State Policy
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- State Policy · IN
Indiana Families Navigate Ongoing I/DD Waiver System Changes Since Late 2023
Indiana's Medicaid waiver system for individuals with intellectual and developmental disabilities has undergone continuous changes since late 2023, including new service rules, case management restructuring, and modified eligibility requirements. Families and providers are managing multiple policy shifts simultaneously while maintaining care continuity. The accumulated changes affect how services are authorized, delivered, and documented across Indiana's I/DD waiver programs. These reforms create operational uncertainty for MCE plans administering waiver services and providers contracted to deliver them.
- State Policy · IN
Indiana Medicaid Enrollment Drops 18.5% in One Year, Raising Uninsurance Concerns
Indiana's Medicaid enrollment declined by 343,000 people (18.5%) between June 2025 and June 2026, falling from 1.86 million to 1.51 million enrollees — one of the steepest drops nationally. The decline follows the end of Medicaid continuous coverage protections and completion of post-PHE redeterminations. Hospitals, providers, and advocates are concerned about rising uninsurance rates as former enrollees lose coverage. The enrollment reduction affects provider revenue, hospital uncompensated care levels, and managed care plan membership and capitation.
- State Policy · AR
CMS Denies Arkansas Medicaid Expansion Waiver Renewal Covering 200,000 Enrollees
The Centers for Medicare and Medicaid Services rejected Arkansas' request to renew its hybrid Medicaid expansion waiver, which currently covers more than 200,000 low-income adults. Governor Sarah Huckabee Sanders' office confirmed the verbal denial from CMS on Friday. The decision creates immediate uncertainty about whether Arkansas will continue expansion coverage, with potential coverage termination if no alternative arrangement is reached. Arkansas' expansion operates under a Section 1115 waiver with unique program features that required federal approval to continue.
- State Policy
HUD Point-in-Time Data Shows Trends in Homelessness Characteristics
This data note from KFF reviews trends in homelessness and characteristics of people experiencing homelessness using HUD's Point-in-Time count data. The analysis covers sheltered and unsheltered populations identified through annual surveys. While homelessness itself is not a Medicaid program issue, states increasingly use Medicaid waivers and health-related services to address housing instability among enrollees, particularly through LTSS and behavioral health programs. The data provides demographic and trend context relevant to state agencies designing targeted interventions.
- State Policy · NY
New York Imposes Six-Month Moratorium on Medicaid Provider Enrollment for Certain Categories
New York's Medicaid Director announced an immediate six-month moratorium on new provider enrollments and change of ownership applications for certain provider categories, effective July 30, 2026. The moratorium affects specific provider types yet to be fully detailed but includes enrollment and ownership transfer processing freezes. The policy takes effect immediately and runs through January 2027. This represents a significant network access and administrative barrier for health plans managing provider networks, providers seeking Medicaid participation or ownership changes, and state agencies coordinating with managed care organizations on network adequacy requirements during the moratorium period.
- State Policy · NE
Nebraska Launches Dashboard Tracking Rural Health Transformation Program Funding
Nebraska's Department of Health and Human Services launched a public dashboard on July 30, 2026, to track the distribution of Rural Health Transformation Program funds across the state. The tool provides transparency on how transformation program dollars are allocated to rural providers and communities. The dashboard is live and accessible to stakeholders and the public. This matters for Nebraska Medicaid providers and state agencies because it increases visibility into state-administered funding flows that may support rural provider participation in Medicaid programs and value-based care initiatives.
- State Policy · MO
Missouri Medicaid Faces $1 Billion Federal Penalty Over Payment Error Rate by 2029
Missouri's Medicaid program could face over $1 billion in federal penalties under the One Big Beautiful Bill Act passed by Congress in 2025 unless it reduces its payment error rate below 3% by October 2029. The legislation also imposes new federal mandates that will affect state program operations. Advocates are raising questions about the role of managed care organizations in meeting these requirements as the state enters a period of significant budget pressure. The stakes are particularly high for Missouri, which faces enforcement timelines tighter than many other states.
- State Policy · NE
Nebraska to Disenroll 200 Medicaid Beneficiaries Under Work Requirements on August 1
Nebraska will disenroll approximately 200 Medicaid beneficiaries on August 1, 2026, for failing to meet work requirements, according to the state's Medicaid director in an interview with Tradeoffs. This marks the first wave of coverage losses under the Trump administration's work requirement policies. The disenrollments will affect beneficiaries who did not comply with work, volunteer, or job training mandates. This initial action signals the beginning of broader coverage reductions as Nebraska enforces work requirements approved under federal waiver authority.
- State Policy · NC
Lumbee Tribe Faces Healthcare Access Challenges After Federal Recognition in North Carolina
The Lumbee Tribe, recently granted federal recognition, confronts significant healthcare disparities in Robeson County, North Carolina, one of the worst-performing counties nationally for health outcomes. Tribal leaders must now determine how to address these gaps, potentially without immediate federal Indian Health Service support that typically accompanies recognition. The decision affects healthcare access for tribal citizens, many of whom likely rely on Medicaid given the county's high uninsured and poverty rates. The timing and scope of any federal healthcare infrastructure remains uncertain.
- State Policy · MI
Michigan Advocates Warn Federal Changes Could Cut Coverage for 200,000 Medicaid Beneficiaries
Health providers and advocates gathered at Michigan's Capitol on the 61st anniversary of Medicaid to warn that pending federal changes threaten coverage for approximately 200,000 Michigan Medicaid beneficiaries. The coalition highlighted risks to program access as federal policy shifts emerge. The timing and specific nature of the federal changes were not detailed in the brief report. For Michigan Medicaid stakeholders — state agencies, health plans, and providers — this signals potential enrollment losses and associated operational impacts as advocacy efforts mobilize against federal policy changes affecting the state program.
- State Policy · UT
Utah Advocates Warn Federal Rule Could Reduce Medicaid Coverage After Congressional Cuts
Utah Medicaid advocates are raising concerns that a new federal Medicaid rule will further reduce coverage in the state, compounding recent Congressional cuts to the program. The advocates cite cases of beneficiaries who could lose coverage, including substitute teachers facing gaps during summer months, a single mother who nearly lost her vision, and children affected by family custody situations. The timing and specific provisions of the federal rule are not detailed in the available excerpt, but advocates warn the combined effect of federal and Congressional actions threatens coverage continuity for vulnerable populations.
- State Policy · IL
Illinois Medicaid Disenrollment Drives Hospital Revenue Loss Ahead of Federal Work Requirements
Hospitals in Illinois are reporting financial losses as Medicaid enrollment declines in advance of federal work requirements scheduled to take effect in early 2027 under HR-1. William Davis, president of Deaconess Health System's Illinois region, is tracking enrollment drops among patients who previously had Medicaid coverage. The disenrollment is occurring before the federal mandate becomes operational, suggesting state-level eligibility changes or procedural terminations are already under way. The trend indicates that providers in states preparing for work requirement implementation may face immediate revenue pressure from coverage losses.
- State Policy · MI
Planned Parenthood of Michigan Closes Three Clinics After Medicaid Eligibility Changes
Planned Parenthood of Michigan permanently closed three clinic locations in Lansing, Livonia, and Warren effective immediately on Thursday, citing funding constraints after Republican federal legislation changed Medicaid coverage eligibility at Planned Parenthood facilities. The closures directly impact Medicaid beneficiaries' access to reproductive health services at these locations. The organization attributed the decision to financial pressures resulting from the federal Medicaid eligibility changes affecting Planned Parenthood providers specifically.
- State Policy
States Deploy Mobile Clinics and EMS Partnerships to Expand Rural Substance Use Treatment
States are implementing mobile clinics and emergency medical services partnerships to address rural access gaps in substance use disorder treatment. These delivery models aim to reach Medicaid beneficiaries in underserved areas where traditional brick-and-mortar providers are scarce. The strategies focus on expanding medication-assisted treatment and overdose prevention services in communities with limited behavioral health infrastructure. State Medicaid agencies can use federal authorities including Section 1115 waivers and health home state plan amendments to finance these alternative delivery models.
- State Policy · IN
Indiana Medicaid to Cover GLP-1 Medications for Obesity Under Federal Initiative
Indiana Governor Mike Braun directed the state's Family and Social Services Administration to cover GLP-1 medications for obesity through a federal Centers for Medicare & Medicaid Innovation Center initiative. The policy will affect 1.9 million Medicaid enrollees in Indiana. The directive was issued July 30, 2026, though specific implementation timelines were not provided in the announcement. This marks a significant expansion of pharmacy benefits for Indiana's Medicaid population, as most state Medicaid programs have historically excluded coverage of anti-obesity medications.
- State Policy · LA
Louisiana Controlled Substance Law Restricts Hospital Access to Hemorrhage Medications
Louisiana's 2024 law reclassifying misoprostol and mifepristone as controlled substances has limited hospital access to these medications for emergency hemorrhage treatment in pregnant patients. The restrictions affect how quickly providers can obtain these drugs in non-abortion medical emergencies, creating delays in time-sensitive obstetric care. Other states are reportedly considering similar legislation. The law has operational implications for Medicaid-covered maternity care, where hemorrhage is a leading cause of maternal mortality and misoprostol is a standard emergency treatment.
- State Policy · CO
Colorado Enacts ABA Provider Licensure Law With Medicaid Implications
Colorado Governor signed HB 26-1425 on June 2, 2026, establishing the Applied Behavior Analysis Practice Act. The law creates comprehensive licensing requirements for ABA practitioners and provider entities operating in Colorado, including facility licensing, professional liability insurance mandates, and provisions affecting Medicaid reimbursement. The legislation includes phased implementation timelines. ABA providers serving Colorado Medicaid beneficiaries must prepare for new credentialing, facility standards, and compliance requirements that will affect network participation and claims processing.
- State Policy · IA
Iowa Democratic Gubernatorial Candidate Pledges to End Medicaid Managed Care
A Democratic candidate for Iowa governor has announced plans to eliminate the state's private Medicaid managed care program if elected, which would make Iowa the second state to exit managed care after implementing it. The candidate characterized the current managed care system as "a disaster." Iowa transitioned to managed care several years ago, contracting with private health plans to administer Medicaid benefits. The outcome of the gubernatorial race will determine whether Iowa's Medicaid MCOs retain their contracts or face termination, affecting coverage for hundreds of thousands of enrollees.
- State Policy
Pennsylvania, Nevada, Wisconsin Medicaid Directors Detail Member Engagement Strategies
Three state Medicaid directors describe operational approaches for gathering and acting on member feedback, including advisory councils, community listening sessions, and embedding member voices in agency decision-making. The leaders discuss how they structure engagement to reach diverse populations, particularly members with complex needs, and translate input into policy and operational changes. These practices aim to improve program responsiveness and member experience across eligibility, benefits, and service delivery.
- State Policy · LA
Louisiana Enacts Commercial PBM Reimbursement Floor Using NADAC
Louisiana enacted Act 913 on June 12, establishing a commercial market reimbursement floor for pharmacy benefit managers that requires use of National Average Drug Acquisition Cost (NADAC) as the reimbursement benchmark. The law applies to commercial PBM arrangements and includes provisions intended to prevent cost-shifting to patients. The legislation took effect upon signing and affects how PBMs reimburse pharmacies in commercial insurance markets in Louisiana.