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.
Why it mattersRising child uninsurance signals enrollment barriers state Medicaid agencies must address through outreach, eligibility simplification, and retention strategies — particularly for Hispanic and immigrant families — while federal spending cuts and expansion program uncertainty compound coverage losses.
CHIP · Managed Care · Maternal
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.
Why it mattersThe approved regional plans will determine the structure and governance of behavioral health service delivery for New Mexico Medicaid beneficiaries, affecting provider networks, access points, and care coordination across most of the state.
Behavioral Health
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.
Why it mattersState Medicaid agencies and MCOs must execute large-scale member communications while maintaining continuity of care during program transitions triggered by federal policy changes.
Managed Care
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.
Why it mattersIf enacted, this would represent a major shift in Connecticut's Medicaid delivery system, introducing managed care in a state that currently operates primarily fee-for-service — affecting MCO market entry opportunities, provider payment arrangements, and program eligibility for approximately 900,000 Connecticut Medicaid enrollees.
Managed Care · Finance
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.
Why it mattersMontana's Medicaid agency leadership change during active implementation of federal work requirements and a multi-year rural hospital transformation grant creates potential administrative continuity risk for state plan operations and waiver activity.
Managed Care · Behavioral Health · Finance
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.
Why it mattersMaryland Medicaid stakeholders now have public visibility into program integrity enforcement and recoupment activity affecting providers and local agencies, though actual recovery amounts remain unclear.
Managed Care · Finance
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.
Why it mattersMedicaid covers a disproportionate share of births in rural Missouri, making access gaps and adverse birth outcomes a direct cost and quality concern for the state Medicaid agency and managed care plans serving maternity populations.
Maternal · Managed Care
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.
Why it mattersState Medicaid agencies and health plans face direct budget exposure depending on whether voters approve or reject revenue measures designed to offset federal Medicaid cuts and sustain program funding levels.
Finance
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.
Why it mattersThe return of delivery services in a rural Tennessee county affects Medicaid managed care network adequacy and beneficiary access to maternity care, particularly for pregnant enrollees who previously faced longer travel distances for labor and delivery.
Maternal · Managed Care
