State Policy
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- State Policy
KFF Tracker Compiles Abortion Ballot Initiatives for November 2026 Election
KFF has published a tracker reviewing abortion-related ballot initiatives currently slated for November 2026 across multiple states. The brief examines how these measures may impact abortion access depending on election outcomes. While abortion ballot initiatives do not directly regulate Medicaid coverage or managed care operations, they can affect reproductive health coverage requirements for state Medicaid programs and managed care plans if measures pass that expand or restrict abortion access. State Medicaid agencies and MCOs operating in states with ballot measures may face subsequent coverage policy changes.
- State Policy
NASHP Convenes States on Children's Behavioral Health Service Delivery Models
The National Academy for State Health Policy (NASHP) reports it convened states through a policy academy focused on strengthening behavioral health services for children and youth. Participating states worked on expanding service capacity, supporting the behavioral health workforce, and improving care coordination across systems. The initiative addresses persistent challenges in children's behavioral health access and integration, particularly relevant for states expanding Medicaid-covered behavioral health benefits and managed care network adequacy requirements. Details on specific state participants, policy commitments, or timelines were not provided in the source material.
- State Policy · AR
Arkansas Launches Outreach Campaign for Medicaid Work Requirements Starting January
Arkansas Department of Human Services released an outreach toolkit Thursday including flyers, posters, text messages, and videos to inform Medicaid expansion enrollees about work requirements taking effect in January. The requirements will apply to certain expansion population members. Affected enrollees will need to meet work, education, or qualifying activity thresholds to maintain coverage. The campaign reflects Arkansas's move to implement community engagement requirements following federal approval.
- State Policy · FL
Florida ABA Task Force to Hear Managed Care Plans on Autism Therapy Delivery
A Florida task force examining applied behavior analysis service delivery for children with autism and special needs will convene Monday to hear from managed care organization representatives, including Simply Healthcare, Sunshine Health, and Humana Healthy Horizons. The task force is considering potential changes to how the state structures and delivers ABA therapy through its Medicaid program. The meeting follows earlier sessions exploring current delivery models and stakeholder concerns about access and reimbursement.
- State Policy · SD
CMS Awards South Dakota $13 Million for Mobile Crisis Response and Behavioral Health Expansion
CMS awarded South Dakota $13 million to expand behavioral health services and establish a statewide 24/7 mobile crisis response service. The funding will support crisis intervention teams, workforce development, and infrastructure to improve access to behavioral health care across the state. Implementation timing was not specified in the announcement. The investment addresses South Dakota's behavioral health access gaps and aligns with federal priorities to expand crisis services as alternatives to emergency department utilization.
- State Policy · NC
UNC Health Pardee Opens Adolescent Behavioral Health Inpatient Unit in Hendersonville
UNC Health Pardee has opened an inpatient adolescent behavioral health center in Hendersonville, North Carolina, serving teens in Henderson and surrounding counties experiencing mental health crises. The new facility addresses a regional gap in youth psychiatric services. The opening is relevant to North Carolina Medicaid given that Medicaid covers approximately half of all children in the state and is a major payer for behavioral health services, including inpatient psychiatric care for eligible adolescents.
- State Policy · RI
Rhode Island Outlines Rural Health Projects Under $156M Federal Award
Rhode Island is developing plans for its $156.17 million allocation from a nationwide rural healthcare funding program enacted in July 2026. The state is working to finalize project details ahead of an October federal deadline. The funding is part of a $50 billion national initiative targeting rural health infrastructure and services. Rhode Island Medicaid agencies and providers serving rural populations should monitor how these dollars will be deployed and whether Medicaid-funded services or facilities are included in the state's implementation plan.
- State Policy · VT
Vermont FQHC Opens Three 340B Pharmacies Amid Statewide Closures
North Star Health, a Federally Qualified Health Center, opened pharmacies in Springfield and Londonderry, Vermont, and Charlestown, New Hampshire, in September 2026, leveraging 340B drug pricing to charge patients less than commercial pharmacies. Vermont lost 28 pharmacies between 2019 and 2024, leaving pharmacy deserts in Windsor and Rutland counties where North Star operates. The Springfield pharmacy began operations in November 2025 for out-of-pocket and commercial patients and now contracts with Medicare and Medicaid. The 340B discount allows North Star to offset losses from low primary care and behavioral health reimbursement, according to CEO Josh Dufresne.
- State Policy · IN
Indiana FSSA Issues RFP for Second Short-Term Residential Facility for Disabled Adults
The Indiana Family and Social Services Administration issued a request for proposals for a provider to operate a 10-20 bed short-term residential facility for intellectually disabled adults with severe behavioral, psychiatric, or medical needs. The facility would replace a co-ed facility that closed in 2024 and address a service gap, particularly for women, as Indiana's only existing comprehensive rehabilitative management needs facility serves men only. The current per diem rate for such facilities is $703. Disability advocates have raised concerns that the new facility, combined with recent changes to Medicaid waiver assessments that have resulted in higher denial rates, could signal a shift toward institutionalization rather than community-based care.
- State Policy · NC
North Carolina Medicaid Launches Expedited Reverification for High-Risk Providers
North Carolina Medicaid has initiated an expedited, off-cycle reverification process targeting certain high-risk providers. Affected providers must complete the reverification process to maintain enrollment status, with failure potentially resulting in disenrollment from the state's Medicaid program. The initiative creates immediate due diligence considerations for providers undergoing transactions, as enrollment status could be subject to accelerated review outside the standard cycle. This action follows federal program integrity requirements that permit states to conduct targeted reverifications of providers posing elevated financial or compliance risk.
- State Policy · KY
Kentucky Planned Parenthood Vows to Continue Operations After Medicaid Termination
Planned Parenthood announced it will maintain operations in Kentucky following termination from the state's Medicaid program. The organization stated it remains committed to serving patients in Kentucky despite the ban. The termination affects Medicaid beneficiaries' ability to receive reimbursed services at Planned Parenthood locations. This development follows broader state efforts to exclude certain family planning providers from Medicaid networks, requiring affected beneficiaries to seek covered services from alternative Medicaid-enrolled providers.
- State Policy · TN
Tennessee Hospital to Resume Labor and Delivery Services in Spring 2027
Henry County Hospital in Paris, Tennessee will restore maternity services beginning spring 2027, according to a September 22 announcement from West Tennessee Healthcare. The hospital has recruited an additional physician to its women's health team to support the resumption of deliveries. The restoration addresses a gap in local access to obstetric care in the region. For Medicaid agencies and managed care plans serving pregnant beneficiaries in rural Tennessee, this represents restoration of a delivery site that affects network adequacy and access to maternity benefits in Henry County.
- State Policy · NM
New Mexico Approves 11 of 13 Regional Behavioral Health Plans
The committee tasked with rebuilding New Mexico's behavioral healthcare infrastructure has approved 11 of 13 regional plans, with two regional plans remaining for approval. The chair provided the update to the interim Legislative Finance Committee on Tuesday. The approvals represent progress toward statewide implementation of a restructured behavioral health delivery system. This development directly affects how behavioral health services will be organized and delivered across New Mexico's Medicaid program.
- State Policy · AR
Arkansas Child Uninsured Rate Reaches Decade High at 7.7 Percent
Arkansas Advocates for Children and Families reports that 57,000 Arkansas children — 7.7% of the state's child population — were uninsured in 2024, an increase of 7,000 from the previous year and the highest level in a decade. Hispanic children face the highest uninsured rate at nearly 14%, and foreign-born children are more than seven times more likely to be uninsured than U.S.-born children. The report attributes rising uninsurance to Medicaid disenrollment following pandemic-era continuous enrollment protections and warns that federal Medicaid spending cuts under H.R. 1 will create additional instability. Arkansas' Medicaid expansion program, covering more than 200,000 low-income adults, faces an uncertain future after the Trump administration denied the state's renewal request.
- State Policy · OR
Oregon to Notify 600,000 Medicaid Members of Coming Program Changes
Approximately 600,000 Oregon Health Plan members will receive notices about upcoming changes to the state's Medicaid program following new federal requirements. The notices will inform members of modifications to their coverage. The timing of the changes and specific effective dates were not detailed in the available information. The notifications represent a significant communication effort affecting roughly half of Oregon's Medicaid enrollment, requiring coordination between the state and health plans to ensure members understand how their benefits or program participation may shift.
- State Policy · CT
Connecticut GOP Candidate Proposes $336M Medicaid Cut, Managed Care Transition
Connecticut Republican gubernatorial candidate Ryan Fazio announced a tax cut plan that would reduce Medicaid spending by $336 million annually by 2031 through eliminating coverage for undocumented residents, fraud reduction efforts, and transitioning to a managed care model for the state's Medicaid program. The proposal would also cut $1.2 billion in annual state spending and $500 million in borrowing. The managed care transition faces strong opposition from the Democratic-controlled state legislature. The plan's fiscal projections rely on outdated revenue forecasts and do not account for recent investments in municipal aid, childcare, and social services.
- State Policy · MT
Montana DPHHS Director Charlie Brereton to Leave Oct. 30, Harrington Named Successor
Charlie Brereton will step down as director of Montana's Department of Public Health and Human Services on October 30 after four years, moving to the private sector. Dr. Doug Harrington, the department's state medical officer, will replace him. The transition occurs as DPHHS oversees a $233 million federal Rural Health Transformation Program grant, implements new Medicaid and SNAP work requirements set to begin this fall, and manages a $7 billion biennial budget covering Medicaid, behavioral health, and other health and human services programs. Brereton led the agency through Medicaid unwinding, behavioral health investments, and rural hospital stabilization efforts.
- State Policy · MD
Maryland Health IG Reports $42M in Improper Payments from Audits Now Public
Maryland's Office of Inspector General for Health conducted 1,369 investigations and 53 audits over fiscal years 2023-2025 identifying $42 million in improper or unrecovered payments from healthcare providers and local health departments. The agency has now posted 20 audit reports publicly for the first time after operating largely without public disclosure since becoming independent in 2022. The reports detail $4.3 million owed by 13 healthcare providers for inadequate documentation and duplicate payments, plus $1.7 million owed by local health departments for documentation errors and missing equipment. The Maryland Department of Health, not the IG, handles recoveries and has historically forgiven portions of identified overpayments.
- State Policy · MO
Over Half of Missouri Counties Lack Labor and Delivery Services, March of Dimes Reports
A new March of Dimes report finds that more than 50% of Missouri counties are maternity care deserts with no labor and delivery units or obstetric physicians, affecting nearly 140,000 women of childbearing age. Between 2010 and 2024, nine Missouri counties lost hospital-based obstetric services, driven by high fixed costs, low birth volumes, and higher Medicaid patient shares at rural hospitals. Research shows that after rural counties lose obstetric services, risks of preterm birth, out-of-hospital birth, and delivery at facilities without dedicated obstetric units increase. The closures add an average of 25 minutes to travel times for families near affected facilities.
- State Policy
Nine States to Vote on Tax Measures Affecting Medicaid and Public Program Funding
Voters in at least nine states will decide tax ballot measures this fall that could significantly alter revenue available for Medicaid and other public services. California's Proposition 40 would impose a one-time 5% wealth tax on billionaires to close budget gaps in Medicaid, food assistance, and education programs — a response to federal funding losses from the 2025 One Big Beautiful Bill Act. Colorado and Washington state also face income tax measures. California's measure would raise tens of billions for Medicaid and other services, though competing ballot measures could undo it if they receive more votes. The outcomes will determine state capacity to fund Medicaid programs amid tightening federal support.
