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Monday, August 31 · 76 stories
- State Policy · TN
Tennessee Faces TennCare Funding Gap as Federal Match Rate Declines
Tennessee's next governor will confront tightening budget constraints driven by reduced federal Medicaid matching funds and declining highway revenues. The state's federal Medicaid reimbursement rate has fallen as Tennessee's per capita income rises, forcing the state to cover more TennCare costs or reduce enrollment. Federal legislation passed in June 2025 reduced state funding further, adding $77 million in required state SNAP spending and potentially $171 million more in federal penalties. The state faces these pressures after years of surpluses that funded tax cuts and infrastructure projects using one-time cash rather than sustainable revenue sources.
- State Policy · KY
Kentucky Hospitals Expand Opioid Treatment Access Through Emergency Department Bridge Program
Kentucky hospitals are implementing the Kentucky Statewide Opioid Stewardship program (KYSOS), a partnership between the Kentucky Hospital Association and the Cabinet for Health and Family Services, to reduce opioid overprescribing and connect patients to treatment. The program's Emergency Department Bridge Program links patients with opioid use disorder to treatment during ED visits. Kentucky reported a 23% decline in overdose deaths in 2025, the fourth consecutive year of decline, though 1,110 Kentuckians still died from overdoses. The initiative addresses prescribing practices, pain management, and recovery resources across hospital inpatient units, outpatient clinics, and emergency departments.
- State Policy · OR
Oregon Approves 22% Individual Premium Hike, Considers Marketplace Enrollment Caps
Oregon's Division of Financial Regulation approved premium increases of 21.9% for individual marketplace plans and 15.5% for small group plans, effective for the 2027 plan year. Average monthly premiums for a 40-year-old Portlander will reach $599-$734, up from $567. The state will allocate an additional $15 million to its reinsurance program and explore enrollment caps for certain plans to manage market stability. The increases stem from expired enhanced ACA subsidies, rising medical costs, and tariff pressures, while federal work requirements for Medicaid could further shift individuals to the marketplace without subsidy access.
- State Policy · KY
Kentucky Senator Requests Study of Child Welfare Services Structure and Alignment
Kentucky Senator Danny Carroll filed a bill request on August 19, 2026, to establish a working group studying the state's children and family services structure, including whether services should be consolidated or separated from the Cabinet for Health and Family Services. The study would examine child placement processes from kinship care through permanency, review funding sources, and assess how programs affect each other. The senator referenced Ohio's Department of Children and Youth restructuring as a model. This follows ongoing challenges with kinship care policy implementation under SB 151, foster home shortages, and unmet high-acuity placement needs for children in state custody.
- State Policy · VT
Vermont Primary Care Physician Workforce Drops to 529 Providers, 2024 State Survey Shows
Vermont's primary care physician workforce declined to 529 providers in 2024, down from 569 in 2022 and 634 in 2004, according to a new Vermont Department of Health census. Only 39% of primary care doctors work full-time, equivalent to 402 full-time clinicians statewide. Vermont Health Commissioner Dr. Rick Hildebrant said efforts to reverse the trend are not happening fast enough. While Vermont has a higher per-capita ratio of primary care providers than most states, access remains a challenge for Medicaid beneficiaries and other Vermonters seeking appointments.
- State Policy · CA
California Ballot Measure Would Require Community Clinics to Spend 90% of Revenue on Patient Care
California voters will decide in November 2026 whether to approve Proposition 44, which would require nonprofit community health clinics to spend 90% of their revenue on patient care and empower the Attorney General to settle disputes. A study commissioned by the California Primary Care Association estimates that 91% of health centers do not currently meet this standard and could face $1.7 billion in penalties in the first year alone. The measure would penalize clinics for capital projects, equipment purchases, technology upgrades, and budget reserves. Community health clinics serve more than 7 million patients annually, including one in three Medi-Cal enrollees.
- State Policy · OR
Oregon Fire District Ends Ambulance Service Citing Medicaid Reimbursement Shortfall
Klamath County Fire District 3 in Oregon voted unanimously August 28, 2026 to discontinue ambulance service, citing unsustainable costs driven by Medicaid and Medicare reimbursement covering only approximately 15% of billed charges. The rural district, which has provided ambulance transport since late 2023, faced additional financial strain from long response times across its vast service area and calls that do not result in billable hospital transports. Ambulance coverage for the eastern Klamath County region will now fall to surrounding agencies with longer response times, while District 3 will continue first-responder services only. The closure eliminates 10 positions and reduces the district's annual budget from $500,000 to $150,000.
- State Policy · NE
Nebraska Awards $97.7M of $218.5M First-Year Rural Health Transformation Program Allocation
Nebraska has distributed $97.7 million of its $218.5 million first-year allocation from the federal Rural Health Transformation Program, with grants required to be awarded by October 31, 2026. The state released a dashboard tracking grants by county and program area, including community health worker infrastructure and workforce development in shortage areas. Nebraska received the eighth-highest first-year funding among states from the $50 billion federal program authorized to offset Medicaid cuts' impact on rural areas. The state reports strong progress compared to other states in deploying the five-year grant program.
- State Policy · ND
North Dakota Opens $50.5 Million Rural Health Grant Applications
North Dakota's Department of Health and Human Services has opened applications for $50.5 million in Rural Health Transformation Program grants covering ambulance equipment, childcare for healthcare workers, telehealth infrastructure, remote patient monitoring, and behavioral health needs assessments. Application deadlines run from August 8 through August 18, 2026, with awards ranging from a single $500,000 behavioral health grant to 110 ambulance equipment grants of $200,000 each. An additional $2 million for accessible vehicles serving Medicaid recipients and rural residents will be announced later. The funding is part of North Dakota's nearly $200 million first-year allocation from federal rural health legislation signed in 2025.
- State Policy · AL
Doug Jones Proposes Medicaid Expansion, IVF Protections in Alabama Gubernatorial Platform
Democratic gubernatorial nominee Doug Jones unveiled a policy agenda calling for Medicaid expansion, constitutional protections for IVF and contraception, a one-year moratorium on data centers, affordable housing expansion, and greater local government authority including citizen ballot initiatives. The proposals, announced July 27, 2026, would require legislative approval if Jones wins the November election. Republicans currently control both chambers of the Alabama Legislature and hold supermajorities. Jones faces Republican nominee Tommy Tuberville in the general election.
- State Policy · NM
Labor and Delivery Closures Force New Mexico Medicaid Beneficiaries to Travel for Childbirth
Hospital labor and delivery unit closures across New Mexico are forcing pregnant patients to travel farther for care, with Gallup losing roughly half its birthing capacity when Rehoboth McKinley Christian Health Care Services closed its unit in 2022. Providers report delays in prenatal care, patients disconnecting from providers, and increased postpartum depression and substance use disorders as families navigate where to give birth. The University of New Mexico's Improving Maternal Health Project is training community health workers and doulas to address provider shortages, but clinicians say the closures create compounding access barriers for high-risk patients.
- State Policy · WI
Wisconsin Legislative Primaries Could Determine Medicaid Expansion Path
Wisconsin's August 11 primary elections will shape competitive Assembly and Senate races that could flip legislative control in November. Democrats need to flip two Senate seats and five Assembly seats to win majorities in both chambers. The outcome will determine whether the next governor can enact key policy priorities including Medicaid expansion. Republican committees have raised over $11 million, significantly outpacing Democratic fundraising, with major contributions from billionaire donors. The general election is November 3.
- State Policy · OH
Ohio ACA Enrollment Drops 32% After Federal Subsidies Expire
Ohio has experienced the nation's steepest decline in Affordable Care Act marketplace enrollment since enhanced federal subsidies expired in January 2026, with enrollment falling more than 32%. Rural Ohioans are disproportionately affected by the loss of premium assistance. The decline comes as the Trump administration proposes Medicaid spending cuts of $900 billion over 10 years, which could push millions off the program. Ohio Attorney General and federal officials have increased public messaging around Medicaid fraud cases, which policy analysts characterize as an effort to build support for program cuts.
- State Policy · SC
South Carolina Faces Criminal Charges Over Alleged Neglect Deaths at Medicaid-Funded Disability Facility
South Carolina's Attorney General charged three individuals, including a licensed administrator, with neglect resulting in death and kidnapping after two residents died and others allegedly suffered serious harm at Park Circle Home, a community residential care facility in North Charleston receiving Medicaid funding. Thaddeus Moose, 64, died in April 2025 from septic shock and Stage 4 pressure ulcers ruled a homicide; a second unidentified resident died in December 2024. A March 2026 search warrant found two residents locked in a room with no exit. The case highlights fragmented oversight across licensing, Medicaid, protective services, and ombudsman agencies, with no unified public reporting on serious incidents at state-licensed facilities. South Carolina's Medicaid waiver waiting list exceeds five years for some disability services.
- State Policy · AZ
Arizona ACA Premiums Rise 28-35% Following Federal Healthcare Cuts, Hospital Closures Begin
Arizona marketplace premiums increased 28% to 35% in 2026 following the 2025 One Big Beautiful Bill Act, which reduced healthcare funding by over $1 trillion through 2034. Insurers have requested additional rate hikes averaging 25.4% for 2027, and Select Specialty Hospital-Tucson East announced closure in September 2026. Medicaid work requirements and coverage restrictions effective January 2027 are projected to result in 123,000 to 246,000 Arizonans losing Medicaid expansion coverage by 2028. The changes follow expiration of enhanced ACA premium tax credits and cuts to Medicaid funding.
- State Policy · NM
New Mexico Releases $50M in State Funds to 41 Rural Providers Facing Federal Cuts
The New Mexico Health Care Authority on August 4, 2026, announced recipients of $50 million in state funds approved during an October 2025 special legislative session to stabilize rural healthcare providers. The funding, distributed to 41 providers across rural New Mexico over three years, addresses impacts from federal Medicaid cuts included in the "One Big Beautiful Bill Act." Recipients report they will use funds for workforce recruitment and retention amid growing demand and increased Medicaid claim denials. The state Legislature expanded use of the existing Rural Healthcare Delivery Fund to allow stabilization payments, not just funding for new or expanding services.
- State Policy · MD
Maryland Cuts Home-Based Services Funding Amid Federal Medicaid Reductions
Maryland enacted cuts to home- and community-based services (HCBS) for Medicaid beneficiaries with disabilities, following federal reductions in Medicaid funding under the One Big Beautiful Bill Act. Advocates partially limited the scope of cuts but could not prevent them. The reductions threaten services that enable people with disabilities to live in community settings rather than institutions. Federal enforcement changes have weakened requirements that states prioritize community-based care over institutional placements, while state budget pressures have accelerated service cuts.
- State Policy · MD
Maryland Cuts $126 Million in Medicaid HCBS Funding Amid Federal Rollback
Maryland cut $126 million in Medicaid home- and community-based services funding following federal reductions in Medicaid matching rates under the One Big Beautiful Bill Act signed by President Trump in summer 2026. The cuts affect services that enable people with disabilities to live in their communities rather than institutions. Advocates, including disabled individuals and families, lobbied the Maryland legislature to limit the cuts but could not prevent them entirely. The reductions reflect a broader national trend as federal protections for community-based disability services erode and states respond to budget shortfalls.
- State Policy · MD
Maryland Cuts Home Services for Medicaid Beneficiaries with Complex Medical Needs
Maryland's Department of Health has reduced funding for disability services that enable Medicaid beneficiaries with complex medical needs to remain in their homes and communities rather than institutional settings. The cuts eliminate respite care for family caregivers, staffing for safety needs, and community inclusion programming, affecting beneficiaries who rely on self-directed services because they require nursing-level care. The state is also requiring family caregivers to provide more unpaid care to maintain eligibility for paid nursing services. The changes disproportionately impact individuals ineligible for traditional provider service models due to medical complexity.
- State Policy · WV
West Virginia Diverts $8M in TANF Funds to Broken PATH Database System
West Virginia's Department of Human Services is using nearly $8 million in federal Temporary Assistance for Needy Families funding to maintain its troubled PATH system, the state's online management platform for Medicaid, foster care, and welfare programs. The $400 million system, launched under the previous administration, continues experiencing regular outages and data processing failures despite ongoing investment. Governor Morrisey cited TANF funding shortfalls when abruptly closing school clothing allowance applications in July after seven days, raising questions from state legislators about whether PATH maintenance costs contributed to the program's budget deficit. State lawmakers allocated an additional $7.4 million for PATH operations in the FY 2027 budget, with the Department of Human Services unable to specify total expected annual spending on the system.
