State Policy
Latest
- State Policy · MN
Minnesota Issues Provisional Licenses to 433 Autism Service Providers Under New Oversight Law
Minnesota's Department of Human Services received provisional license applications from 433 of 481 autism service provider sites under a new state law requiring licensure for Medicaid-funded autism services. The licensing requirement was enacted to increase oversight following explosive program growth and fraud allegations in recent years. The high application rate suggests most providers are seeking to remain in the Medicaid program under the new regulatory framework. This represents a significant expansion of state oversight over previously less-regulated autism service delivery.
- State Policy · MO
Missouri Drops 333,000 Medicaid Enrollees in 14 Months, 92% Due to Paperwork Issues
Missouri terminated Medicaid coverage for 333,265 beneficiaries between January 2025 and February 2026, with 91.9% disenrolled for procedural reasons rather than ineligibility determinations, according to CMS data. The state's high procedural termination rate indicates systemic renewal and redetermination processing problems. This disenrollment pattern affects managed care organizations through membership loss, revenue reduction, and potential contractual quality metric penalties tied to continuity of coverage. MCOs operating in Missouri face continued enrollment volatility as the state processes redeterminations.
- State Policy · OH
Ohio Withdraws Proposal to Ban Family Caregivers Under Medicaid
Ohio lawmakers removed language from House Bill 795 that would have prohibited family members living with Medicaid recipients from serving as certified caregivers. The provision was withdrawn Monday following significant public opposition. The proposal targeted Ohio's Medicaid home healthcare program, which allows beneficiaries to hire family members as paid caregivers. The reversal preserves existing caregiver arrangements for Medicaid managed care plans operating in Ohio's home and community-based services programs.
- State Policy · CA
California Union Sponsors Ballot Measures to Cap Healthcare Executive Pay, Regulate Clinics
A major California healthcare union has introduced two ballot initiatives targeting community clinics and capping executive and managerial compensation at hospitals and physician groups. The measures have triggered widespread opposition from healthcare industry stakeholders. The initiatives emerge amid anticipated Medicaid budget reductions in California, intensifying long-standing labor-industry tensions. If approved by voters, the measures would impose operational and financial restrictions on healthcare entities that contract with Medicaid managed care organizations.
- State Policy · IL
Illinois Awards Medicaid Managed Care Contracts to Six Insurers Including Humana
Illinois announced its intent to award new Medicaid managed care contracts to six health insurers: five incumbents and new entrant Humana. The contracts, each representing tens of billions of dollars in revenue over the contract period, will cover the state's Medicaid managed care program. The awards follow a procurement process and are subject to standard protest periods before final execution. This represents a significant market entry for Humana in Illinois Medicaid and continuation for existing plans in one of the nation's largest state programs.
- State Policy · CA
National Health Law Program Publishes Updated Medi-Cal Advocacy Guide for California
The National Health Law Program has released an updated advocate's guide to Medi-Cal services in California. The guide is designed to help advocates, beneficiaries, and legal professionals navigate California's Medicaid program, which covers 15 million low-income residents. The resource addresses current challenges including federal and state budget pressures and potential cuts to the program. It serves as a reference tool for understanding Medi-Cal eligibility, covered services, and beneficiary rights in California's managed care environment.
- State Policy
Survey: Most Medicaid Enrollees Unaware of Impending Work Requirements
A Health Management Academy survey found that over half of Medicaid enrollees are unaware of work requirements set to take effect in less than six months. Enrollees will be required to report work, education, or volunteer hours to maintain coverage. The findings suggest significant risk of coverage loss due to administrative non-compliance rather than actual ineligibility. States and managed care plans will need to intensify member outreach and education efforts to prevent disenrollment of otherwise eligible members.
- State Policy
Abortion Access Varies Widely Across States Four Years After Dobbs
Four years after the Supreme Court's Dobbs decision returned abortion regulation to individual states, access to abortion services varies dramatically across the country. States have implemented divergent policies ranging from near-total bans to expanded protections and coverage. The patchwork of state laws affects Medicaid coverage of abortion services, maternal health outcomes, and health plan network adequacy requirements. Managed care organizations operating in multiple states must navigate conflicting state regulations on covered services, provider networks, and member access.
- State Policy
NASHP Hosts Webinar on State Nursing Home Quality Improvement Strategies
The National Academy for State Health Policy will host a webinar on June 9, 2026, from 3–4 p.m. ET focusing on state strategies to improve nursing home care quality. The session will examine state-level policy approaches and interventions aimed at enhancing care delivery in nursing facilities. For Medicaid managed care organizations with long-term services and supports responsibilities, the webinar may cover quality oversight mechanisms, rate-setting considerations, and regulatory approaches that could affect MCO contracts with nursing facilities.
- State Policy · LA
Louisiana Immigration Reporting Law Reduces Medicaid Enrollment Among Eligible Families
Louisiana enacted a law one year ago requiring state agencies to report undocumented immigrants to federal authorities, which has resulted in eligible immigrant families avoiding Medicaid applications for themselves and their qualifying children. The law applies broadly to state benefit programs including Medicaid. Eligible children, including U.S. citizens in mixed-status families, are reportedly foregoing enrollment due to fear of family separation or deportation. The chilling effect has reduced uptake of services among populations with legal eligibility, creating coverage gaps and uncompensated care risk.
- State Policy · WI
Wisconsin APRN Modernization Act Grants Full Practice Authority Effective September 1, 2026
Wisconsin's APRN Modernization Act, passed in August 2025, takes effect September 1, 2026, granting Advanced Practice Registered Nurses full practice authority without requiring collaborative arrangements with physicians. Wisconsin becomes one of approximately two dozen states with full practice authority for APRNs. The change affects how Medicaid managed care organizations credential, contract with, and reimburse APRNs as independent practitioners. MCOs must update provider networks, credentialing policies, and reimbursement methodologies to reflect APRNs' expanded scope of practice.
- State Policy
2026 Maternal Mental Health State Report Cards Find No State Earns Overall F Grade
The Policy Center for Maternal Mental Health and George Washington University released the 2026 Maternal Mental Health State Report Cards, showing improvement in state-level performance with no states receiving an overall failing grade for the first time. The report evaluates state policies addressing maternal mental health conditions, which affect one in five mothers and impose significant financial costs when untreated. A new assessment category for parental support reveals widespread deficiencies across states. The report cards provide a framework for states to benchmark their maternal mental health infrastructure and identify policy gaps.
- State Policy · HI
Hawaii Launches $28M Rural Health Workforce Program With Service Commitments
Hawaii is launching a $28 million full-tuition program for healthcare students who commit to practicing in rural communities. The Hawai'i Outreach for Medical Education in Rural Under-resourced Neighborhoods program will cover tuition and fees for students pursuing healthcare and Health IT training beginning in September. In exchange, participants must work in designated rural areas after graduation. The program aims to address persistent provider shortages in Hawaii's underserved communities.
- State Policy
State Medicaid Work Requirements Data Now Being Tracked Under 2025 Reconciliation Law
A tracking initiative is monitoring state-level implementation of Medicaid work requirements mandated by the 2025 Reconciliation Law. The effort compiles detailed state and national data on how states are operationalizing work requirements, including eligibility verification processes, exemption categories, reporting systems, and compliance mechanisms. Implementation timelines and specific state policies vary as states develop infrastructure to meet federal mandates. For Medicaid managed care organizations, this creates new administrative responsibilities around member eligibility tracking, reporting coordination with state agencies, and potential enrollment fluctuations as work requirements take effect.
- State Policy
Medically Tailored Meal Programs Reduce Hospital Use in State Medicaid Population
A state Medicaid program demonstrated that medically tailored meal interventions reduced hospital utilization and healthcare costs among high-need beneficiaries. The program provided nutrition services targeting members with diet-sensitive chronic conditions. Results showed measurable decreases in inpatient admissions and emergency department visits among participating members compared to controls. The findings support growing interest in addressing social determinants of health through Medicaid managed care benefit design.
- State Policy
States Target Corporate Practice of Medicine in Telehealth Crackdown
Multiple states are introducing legislation to restrict corporate ownership structures that underpin most direct-to-consumer telehealth platforms. The legislative push focuses on corporate practice of medicine doctrine, which prohibits non-physician entities from employing physicians or controlling medical decisions. These state actions could force telehealth companies to restructure their business models or exit certain markets. The timing coincides with increased regulatory attention on telehealth prescribing practices following pandemic-era flexibilities.
- State Policy · NJ
New Jersey Hospital System Mobilizes to Retain 500,000 Medicaid Patients Facing Disenrollment
Hackensack Meridian Health is launching an outreach campaign to educate approximately 500,000 New Jersey Medicaid beneficiaries at risk of losing coverage, with $3.5 billion in reimbursement at stake for the 18-hospital system. The health system president cited concerns about increased emergency department utilization if patients lose coverage and delay care. The disenrollment threat appears connected to federal legislation referenced as the One Big Beautiful Bill Act. Hackensack Meridian is working to help eligible patients maintain enrollment through education and assistance with renewal processes.
- State Policy · CA
California Implements Emergency Psychiatric Hospital Staffing Ratios With Financial Penalties
California's Department of Public Health implemented emergency regulations on June 1, 2025, establishing minimum nurse-to-patient ratios for psychiatric hospitals and imposing financial penalties for noncompliance. The regulations were developed in response to a February 2025 San Francisco Chronicle investigation documenting dysfunction, abuse, and understaffing at California behavioral health facilities. The emergency rules apply to all psychiatric hospitals operating in California. Facilities must meet the new staffing standards immediately or face state-imposed penalties.
- State Policy
Uninsurance Rate for Children Under 6 Hits Decade High, Up 220,000 Since 2022
A new report shows uninsurance among children birth through age 5 has reached its highest level in nearly a decade, with more than 220,000 young children losing coverage between 2022 and 2024. The increase follows the end of Medicaid continuous enrollment protections and state redetermination processes. The trend represents a reversal of coverage gains achieved during the public health emergency. Young children are predominantly enrolled in Medicaid and CHIP, making these coverage losses directly relevant to state program performance and managed care plan enrollment.
- State Policy
KFF Launches Medicaid Unwinding Tracker With State-Level Renewal and Disenrollment Data
The Kaiser Family Foundation has published a tracker providing state-by-state data on Medicaid renewals, disenrollments, and monthly enrollment during the unwinding period following the end of the COVID-19 public health emergency continuous coverage requirement. The tracker compiles the most recent available data from each state, allowing comparison of disenrollment rates and renewal outcomes across states. This tool enables managed care organizations to monitor enrollment trends in their service areas and assess the impact of unwinding on member populations. The data is updated as states report new figures.