budget data and the Sycamore Institute. The law raises states' share of SNAP administrative costs from 50% to 75%, adding $58 million to Tennessee's Department of Human Services budget in fiscal year 2026, and requires states with payment error rates above 6% to begin covering a share of SNAP benefit costs starting October 2027. Tennessee's 2025 error rate was 9.44%, which would trigger a 10% benefit cost share worth an estimated $162-171 million if it doesn't improve. States can choose 2025 or 2026 error-rate data to calculate contributions, but 2026 figures won't be released until June 2027, leaving Tennessee's exact liability uncertain. The changes took effect Thursday and arrive alongside tightened SNAP work requirements that have already removed over 100,000 Tennesseans from the program.
- State Policy · MN
Minnesota Individual, Small Group Insurance Rates to Rise 17% in 2027
Minnesota's Department of Commerce announced average 2027 premium increases of 17% for individual and small group health insurance plans, affecting roughly 203,000 individual market enrollees and 184,000 small group enrollees. This marks a second consecutive year of double-digit hikes, following a 22% individual market increase and 14% small group increase in 2026. State officials cited rising medical and drug prices, increased utilization, and growth of "profit-driven entities" in healthcare delivery and financing as drivers. The announcement coincided with a state Senate hearing where health economists linked hospital consolidation, including a newly announced merger between Essentia and HealthPartners, to rising premiums, and comes amid reduced federal premium tax credits and election-year political blame-shifting.
- State Policy · NM
NM House Candidates Clash Over Medicaid in District 3 Race
Incumbent U.S. Rep. Teresa Leger Fernández (D) faces state Rep. Martin Zamora (R-Clovis) in the Nov. 3, 2026 general election for New Mexico's 3rd Congressional District. In an interview with Source NM, Leger Fernández criticized Trump administration and Republican-backed cuts to Medicaid and food assistance, citing 10,000 New Mexico children who lost federal benefits due to the One Big Beautiful Bill, and said she would prioritize legislation to increase healthcare providers in rural areas. Zamora, who did not respond to interview requests, has campaigned on property rights, energy jobs, crime and border security rather than healthcare. The race will determine representation for a largely rural northern and eastern New Mexico district with significant Medicaid-dependent populations.
- State Policy · IA
Iowa Candidates Clash Over Medicaid, Immigration in Debate
Iowa state Rep. Lindsay James (D) and Republican Joe Mitchell debated Thursday ahead of the 2026 race for the state's 2nd Congressional District seat. Mitchell accused James of supporting Medicaid and SNAP access for undocumented immigrants, citing her vote against a measure requiring immigration status and residency verification for benefit eligibility; James called the characterization dishonest and said Iowans are her priority. The candidates also sparred over border security, immigration enforcement funding, and data-center tax incentives. The seat is open because incumbent Rep. Ashley Hinson is running for U.S. Senate.
- State Policy · NJ
NJ Advocates Demand Oversight After Opioid Funds Misspent
New spending reports released Thursday show New Jersey state, county, and municipal officials spent opioid settlement funds on bounce houses, DJs, dirt bike demonstrations, ice cream events, graduation parties, and other questionable items instead of core addiction treatment and prevention priorities. The $60 million spent over the past year is part of $1.1 billion New Jersey will receive through 2038 from drug manufacturers, distributors, and pharmacies to resolve opioid lawsuits. Harm reduction advocates, including the New Jersey Organizing Project and Sea Change Recovery Community, are calling for tighter oversight, pointing to prior criticism from the former state comptroller and attorney general over similar misuse, including a $45 million diversion to hospitals facing federal Medicaid cuts. Municipalities were singled out as the "worst offenders" of stretching definitions of prevention and treatment barriers to justify spending.
- State Policy · ME
LePage, Dunlap Spar Over Medicaid in Maine House Debate
Maine Morning Star reports that Republican Paul LePage and Democrat Matt Dunlap clashed in their first debate for Maine's open 2nd Congressional District seat, sparring over healthcare policy including Medicaid. Dunlap backed restoring expired ACA marketplace premium subsidies, which 85% of Maine's 61,000 CoverME.gov enrollees relied on, and voiced long-term support for universal healthcare; LePage opposed Medicaid expansion and defended federal Medicaid cuts, citing a $50 billion rural health funding program as an offset. LePage also repeated claims of widespread Medicaid fraud in Maine, though the state's most recent federal payment error rate was 2.4%, below the 3.2% national average, with only about 0.1% of spending confirmed incorrect. The debate occurred Oct. 1, ahead of the election to replace outgoing Rep. Jared Golden.
- State Policy · SD
South Dakota House Candidates Clash Over Tariffs, Medicaid Work Requirements
At an Oct. 1 debate co-hosted by South Dakota Public Broadcasting and South Dakota News Watch, Republican Marty Jackley and Democrat Nikki Gronli, candidates for South Dakota's U.S. House seat, sparred over tariffs, energy costs and the One Big Beautiful Bill Act's healthcare provisions. Jackley criticized Trump's push to import Argentine beef but otherwise backed Trump's tariff approach, while Gronli said tariffs and the Iran conflict have driven up costs for farmers and families. On Medicaid, Jackley defended the law's new work requirements as a fraud-prevention measure and praised sending rural health transformation dollars (South Dakota has received $189 million so far) to states to decide how to spend. Gronli argued the law's cuts to Medicaid and other programs would harm residents who depend on them. The general election is Nov. 3.
- State Policy · OR
Oregon Panel to Send Lawmakers Universal Health Plan by Dec. 1
A nine-member Universal Health Plan Governance Board, created by the Oregon legislature in 2023, will deliver a proposal to lawmakers by December 1 for a single-payer system covering medical, vision, dental, and mental health benefits for all residents starting in 2032, with no premiums, deductibles, or copayments. Lawmakers could vote on the plan in the 2027 session or send it to voters as a 2028 ballot measure. The plan would replace insurance premiums and out-of-pocket costs with new corporate and personal taxes funding a single payment pool for all providers, and would make Oregon the first state with single-payer coverage if adopted. Similar ambitions exist in California, New York, and Washington, but prior single-payer efforts in Vermont and ballot measures in Colorado, Oregon, and California have all failed amid industry opposition.
- State Policy · VA
Federal Funding Cuts End Virginia Medicaid Coverage for Legal Immigrants
In its morning headlines roundup, Virginia Mercury highlights a VPM report that federal funding cuts have ended Medicaid eligibility for thousands of legal immigrants in Virginia. The coverage losses stem from changes in federal funding tied to the Trump administration's policy actions, affecting legal immigrants who previously qualified for the program. The roundup also includes unrelated Virginia election and news items. No specific effective date or population count is detailed in the source material beyond the general claim of thousands losing access.
- State Policy · MA
Commentary: MassHealth GLP-1 Coverage Cuts Shift Costs, Not Savings
In a commentary piece, a CPA and nurse argues that Massachusetts insurers' decisions to end GLP-1 coverage for obesity, including MassHealth's move affecting about 22,000 members and the Group Insurance Commission's similar cut for public employees, produce illusory savings. The author cites trial data showing patients regain weight and cardiometabolic gains reverse within a year of stopping treatment, and notes insurers like Point32Health project over $100 million in savings even as premiums rise 10.4 percent for 2027. The piece argues this amounts to cost-shifting onto future payers and patients rather than genuine cost reduction, disproportionately harming lower-income residents. The author calls for Massachusetts to negotiate drug prices, adopt evidence-based eligibility criteria, and require insurers to publicly report health and cost outcomes from coverage restrictions.