State Medicaid Leaders Detail OBBBA Response at NASHP Conference
At NASHP's 2026 Annual Conference, state Medicaid leaders discussed implementing federal requirements under the One Big Beautiful Bill Act (OBBBA) while addressing program efficiency, access, and quality. Pennsylvania Secretary Valerie Arkoosh highlighted housing and reentry investments through Section 1115 waivers and Rural Health Transformation Program funding; Louisiana Secretary Bruce Greenstein described the state's "Quest for Quality" strategy, including raising the managed care quality withhold to 3 percent of plans' monthly capitation payments tied to HEDIS performance targets. Colorado Representative Kyle Brown discussed the state's bipartisan Commission on Medicaid, established in 2026 to address unsustainable cost growth. Separately, NASHP convened officials from 25 states and D.C. on children's Medicaid and CHIP coverage, discussing enrollment tracking, ex parte renewals, and eligibility system changes to mitigate coverage losses from OBBBA implementation, as well as HCBS efficiency efforts in Arizona and Iowa including Iowa's use of analytics to detect fraud.