Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
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Federal Policy·13h ago

Georgetown Analysis Shows Medicaid Covers 43% of Children Under Age 3

Georgetown University's Center for Children and Families analyzed 2015-2024 Census data on health coverage for infants and toddlers under age 3. The analysis uses American Community Survey data to track coverage trends for this population, which has historically high Medicaid enrollment rates. The brief provides state-level and national estimates of coverage patterns over the decade. The findings offer a baseline for assessing coverage changes as states continue to complete Medicaid redeterminations following the end of continuous enrollment.

Industry·6d ago

Big Five Medicaid MCOs Report Q2 2026 Earnings Results

The five largest publicly-traded Medicaid managed care organizations — Centene, CVS Health/Aetna, Elevance Health, Molina Healthcare, and UnitedHealth Group — have released second-quarter 2026 financial results. These companies collectively serve approximately half of all Medicaid enrollees nationwide. The earnings reports provide insight into revenue trends, medical loss ratios, enrollment changes, and profitability across the Medicaid managed care sector during the quarter ending June 30, 2026.

Federal Policy·6d ago

CMS Clarifies Custodial Parents Largely Exempt from Medicaid Work Reporting Requirements

The Centers for Medicare and Medicaid Services released an Interim Final Rule clarifying exemptions from new Medicaid work reporting requirements set to take effect in January 2027. The guidance confirms that most custodial parents and caretaker relatives are excluded from work reporting mandates, addressing widespread confusion as 28 states prepare implementation. The clarification affects state planning and system development currently underway. The IFR provides critical operational guidance for state Medicaid agencies navigating compliance with federal work reporting provisions while minimizing improper coverage terminations for exempt populations.

State Policy·MO·12d ago

Missouri Voters Reject Constitutional Amendments That Would Have Raised Ballot Measure Thresholds

Missouri voters defeated two proposed constitutional amendments this week that would have made future ballot initiatives harder to pass. Proposed Amendment 4 failed 80% to 20%; it would have required constitutional amendments to win a majority in every congressional district. The rejected measures had implications for health policy ballot initiatives like Medicaid expansion, which Missouri voters approved via ballot measure in 2020. The defeat preserves the existing ballot measure process for future Medicaid policy changes at the state level.

Federal Policy·13d ago

Georgetown Researcher Testifies on Medicaid Program Before Senate Budget Committee

Andy Schneider of Georgetown University's Center for Children and Families testified before the U.S. Senate Budget Committee on August 4, 2026, at a hearing titled "Medicaid the Reality." The testimony addressed the current state of the Medicaid program for federal policymakers. The hearing reflects ongoing Congressional scrutiny of Medicaid financing and operations, which could inform future legislative or oversight activity affecting state agencies and managed care plans.

Federal Policy·19d ago

Updated Brief Examines Medicaid Coverage Among Early Childhood Educators Using 2024 Data

A coalition including the Center for Law and Social Policy and the National Association for the Education of Young Children has republished a brief examining Medicaid coverage among early childhood educators, incorporating 2024 data and recent federal policy developments. The brief analyzes how Medicaid serves this workforce population and discusses implications of federal actions over the past year. Early childhood educators represent a low-wage workforce with high rates of Medicaid enrollment. The updated analysis provides current context for policymakers and stakeholders assessing coverage needs in this sector.

Federal Policy·19d ago

Georgetown Center for Children and Families Submits Comments on Medicaid Work Requirements Interim Final Rule

The Georgetown University Center for Children and Families submitted comments to CMS regarding the interim final rule implementing Medicaid work reporting requirements mandated by H.R. 1. The rule establishes federal requirements for states to implement work reporting for certain Medicaid beneficiaries. The comments address implementation concerns and potential impacts on beneficiary enrollment and coverage continuity. The rule affects state Medicaid agencies responsible for implementing work reporting systems and health plans managing enrollment and disenrollment processes.

Federal Policy·20d ago

Commerce Order Bans Census Bureau Privacy Methods, Threatens Medicaid Enrollment and Utilization Data

On June 4, 2026, the Commerce Department issued Administrative Order 216-26 banning "noise infusion" privacy techniques in Census Bureau and Bureau of Economic Analysis data products, effective immediately. The order affects data systems that state Medicaid agencies and researchers rely on for enrollment projections, eligibility determination, and program evaluation, including American Community Survey data used to estimate uninsured rates and demographic trends. Census Bureau officials have warned the ban may compromise their ability to release small-area statistics while protecting respondent privacy, potentially limiting availability of county-level data critical for Medicaid managed care network adequacy assessments and CHIP outreach.

Federal Policy·21d ago

Senator Kim Introduces MediKids Act for Universal Child Health Coverage

Sen. Andy Kim (D-NJ) introduced S. 5037, the MediKids Act, to establish guaranteed healthcare coverage for all children in America. The bill was cosponsored by four Democratic senators and referred to the Senate Finance Committee. No timeline for committee consideration has been announced. If enacted, the legislation would significantly expand federal health coverage for children beyond current Medicaid and CHIP eligibility thresholds, affecting state program design and federal-state financing arrangements.

Federal Policy·23d ago

CMS Proposes Rule Implementing H.R. 1 Provider Tax Restrictions

CMS issued a proposed rule on July 21, 2026, implementing two of three provider tax restrictions from H.R. 1, which limits states' ability to use provider taxes to finance their Medicaid share. The rule prohibits new provider taxes and increases in existing taxes. This affects state Medicaid financing strategies and budget planning, with implications for how states fund their programs and potential pressure on state general funds. The proposal will proceed through standard notice-and-comment rulemaking.

Federal Policy·27d ago

Urban Institute Finds Postpartum Coverage Gains Stalling Among New Mothers

The Urban Institute reports that health insurance coverage for new mothers in the first year postpartum has improved in recent years but progress has stalled, according to Census Bureau American Community Survey data. The analysis examines uninsured rates among women ages 19 and older who gave birth within the past year. The findings come as states navigate the end of Medicaid continuous enrollment and implementation of the American Rescue Plan's optional 12-month postpartum coverage extension. The report signals potential erosion of maternal coverage gains that have reduced coverage gaps during the critical postpartum period.

Federal Policy·28d ago

Webinar Examines H.R.1 Impact on Medicaid Maternal and Infant Health Programs

A webinar titled 'Medicaid Connections: Maternal and Infant Health and Justice' addresses how H.R.1 legislation affects Medicaid-funded maternity care. The session focuses on reproductive justice and optimizing Medicaid to fund holistic, culturally centered care including midwifery and doula services. As the nation's largest payer for maternity care, Medicaid plays a central role in addressing systemic health inequities for maternal and infant populations. The webinar provides guidance for policymakers on funding structures that support comprehensive perinatal services.

Industry·30d ago

988 Lifeline In-State Call Answer Rate Data Unavailable Due to Access Restrictions

This content is password-protected and cannot be accessed for analysis. The title suggests it may contain data on in-state answer rates for the 988 Suicide and Crisis Lifeline. Without access to the underlying content, it is not possible to determine what information is presented, when any reported data applies, or whether it contains actionable intelligence for Medicaid managed care organizations. The 988 Lifeline, launched nationally in July 2022, is relevant to Medicaid MCOs that cover behavioral health crisis services, but the specifics of this protected content remain unknown.

State Policy·30d ago

KFF Examines State Strategies to Protect Pregnant Women from Medicaid Work Requirements

KFF published an analysis examining how states may structure Medicaid work reporting requirements to protect coverage for pregnant and postpartum women. The analysis reviews state options for exemptions, verification processes, and coverage continuity mechanisms as states implement work and community engagement requirements. States must balance federal compliance with maternal health access as work requirements return to consideration. For managed care organizations, the analysis highlights operational challenges in identifying exempt populations, managing enrollment disruptions, and maintaining continuity of prenatal and postpartum care under varying state policies.

Federal Policy·34d ago

CMS Issues Interim Final Rule Imposing Work Reporting Requirements on Medicaid Beneficiaries

CMS has published an interim final rule establishing work reporting requirements for certain Medicaid beneficiaries. The rule requires states to implement reporting systems for work activities as a condition of eligibility for non-exempt populations. The requirements take effect for state implementation planning immediately, with full compliance deadlines to be determined by state plan amendments. This marks a significant shift in Medicaid eligibility policy affecting managed care organizations' enrollment processes, member communication obligations, and systems for tracking beneficiary compliance with work requirements.

Federal Policy·42d ago

CMS Requests State Medicaid Provider Revalidation Strategies in April Administrator Letter

CMS Administrator Dr. Mehmet Oz sent a letter to State Medicaid Directors on April 23, 2026, requesting each state develop and submit a comprehensive two-year provider revalidation strategy focused on high-risk providers. The letter, identified as an SMD (State Medicaid Director letter), is not published on the official Medicaid.gov site but is available through Fox News. Minnesota's early implementation offers initial lessons for states responding to the directive. The request affects all state Medicaid agencies and their managed care partners responsible for provider enrollment and network adequacy.

State Policy·CO·43d ago

Colorado Maternal Health Initiative Leader Discusses Perinatal Care Transformation Under Medicaid

Elephant Circle founder Indra Lusero discusses Colorado's comprehensive maternal health initiatives under Medicaid in a Q&A format. Colorado was among the first states to pursue broad perinatal care reforms aimed at improving outcomes for pregnant and postpartum enrollees. The interview covers the state's maternal health strategy during a period described as involving recent federal funding constraints. The discussion addresses how Colorado's Medicaid program has approached perinatal care delivery and payment reform.

Federal Policy·43d ago

Proposed Medicaid Work Requirements Face Rural Service Delivery Challenges

A proposed federal rule implementing H.R. 1's Medicaid work and volunteer reporting requirements faces operational challenges in rural areas where postal service limitations may prevent beneficiaries from meeting documentation deadlines. The law, projected to result in 10 million Americans losing coverage, requires monthly work or volunteer activity reporting to maintain eligibility. Rural beneficiaries may face particular difficulty submitting timely verification due to mail delays and limited internet access. The rule remains in proposed form with implementation timing not yet finalized.

State Policy·48d ago

State Legislatures Respond to H.R. 1 Medicaid Cuts in 2026 Sessions

State legislatures concluded 2026 sessions with varied responses to federal Medicaid cuts enacted under H.R. 1 approximately one year ago. States faced budget shortfalls and policy changes requiring legislative action to address coverage gaps, provider payment reductions, and program restructuring. The article follows up on earlier reporting from March 2026 that examined ten state responses to what are described as the largest Medicaid cuts in history. Implementation timelines and specific state actions vary by jurisdiction.

Federal Policy·49d ago

Georgetown Hosts Webinar on Medicaid Federal-State Financing Basics

The Georgetown University Center for Children and Families held a webinar on June 30, 2026 covering foundational Medicaid financing concepts. The session explained the federal-state partnership structure, mandatory federal funding not subject to annual appropriations, and state financing mechanisms for their matching share. The webinar targeted audience members seeking to understand basic Medicaid funding mechanics. A recording will be made available on Georgetown's website.

Federal Policy·51d ago

Ten States Enter CCBHC Medicaid Demonstration as H.R. 1 Threatens Funding

Ten additional states have joined the Certified Community Behavioral Health Clinic (CCBHC) Medicaid demonstration program, expanding access to comprehensive community-based behavioral health services that meet federal certification standards. The expansion occurs as pending legislation H.R. 1 threatens the demonstration's continued funding. CCBHCs provide integrated behavioral health and physical health screening, crisis services, and care coordination under enhanced Medicaid payment structures. The timing creates uncertainty for managed care organizations with CCBHC network arrangements and for states planning implementation.

State Policy·54d ago

Young Children's Uninsurance Rises Faster Than School-Age Peers Pre-2025

Analysis shows young children experienced faster uninsurance growth compared to school-aged children prior to 2025 Medicaid enrollment declines. The trend emerged before recent federal policy changes including Trump administration actions and H.R. 1 proposals. The data suggests underlying coverage gaps for young children independent of current redeterminations. States may need targeted outreach and enrollment strategies for families with young children to reverse the trend.

Legal·HI·68d ago

HHS OIG Warns Hawaii of Potential Medicaid Fraud Sanctions Over Eligibility Concerns

On May 13, 2025, HHS Inspector General Christi Grimm sent a letter to Hawaii warning of potential administrative sanctions over alleged Medicaid eligibility fraud. The letter was announced by Vice President Vance at a White House Task Force press conference alongside news of a $1.3 billion federal Medicaid payment deferral to California. The OIG letter to Hawaii signals aggressive federal enforcement activity targeting state Medicaid programs for eligibility determinations. The timing and public announcement through the White House suggest coordinated federal pressure on states over Medicaid program integrity issues.

State Policy·69d ago

Child Medicaid and CHIP Enrollment Down 2 Million Since January 2025

Child enrollment in Medicaid and CHIP has declined by more than 2 million since January 2025, according to Georgetown University's Center for Children and Families. The declines vary significantly by state and affect children in working families who often lack access to affordable employer-sponsored coverage. The enrollment losses represent a continuation of coverage instability following the end of the Medicaid continuous enrollment provision. These drops matter because many affected children become uninsured rather than transitioning to other coverage.

Federal Policy·70d ago

CMS Issues First Major EPSDT Guidance Update in a Decade

CMS released updated guidance on the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit in 2024, marking the first comprehensive policy update in approximately ten years. The guidance, issued through a state health official letter, provides states with revised operational and coverage requirements for Medicaid's mandatory pediatric benefit. This updated playbook affects how states structure EPSDT services, including screening schedules, diagnostic services, and treatment coverage for Medicaid-enrolled children. The guidance clarifies federal expectations for state compliance and likely impacts how managed care organizations implement and document EPSDT services in their contracts.

State Policy·77d ago

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·77d ago

2026 Maternal Mental Health State Report Cards Show Nationwide Progress, New Parental Support Gap

The Policy Center for Maternal Mental Health and George Washington University released 2026 state report cards on maternal mental health policy. For the first time, no state received an overall 'F' grade, marking significant progress since prior assessments. However, the report introduces a new failing grade category for parental support policies nationwide. With one in five mothers experiencing maternal mental health conditions, the cards evaluate state-level policy infrastructure, screening, treatment access, and workforce capacity. The report provides benchmarks for state Medicaid programs and managed care organizations addressing maternal behavioral health.

State Policy·79d ago

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.

Federal Policy·79d ago

Uninsured Rate for Children Under 6 Jumped 23% Since 2022 Medicaid Unwinding Began

The number of uninsured children under age 6 increased 23% between 2022 and 2024, reaching the highest level in nearly a decade, compared to a 17% increase for school-aged children. The sharper rise among younger children coincides with Medicaid redeterminations that began after the end of the continuous enrollment provision in spring 2023. Young children face higher procedural disenrollment risk due to more frequent address changes and verification requirements. The data suggests gaps in ex parte renewal processes and family communication strategies that disproportionately affect families with infants, toddlers, and preschoolers.

Federal Policy·79d ago

Uninsured Rate for Children Under 6 Rose 23% Between 2022 and 2024

The number of uninsured children under age 6 increased 23% between 2022 and 2024, reaching the highest level in nearly a decade, compared to a 17% increase for school-aged children. The disproportionate rise among infants, toddlers, and preschoolers coincides with the end of Medicaid continuous enrollment protections that expired in spring 2023. Young children are particularly vulnerable to coverage gaps during redeterminations because families with infants and toddlers move more frequently and face higher procedural disenrollment rates. The trend reflects ongoing challenges in states' unwinding processes and parent awareness of eligibility rules for young children.

State Policy·79d ago

Uninsured Rate for Children Under 6 Hits Decade High, Rising 220,000 Between 2022-2024

A new report shows that over 220,000 additional children under age 6 became uninsured between 2022 and 2024, pushing the uninsurance rate for this age group to its highest level in nearly a decade. The increase follows the end of Medicaid continuous coverage requirements that were in place during the COVID-19 public health emergency. Young children are particularly vulnerable to coverage gaps because they rely heavily on Medicaid and CHIP for health insurance. The trend signals growing challenges for states and managed care plans in maintaining enrollment and preventing coverage loss during renewal periods.

Federal Policy·83d ago

Child Medicaid and CHIP Enrollment Drops by 2 Million Since January 2025

Medicaid and CHIP enrollment among children declined by 2 million between January 2025 and April 2026, according to state-by-state enrollment data. The drop suggests a rising child uninsured rate during this period. The enrollment decline affects managed care organizations through reduced membership and capitation revenue, particularly in states with high CHIP and Medicaid managed care penetration. Plans should monitor monthly enrollment reports and assess financial impacts from membership losses in pediatric populations.

Federal Policy·83d ago

Child Medicaid and CHIP Enrollment Drops by 2 Million Since January 2025

Medicaid and CHIP enrollment for children declined by 2 million between January 2025 and April 2026, according to state-by-state enrollment tracking data. The decline suggests a rising child uninsured rate during this period. The enrollment drop reflects policy changes or administrative actions implemented after the Trump administration took office in January 2025. This represents a significant reversal in coverage trends for pediatric populations served by Medicaid managed care organizations.

State Policy·KS·83d ago

Kansas Legislature Permanently Fixes CHIP Eligibility Law After Multi-Year Waiver Workaround

Kansas enacted legislation in its 2026 session to permanently update state CHIP eligibility rules, ending reliance on temporary federal waivers that previously allowed eligible children to access coverage. The statutory change ensures continuous CHIP enrollment for qualifying Kansas children without recurring waiver renewals. The law codifies eligibility standards that had only been maintained through waiver authority, eliminating administrative uncertainty for families and the state Medicaid agency. This matters for managed care organizations administering Kansas CHIP because it stabilizes the enrolled population and removes the risk of coverage disruptions tied to waiver expiration.

Industry·83d ago

Big Five Medicaid Insurers Report Q1 2026 Financial and Enrollment Results

The five largest publicly-traded Medicaid managed care organizations—UnitedHealth Group, Elevance, CVS Health/Aetna, Centene, and Molina—have released first quarter 2026 financial and enrollment data. These companies collectively serve a majority of Medicaid managed care enrollees nationwide. Their quarterly results typically reveal trends in redetermination impacts, rate adequacy, medical loss ratios, and profitability that signal broader market conditions. State Medicaid directors and MCO executives monitor these earnings reports to benchmark performance, assess competitive positioning, and anticipate contract strategy shifts.

State Policy·83d ago

NASEM Report Highlights Maternal Mortality Gaps, Medicaid Coverage Extensions

The National Academies of Sciences, Engineering, and Medicine released a report on maternal mortality showing Black mothers face a maternal mortality rate of 44.8 deaths per 100,000 live births in 2024, significantly higher than other populations. The report emphasizes the importance of Medicaid postpartum coverage extensions, which 46 states and DC have now adopted to address pregnancy-related complications beyond 60 days. For Medicaid managed care organizations, this underscores the need for enhanced care coordination, cardiovascular screening protocols, and culturally competent care delivery for high-risk maternal populations through the extended 12-month postpartum period.

Federal Policy·CA·83d ago

CMS Defers Federal Medicaid Matching Funds to California, Second Such Action

CMS has announced a deferral of federal Medicaid matching funds to California, marking only the second time in Medicaid's 60-year history such action has been taken. Vice President J.D. Vance announced the deferral at a White House press conference, following a similar announcement on February 25. Federal financial participation deferrals represent CMS's most severe enforcement tool and typically indicate suspected fraud, waste, or abuse requiring state corrective action. The action creates immediate cash flow implications for California's Medicaid program and may signal broader federal enforcement priorities affecting managed care oversight.

State Policy·TX·83d ago

Texas Case Highlights Medicaid Gaps in Postpartum Mental Health Coverage for Black Mothers

A Lufkin, Texas mother charged after exhuming her stillborn daughter's remains illustrates systemic failures in Medicaid postpartum mental health coverage, particularly for Black women who face maternal mortality rates nearly three times higher than white women. The case underscores inadequate screening, follow-up, and culturally competent behavioral health services during the extended postpartum period when grief and mental health crises peak. Texas Medicaid managed care plans must assess whether their networks adequately address perinatal mental health needs and racial disparities in maternal outcomes, especially as federal Medicaid postpartum coverage extends to 12 months in participating states.

Federal Policy·MN·83d ago

CMS Threatens $515M Federal Funds Withhold from Minnesota Medicaid Over Fraud Concerns

CMS Administrator Dr. Mehmet Oz, with support from Vice President J.D. Vance, initiated a two-pronged action against Minnesota's Medicaid program on January 6, threatening to withhold $515 million in federal matching funds. The action centers on alleged fraud concerns within the state's Medicaid program. The article suggests this fiscal enforcement action may be reaching resolution. Minnesota managed care plans and state officials face potential significant federal funding disruptions pending CMS review of state compliance with program integrity requirements.

State Policy·NE·83d ago

Nebraska Launches H.R. 1 Medicaid Work Requirements May 1 Despite Implementation Gaps

Nebraska became the first state to implement work reporting requirements under H.R. 1 on May 1, 2026, despite noted implementation gaps. The state initiated a "soft start" approach, though specifics of enforcement and beneficiary communications remain unclear. Medicaid managed care plans operating in Nebraska should expect member eligibility disruptions as work reporting compliance becomes a redetermination criterion. Plans must prepare for enrollment volatility, potential member outreach responsibilities, and coordination with state agencies on verification processes as other states follow Nebraska's rollout timeline.

Managed Care·83d ago

Medicaid MCOs Deploy Community Health Workers to Close Pediatric Care Gaps

Community health workers (CHWs) are emerging as a strategic tool for Medicaid managed care organizations to address missed well-child visits, immunization delays, and undiagnosed chronic conditions in pediatric populations. CHWs connect families to care by addressing social determinants and system navigation barriers that fragment service delivery. For MCOs, CHW programs offer a mechanism to improve HEDIS measures, close pediatric quality gaps, and meet contractual performance targets while addressing upstream factors that drive preventable utilization. State Medicaid agencies are increasingly encouraging or requiring MCO investment in CHW models as part of value-based care strategies.

Managed Care·83d ago

Medicaid Programs Can Use Community Health Workers to Close Pediatric Care Gaps

Community health workers can help Medicaid programs address missed well-child visits, immunization delays, and undiagnosed chronic conditions in children. CHWs connect families to clinical care and social services, addressing barriers like transportation, language, and health literacy. States can reimburse CHW services through state plan amendments or managed care contracts. The approach is particularly relevant for MCOs managing pediatric populations where preventive care gaps drive long-term costs and poor health outcomes.

State Policy·NE·83d ago

Nebraska Launches Medicaid Work Requirements May 1 Under H.R. 1

Nebraska became the first state to implement Medicaid work reporting requirements on May 1, 2026, following passage of H.R. 1. The state's initial "soft start" approach appears operationally unprepared according to policy observers. Work requirements apply to certain adult Medicaid beneficiaries who must report qualifying activities or face coverage loss. Additional states are expected to follow Nebraska's implementation in coming months as they develop their own work requirement programs under the federal law.

Federal Policy·MN·83d ago

CMS Threatens to Withhold $515 Million in Minnesota Medicaid Matching Funds

CMS Administrator Dr. Mehmet Oz threatened to withhold $515 million in federal Medicaid matching funds from Minnesota on January 6, with Vice President J.D. Vance's support. The action represents a two-pronged attack on the state's Medicaid program, though the article indicates the fiscal assault may be heading for resolution. The withholding threat carries immediate financial implications for state budget planning and MCO payment flows. The timing and resolution pathway remain unclear.

State Policy·TX·83d ago

Texas Mother Charged After Exhuming Infant Highlights Postpartum Mental Health Gaps

In February 2026, a Texas mother lost her newborn at birth and two months later exhumed the infant's remains from a cemetery, resulting in criminal charges. The case underscores systemic failures in postpartum mental health screening and support, particularly for Black mothers who face higher maternal mortality and morbidity rates. Texas Medicaid provides 12 months of postpartum coverage under recent federal policy, but gaps remain in mental health access and culturally competent care. The incident highlights the need for improved perinatal mental health integration in Medicaid managed care, including trauma-informed protocols and community-based interventions for grieving mothers.

Federal Policy·CA·83d ago

CMS Defers Federal Medicaid Matching Funds to California for Second Time

The Centers for Medicare & Medicaid Services (CMS) has deferred federal matching funds to California, marking the second such action in Medicaid's 60-year history. Vice President J.D. Vance announced the deferral at a White House press conference. The first deferral occurred on February 25. CMS is using its authority to withhold federal financial participation based on allegations of program non-compliance. The action represents an escalation in federal enforcement against state Medicaid programs and signals heightened scrutiny of state operations.

Federal Policy·83d ago

NASEM Report Identifies Policy Interventions to Reduce Maternal Mortality Disparities

The National Academies of Sciences, Engineering, and Medicine released a report examining maternal mortality and severe morbidity in the United States, with particular focus on racial disparities. Black mothers face a maternal mortality rate of 44.8 deaths per 100,000 live births in 2024, significantly higher than other populations. The report identifies policy interventions and systemic changes needed to address these outcomes. Medicaid covers approximately 42% of all births nationally, making managed care organizations critical implementers of maternal health quality initiatives.

Industry·83d ago

Big Five Medicaid Insurers Report Q1 2026 Financial and Enrollment Results

The five largest publicly-traded Medicaid managed care organizations—UnitedHealth Group, Elevance, CVS Health/Aetna, Centene, and Molina—have released their first quarter 2026 financial and enrollment data. These health plans collectively serve the majority of Medicaid managed care enrollees nationwide. The quarterly results provide insight into enrollment trends, medical loss ratios, and profitability across the Medicaid managed care market following the completion of Medicaid redeterminations in most states. The report covers performance metrics that signal market conditions for Medicaid MCOs heading into mid-2026.

State Policy·KS·83d ago

Kansas Legislature Updates CHIP Eligibility Rules to Expand Child Coverage Access

The Kansas Legislature passed changes to state law governing Children's Health Insurance Program (CHIP) eligibility during its 2026 session. The updates modify eligibility determination processes to allow more Kansas children who qualify for CHIP to successfully enroll and maintain coverage. The changes address prior administrative barriers that prevented eligible children from accessing the program. The legislation represents a shift from temporary workarounds to permanent policy reform in Kansas CHIP administration.

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