Medicaid news from every state
Medicaid reporting from more than 400 local newsrooms, public radio stations, advocates, attorneys general and state agencies, sorted into one feed per state and updated every four hours.
Medicaid stories from local newsrooms in every state, updated every four hours.
Latest from every state, page 33
- Published Oct 5
- Published Oct 5
- Published Oct 5
- Published Oct 5OH
Ohio Legal Aid Groups Push HB 318 Medicaid Estate Recovery Reforms
Pro Seniors, part of the Medicaid Estate Recovery Coalition of the Alliance of Ohio Legal Aids, is advocating for reforms to Ohio's Medicaid Estate Recovery program through House Bill 318. The coalition sent sponsors Representatives Stephens and Brennan a letter proposing additional statutory changes, including limiting recovery to probate estates, exempting non-probate transfers like life estates, restricting liens to beneficiaries' own estates, and requiring state-hired collection attorneys to disclose exceptions to recovery rather than use misleading collection tactics. The coalition also published a "Know Your Rights" pamphlet on Medicaid Estate Recovery, now available on the Ohio Attorney General's website. HB 318 remains under consideration in the Ohio House as of the October 2026 update.
Why it mattersOhio Medicaid agencies, estate recovery contractors, and long-term care beneficiaries' families face potential changes to lien and recovery practices if HB 318's proposed reforms are enacted.
- Published Oct 5
- Published Oct 5MN
Minnesota DHS Demands CMS Evidence Behind $550M Funding Freeze
Minnesota's Temporary DHS Commissioner John Connolly sent a five-page letter Friday to CMS Administrator Mehmet Oz, disputing the basis for nearly $550 million in withheld Medicaid funding. The freeze has grown through three separate deferrals in 2026, starting with $260 million in February over fraud concerns in 14 programs, followed by $91 million in April and $199 million in July. Connolly argues CMS has identified 870 Minnesota providers as high-risk without explaining its methodology, and disputes that provider disenrollments during a revalidation effort prove fraud rather than administrative issues. The state says it has repeatedly requested supporting documentation from CMS and federal law enforcement but has not received it.
Why it mattersMinnesota's Medicaid program faces continued cash-flow disruption and potential further deferrals absent resolution, directly affecting state budgeting and provider payments tied to federal matching funds.
- Published Oct 5TX
Texans Care for Children Report Finds Early Intervention Funding Falling Behind Costs
In a new report, Texans Care for Children says Texas's Early Childhood Intervention (ECI) program is struggling to keep pace with costs, based on interviews with 18 families and a survey of all 39 ECI providers statewide. The number of ECI providers has dropped from 58 in 2010 to 39 today, and over 90% of surveyed providers said current per-child funding is insufficient for quality services. Medicaid reimbursement rates for Specialized Skills Training and Targeted Case Management, two core ECI services, have not increased since 2011, while declining Medicaid enrollment among ECI participants has further cut reimbursement. The report urges the Texas Legislature to raise per-child funding to $500-$550 per month and increase Medicaid reimbursement rates for these services in the FY 2028-2029 budget.
Why it mattersStagnant Medicaid reimbursement rates and shrinking provider networks threaten access to early intervention therapy for Medicaid-enrolled infants and toddlers with disabilities across Texas.
- Published Oct 5IN
Indiana Projects 58,000 Could Lose HIP Coverage Over Work Rules
Indiana officials estimate more than 58,000 of the roughly 487,000 enrollees in the Healthy Indiana Plan could lose coverage in 2027 for failing to meet new Medicaid work requirements, according to a state news release reported by Mirror Indy. Starting January 2027, HIP members must document at least 80 hours per month of work, volunteering, school or apprenticeship activity, or meet an income threshold, unless they qualify for an exemption such as pregnancy, caregiving, medical frailty or recent incarceration. The requirements stem from state legislation this year and align with federal work-requirement provisions in the "One Big Beautiful Bill." Advocates warn that despite data showing about 70% of Indiana Medicaid adults already work, documentation burdens and reporting confusion could cause eligible people to lose coverage due to paperwork errors rather than actual noncompliance.
Why it mattersState Medicaid agencies and HIP managed care plans must prepare eligibility systems, member communications and appeals processes for mass coverage disruptions when reporting begins in 2027.
- Published Oct 5
- Published Oct 5
- Published Oct 5IA
Iowa Starting Line Compares Bohannan, Miller-Meeks Records Before Election
In a candidate comparison piece, Iowa Starting Line reviews the legislative records of Christina Bohannan and Rep. Mariannette Miller-Meeks ahead of their third matchup for Iowa's 1st Congressional District. The article outlines each candidate's background and bills sponsored, noting Miller-Meeks sits on the House Energy and Commerce Committee, which oversees Medicaid, and voted in committee in May 2025 to advance the health portion of the One Big Beautiful Bill Act. Bohannan's state legislative record and past vote against an abortion-rights constitutional amendment are also detailed. The election is Nov. 3.
Why it mattersMiller-Meeks' seat on Energy and Commerce gives her direct influence over federal Medicaid policy, making this race consequential for the committee's future direction on program financing and eligibility rules.
- Published Oct 5
- Published Oct 5NE
Former Nebraska Guardian Convicted in $140,000 Medicaid Fraud Case
Nebraska Attorney General Mike Hilgers' office announced that Becky Stamp, a former court-appointed guardian from York, was convicted on Oct. 1 in York County District Court of one count of felony theft and 22 counts of financial exploitation. Stamp entered a no contest plea in a case involving the theft of roughly $140,000 from 22 victims who were under her guardianship. The case was prosecuted as Medicaid fraud, indicating the victims were likely Medicaid beneficiaries whose funds or benefits were misappropriated by their appointed guardian. Sentencing details were not included in this announcement.
Why it mattersThe conviction underscores state enforcement priorities around financial exploitation of vulnerable Medicaid beneficiaries by court-appointed fiduciaries, a compliance risk area for guardianship programs and state agencies overseeing incapacitated enrollees.
- Published Oct 5
- Published Oct 5
- Published Oct 5
- Published Oct 5CA
CenCal Health Funds $2M Medi-Cal Navigation Hub for Central Coast
CenCal Health, the Medi-Cal managed care plan for Santa Barbara and San Luis Obispo counties, has launched Central Coast Coverage, a $2 million regional navigation hub built with community partners to help members keep Medi-Cal coverage through upcoming eligibility changes. The hub offers one-on-one assistance, multilingual resources and help completing renewal forms, and is being run through grants to Family Service Agency and other local organizations. County estimates show up to 44,000 residents are at risk of losing coverage, with 18,000 already disenrolled since August 2025, disproportionately working-age adults. The effort is timed ahead of 2027 federal and state changes expected to bring more frequent renewals and new work and community service requirements.
Why it mattersFor Medi-Cal MCOs and county agencies, proactive renewal navigation is becoming a key strategy to limit coverage churn and avoid downstream cost and access pressures as stricter eligibility rules take effect in 2027.
- Published Oct 5CA
California Medical Groups Split Over Prop 40 Billionaire Tax
California voters will decide in November on Proposition 40, a one-time 5% tax on billionaires' net worth that supporters say could raise up to $100 billion, with 90% directed to a special healthcare fund. The measure would let the Legislature alter the tax with a two-thirds vote as long as changes further its purposes, and it bars using the new money to justify cuts to existing state health appropriations. Despite standing to benefit, groups including the California Medical Association, Planned Parenthood Affiliates of California, the California Primary Care Association and the California Children's Hospital Association oppose it, arguing it lacks clear distribution rules and sufficient safeguards against lawmakers using it to backfill rather than add to health spending. Labor-aligned supporters, including the California Federation of Labor Unions and sponsor SEIU-UHW, say the funding is needed to keep hospitals, emergency rooms and maternity wards staffed as federal funding declines.
Why it mattersState Medicaid-adjacent providers and advocacy groups face major uncertainty over whether a multibillion-dollar funding stream for Medi-Cal and safety-net services will materialize as new money or simply replace existing state commitments.
- Published Oct 5
- Published Oct 5MN
Study Finds Coverage Gaps Persist, Reducing Health Care Access
A study published in Medical Care Research and Review by University of Minnesota SHADAC researchers found that despite historic coverage gains since the ACA, coverage gaps among non-elderly adults remained persistently high. Using MEPS-HC data spanning 2008 to 2022, the researchers found continuous coverage rose about 20% over the period, but an estimated 25.3% of adults, or 49 million people, still experienced a coverage gap in 2021-2022. People with coverage discontinuities were less likely to access routine care and prescriptions and more likely to report unmet health needs, an effect that grew larger over time. Gaps were more common among lower-income individuals and those living in the South.
Why it mattersThe findings underscore for state Medicaid agencies and health plans that eligibility churn and coverage transitions, not just uninsurance rates, drive gaps in care access and unmet need.
- Published Oct 5
- Published Oct 5
- Published Oct 5
- Published Oct 5
- Published Oct 5KS
Kansas Counties Place EMS, Health Care Sales Taxes on November Ballot
In its August/September policy update, Health Forward Foundation reports on local budget and ballot developments across Kansas and Missouri counties in its service area. Allen County commissioners placed a half-cent EMS sales tax on the November ballot after a similar measure narrowly failed in 2024, while Wyandotte County voters will decide on a countywide sales tax dedicated to health care services. Johnson County adopted a $1.9 billion fiscal year 2027 budget with a flat mill levy but projects a nearly $22 million structural gap by 2031. The update notes more than 114,000 Kansans have lost KanCare coverage since pandemic-era continuous enrollment ended, with few options to regain coverage absent Medicaid expansion.
Why it mattersState and county officials, advocates, and safety-net providers in Kansas need to track these ballot measures and budget gaps since local tax revenue is increasingly being asked to backfill health and EMS funding shortfalls tied in part to post-pandemic Medicaid coverage losses.
- Published Oct 5
- Published Oct 5OR
Oregon Providers Say Trillium Medicaid Plan Blocks Network Contracts
Behavioral health providers in Lane County, Oregon, including Aspire, say they have been unable to secure contracts with Trillium, the region's Medicaid coordinated care organization, despite seeking to serve its Oregon Health Plan members. Providers report the lack of a contract leaves them without access to their target Medicaid population, and some say they are considering scaling back services as a result. The dispute raises questions about network adequacy and access to behavioral health care for Oregon Health Plan enrollees in the county. No timeline for resolution was reported.
Why it mattersUnresolved contracting disputes between behavioral health providers and a Medicaid managed care plan threaten network adequacy and access to care for Oregon Health Plan enrollees in Lane County.
- Published Oct 5
- Published Oct 5KS
Kansas HCBS Waitlists Grow Despite $24 Million Fund Diversion
KSN reports that Kansas diverted $24 million in developmental disability waiver funding and physical disability waiver savings to the Frail Elderly and Brain Injury waivers, aiming to avoid new waitlists, but the Frail Elderly waitlist has still grown past 400. Meanwhile the IDD waiver waitlist has ballooned past 5,000, exceeding the legislature's 4,000-person cap, with some families waiting nearly a decade or longer for services. Kansas Council on Developmental Disabilities executive director Sara Hart Weir Rogers says outdated, paper-based intake processes and poor data-sharing between KDADS and KDHE are driving delays, and has proposed a six-point, five-year plan to eliminate the IDD waitlist. DCF Secretary Laura Howard, who also leads KDADS, acknowledged the fund diversion in an August release.
Why it mattersKansas Medicaid officials face mounting pressure to fix cross-agency data gaps and funding allocation as HCBS waiver waitlists grow despite legislative caps, directly affecting thousands of beneficiaries' access to home and community-based services.
- Published Oct 5PR
Puerto Rico Governor Urges Congress Act Now on Medicaid Funding Cliff
Governor Jenniffer González Colón released the Final Report of the Multisectoral Advisory Board on Puerto Rico's Medicaid Program, warning that Congress must act before the temporary federal funding boost expires in 2027 rather than waiting until 2028. The enhanced federal matching rate, raised to 76% through fiscal year 2027 under the Consolidated Appropriations Act, 2023, has expanded eligibility, added services and improved provider reimbursement for the roughly 40% of Puerto Rico's population covered by Medicaid. Without congressional action, the report estimates federal funding could drop by about $3,360 million annually as the match rate reverts to 55%. The report calls for a bipartisan, long-term financing solution and floats options including raising or removing the federal funding cap, aligning Puerto Rico's match rate calculation with the formula used for states, and expanding access to programs like disproportionate-share-type hospital payments, the Medicare Savings Program, and long-term services and supports.
Why it mattersA reversion to the lower statutory match rate and funding cap would force Puerto Rico's Medicaid agency, hospitals, and providers to absorb billions in lost federal support, threatening coverage for over a million beneficiaries and provider reimbursement rates.