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Wednesday, September 2 · 11 stories
- State Policy · CT
Connecticut Economic Report Warns Rising Unemployment Threatens SNAP, Medicaid Work Requirements
Connecticut Voices for Children released its annual State of Working Connecticut report Monday, finding low- and middle-income families face rising unemployment (5.2% statewide, tied for highest nationally) amid slow economic growth. The report warns that higher unemployment creates immediate challenges as federal changes requiring 80 hours monthly work to maintain SNAP and Medicaid benefits take effect, with jobs becoming harder to find. Black workers and younger workers face unemployment rates well above the statewide average. The advocacy group recommends state-level programs to offset federal cuts and policy reforms including affordable housing, child care, expanded unemployment insurance, and indexing income taxes to inflation.
- State Policy
Immigration Enforcement Drives Missed Pediatric Appointments, Delayed Medicaid-Covered Care
Healthcare providers report a surge in missed pediatric appointments and delayed care since January 2025 as immigration enforcement activity prompts families to avoid hospitals and clinics. Clinicians cite cases of children going without surgery, hearing aids, and ADHD medication — including U.S. citizen children on Medicaid whose parents fear being targeted through program enrollment data. ICE arrests reached 51,000 in July 2026, with an estimated 146,000 U.S. citizen children having had a parent detained since January 2025. Pediatricians report increased depression, anxiety, and missed developmental milestones among children in immigrant families, regardless of immigration status.
- State Policy · WV
West Virginia SNAP Enrollment Drops 4,000 Children Since Federal Benefit Cuts
West Virginia reports approximately 4,000 fewer children enrolled in the Supplemental Nutrition Assistance Program (SNAP) as of May 2026, one year after the One Big Beautiful Bill Act took effect in July 2025. The federal law made substantial cuts to nutrition assistance programs. State Department of Human Services data shows the decline in child enrollment following implementation of the federal benefit reductions. The enrollment drop reflects the impact of federal SNAP policy changes on low-income families who often qualify for both SNAP and Medicaid.
- State Policy · VA
Virginia ACA Enrollment Drops 94,000 After Federal Subsidies Expire
Virginia's ACA marketplace enrollment fell from 389,000 in 2025 to 295,000 as of September 2026, a decline attributed largely to expired federal subsidies for individuals between 138% and 250% of the federal poverty level. Virginia lawmakers allocated $150 million in the current state budget to create temporary state-level subsidies that will be available when marketplace enrollment opens in November, potentially saving eligible enrollees about 70% on monthly premiums. The relief is temporary; meanwhile, federal reconciliation legislation will impose Medicaid work requirements affecting over 500,000 Virginia enrollees and reduce immigrant coverage by approximately 5,800 individuals, with hospitals projecting a $31 billion reduction in state Medicaid funding over the next decade.
- State Policy
Life Insurance Cash Value Remains Countable Asset Under State Medicaid Eligibility Rules
Life insurance policies with cash surrender value count as resources under Medicaid eligibility determinations in most states, potentially disqualifying applicants whose other assets fall below resource limits. State Medicaid agencies must assess policy values during initial eligibility screening and ongoing estate recovery processes. The treatment varies by state policy, with some states exempting term policies or policies below certain face value thresholds. This affects long-term care applicants and beneficiaries subject to estate recovery, requiring careful asset verification by eligibility workers and estate recovery contractors.
- State Policy · CO
Colorado Implements 80-Hour Monthly Work Requirement for 377,000 Medicaid Enrollees
Colorado has mailed notices to 377,000 Medicaid enrollees informing them of new work requirements to maintain coverage. Beneficiaries must document at least 80 hours of work per month to remain eligible. The state Medicaid agency is implementing the requirement following federal approval. The policy affects non-elderly, non-disabled adult enrollees and represents one of the largest work requirement implementations since CMS authorized states to pursue such waivers.
Tuesday, September 1 · 17 stories
- State Policy · NM
New Mexico County Defends Slow Opioid Settlement Spending as Capacity-Building
Doña Ana County's opioid settlement project manager responded to a New Mexico State Auditor report finding that nearly half of counties and municipalities reported no spending from the state's nearly $1 billion opioid settlement fund through June 2025. The county defended its approach, stating that it prioritized establishing governance structures, stakeholder engagement, and coordinated planning before deploying funds. The manager noted challenges including provider shortages in rural areas and the need to align settlement dollars with other funding sources including Medicaid and New Mexico's Behavioral Health Reform and Investment Act. The county created a joint advisory council with the City of Las Cruces to coordinate behavioral health investments across jurisdictions.
- State Policy · NC
North Carolina Expands School-Based Mental Health Through Federal Project AWARE Grant
North Carolina received two rounds of federal SAMHSA Project AWARE grants totaling $8.8 million (2018) and additional funding (2021) to embed mental health services in six school districts: Beaufort, Cleveland, Rockingham, Jackson, Nash, and Sampson counties. The program created a licensed clinical mental health counselor job classification for school districts, established training programs, and built infrastructure for mental health service delivery in schools. SAMHSA announced $55.7 million in new funding in July 2026, with North Carolina applying for a third cohort; the state expects to learn whether it received funding by September 1, 2026. The initiative replaced fragmented approaches to student mental health with coordinated school-based services.
- State Policy · HI
Hawaii Receives $58M Federal Grant for EMS Infrastructure and Health Workforce
Hawaii has been awarded $58 million through the federal Rural Health Transformation Program to expand emergency medical services and healthcare workforce capacity. The University of Hawaii John A. Burns School of Medicine will receive $45 million for workforce development programs, while the Hawaii Department of Health will use the remaining $13 million to purchase ambulances and upgrade emergency communications systems. The funding addresses rural healthcare infrastructure gaps and provider shortages affecting access to care statewide.
- State Policy
Epic Data Shows Medicaid Coverage Restrictions Shift Costs to Cash-Paying Patients
An Epic research analysis of over 550 million healthcare encounters found that restricting Medicaid coverage drives low-income patients to pay out-of-pocket for medical care. The study quantifies how Medicaid eligibility changes affect patient payment patterns and access to care. The findings are relevant to state policymakers considering Medicaid coverage restrictions and to providers managing increased bad debt and charity care. The research provides evidence of downstream financial impacts when states tighten Medicaid eligibility or benefits.
- State Policy · OR
Oregon State Hospital Superintendent Removed After One Month
Oregon Health Authority removed Oregon State Hospital Superintendent Sean Murphy after a one-month trial period, following the August 1 resignation of OHA Director Sejal Hathi who appointed him in June. Jim Diegel, former interim superintendent and hospital operations strategist, will return to lead the facility while OHA searches for a permanent replacement. The facility faces ongoing compliance issues including a July federal lawsuit over patient care and nearly $5 million in fines for failing to place patients within court-ordered seven-day timelines, though it returned to compliance in June 2026.
- State Policy · GA
Georgia ACA Exchange Plans Propose Premium Increases Up to 29% for 2027
Health insurers on Georgia's ACA marketplace have proposed premium increases ranging from 10% to 29% for 2027 coverage, with open enrollment beginning November 1, 2026. Two insurers—Cigna and UnitedHealthcare—are exiting the market, while Antidote is entering. These increases follow 2026 rate hikes after Congress allowed pandemic-era enhanced ACA subsidies to expire, which led approximately 350,000 Georgians to drop coverage. The proposed rates are not final and remain subject to state review and federal subsidy calculations.
- State Policy · KY
Kentucky Begins Implementing 2024 Kinship Care Law After Two-Year Budget Dispute
Kentucky's Cabinet for Health and Family Services has begun implementing SB 151, a 2024 law providing financial support to relatives raising children who would otherwise be in state foster care. The implementation follows a two-year standoff between Governor Beshear and the legislature over funding, resolved when lawmakers allocated $12 million over the 2026-2027 biennium—below the $30 million Beshear requested. The cabinet issued guidance in July establishing procedures for kinship care placements, allowing eligible relative and fictive kin caregivers to receive foster care per diem payments ranging from $27 to $81 depending on the child's age and medical complexity. Advocates express concern about potential barriers in the application process and lack of public input on implementation procedures.
- State Policy · SD
South Dakota Food Assessment Recommends Medicaid-Funded Produce Prescriptions to Address Food Insecurity
A new statewide food landscape assessment in South Dakota found 30% of residents at risk of food insecurity skip meals to stay within budget. The report recommends introducing produce prescription programs — which allow healthcare providers to prescribe fruits and vegetables redeemable at stores or markets — potentially funded through a Medicaid waiver, similar to approaches used in other states. The South Dakota Healthy Nutrition Collaborative plans to discuss the recommendation with state lawmakers during the 2027 legislative session. The assessment was produced by the state Department of Health, Avera Research Institute, University of South Dakota, and the collaborative, which includes state agencies responsible for Medicaid and social services.
- State Policy
Five States Face Medicaid Ballot Measures in November Midterm Elections
Multiple state ballot measures in the upcoming November midterm elections will determine Medicaid program direction, including potential coverage expansions, funding restrictions, or administrative changes. Specific proposals vary by state but could affect eligibility rules, state budget allocations for Medicaid, or program structure. Voters will decide these measures on Election Day, with implementation timelines depending on state law. The outcomes will directly shape Medicaid program scope and financing in affected states.
- State Policy · FL
Florida Task Force Reviews $2.7 Billion in Medicaid ABA Services, No Recommendations Yet
A Florida legislative task force met September 1 to review applied behavioral analysis (ABA) services for children with autism and developmental disabilities, examining $2.7 billion in annual Medicaid spending across home, school, office, and community settings. The panel, established by the Legislature in FY 2026-27 budget negotiations, is in information-gathering mode and heard presentations on service delivery patterns, including data showing average ABA service duration of 32.5 months and about 10,000 recipients receiving services for five years or more. The task force is charged with recommending revisions to Florida's ABA delivery model to improve care continuity and program sustainability, with final recommendations due to the Legislature by December 31, 2026.
- State Policy · AR
Arkansas Expands Maternal Life360 Home Visiting Program to Northwest Arkansas
Arkansas expanded its Maternal Life360 program to Mercy Hospital Northwest Arkansas on August 31, 2026, providing home visits for high-risk Medicaid and expansion enrollees through a child's second birthday. The program, operated through Family Network, offers pregnancy education, postpartum support, and resource navigation in English, Spanish, and Marshallese. Mercy Northwest Arkansas becomes the fourth active site; the state plans further expansion to address Arkansas's high maternal and infant mortality rates.
- State Policy · KS
Kansas Pharmacist Reports Revenue Loss Under New PBM Transparency Law
Kansas pharmacist Will Anderson reports his Lawrence pharmacy is losing revenue following implementation of Senate Bill 20, which took effect in April 2026 after passage in March. The law bans spread pricing by pharmacy benefit managers, sets a floor for pharmacy reimbursement, and requires transparent reimbursement formulas based on actual drug acquisition costs plus dispensing fees. Anderson, who advocated for the law, expects the revenue loss to reverse as the industry adapts and says similar reforms in other states generated significant Medicaid savings — Ohio eliminated spread pricing and saved over $224 million in one year.
- State Policy · NH
New Hampshire Disability System Records 21 Abuse Cases, 30 Deaths in First Half of 2026
State records show 21 confirmed cases of sexual, physical, or emotional abuse and 30 deaths occurred in New Hampshire's state-run intellectual and developmental disability care system from January through June 2026. The system, which contracts with private agencies to serve people with disabilities including autism and cerebral palsy, received 280 reports of abuse, neglect, or exploitation during this period; state investigators deemed 75 credible, with 88 investigations still incomplete. The data indicates continued systemic problems nine months after a media investigation documented widespread abuse and neglect in the program, which serves Medicaid-funded LTSS beneficiaries.
- State Policy · TX
Texas Medicaid Application Backlog Reaches 210,000 Amid SNAP Accuracy Requirements
Texas' Medicaid application backlog grew by more than 209,000 cases between January and August 2026, reaching a total backlog exceeding 210,000, according to state data shared in stakeholder meetings. The SNAP backlog grew by over 146,000 during the same period. State officials and advocates attribute the delays to new SNAP accuracy requirements affecting eligibility processing capacity. The backlog directly delays coverage for eligible individuals and may affect states' federal performance metrics under Medicaid timeliness standards.