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Monday, August 31 · 76 stories
- State Policy · MO
Missouri Voters Reject GOP Tax Amendment and Constitutional Change Measure in August Primary
Missouri voters on August 6, 2026 defeated Amendment 5, a Republican-backed tax overhaul supported by $23 million in outside funding, by 67 percentage points, losing in every county. The same electorate approved Amendment 1, renewing a sales tax for state parks, with 82% support, and rejected Amendment 4, which would have required constitutional amendments to pass in every congressional district, with less than 20% voting yes. The results suggest Missouri voters can distinguish between ballot measures despite concerns from state officials about out-of-state influence and voter confusion.
- State Policy · NV
Nevada Governor Claims Credit for Children's Hospital Despite Supporting Medicaid Cuts to Its Funding
Gov. Joe Lombardo (R-NV) is running campaign ads touting his role in establishing Nevada's first standalone children's hospital, set to open in 2030. However, Lombardo supported the One Big Beautiful Bill Act, which reduces a provider tax that was originally credited with making the hospital financially viable and cuts Medicaid funding that many pediatric patients rely on. Democrats criticized the governor for not opposing the provider tax cap reduction. Hospital executives say the project is moving forward despite the federal funding changes.
- State Policy · AR
March of Dimes: Half of Arkansas Counties Lack Maternity Care Access
A March of Dimes report found that 78,000 Arkansas women of reproductive age lived in maternity care deserts in 2024, with 33 of 75 counties lacking hospitals with delivery services or obstetric physicians. Nearly 5,000 babies were born to residents of those counties. Arkansas has not adopted the federal option to extend postpartum Medicaid coverage from 60 days to 12 months, despite roughly half of state births being Medicaid-covered. The report comes amid uncertainty over Arkansas' ARHOME Medicaid expansion, which the Trump administration has declined to renew, and federal rural Medicaid cuts of $15.5 billion annually that advocates warn could worsen hospital and maternity unit closures.
- State Policy · NC
North Carolina Legislature Studies Privatizing State Psychiatric Hospitals Under New Law
North Carolina enacted legislation (H1104) directing a feasibility study on privatizing or transferring operation of the state's three public psychiatric hospitals. The state's psychiatric hospital system has faced severe capacity constraints since early 2000s reforms cut bed capacity by half, with current bed availability further reduced by staffing shortages and increased court-ordered admissions for competency restoration. The provision authorizes examination of transferring operations to private companies or universities. If implemented, privatization would affect the state's safety-net behavioral health infrastructure, which currently serves indigent and complex Medicaid patients and provides critical workforce training for North Carolina's behavioral health system.
- State Policy · ND
North Dakota Governor Names Conner Swanson as Health and Human Services Commissioner
Gov. Kelly Armstrong appointed Conner Swanson, a longtime senior adviser, as commissioner of North Dakota's Department of Health and Human Services, effective August 29, 2026. Swanson will oversee a $5.7 billion biennial budget, more than 2,000 employees, and agency operations including Medicaid administration and federal grant programs. He succeeds interim commissioner Pat Traynor, who served since June 2025. Swanson previously worked as a policy adviser and communications director for Armstrong in Congress and played a role in the Rural Health Transformation Program deploying federal grants for rural health infrastructure.
- State Policy · IA
Iowa Congressional Candidate Criticizes Opponent's Vote on Medicaid Cuts in 2025 Reconciliation Bill
Iowa State Sen. Sarah Trone Garriott, the Democratic challenger in Iowa's 3rd Congressional District, criticized incumbent Rep. Zach Nunn for voting for the 2025 "One, Big Beautiful Bill Act," which included cuts to Medicaid funding. Speaking at the Iowa State Fair on August 14, 2026, Trone Garriott argued Nunn's votes have raised costs for Iowans and cited his support for the reconciliation bill alongside his voting record on tariff policies. The Nunn campaign defended his legislative record, pointing to 27 bills signed into law. The race is a rematch of sorts, with Trone Garriott having previously unseated a Republican incumbent in the Iowa State Senate in 2022.
- State Policy · KY
Kentucky Case Exposes Medicaid Gap in Crisis Stabilization for Severe Mental Illness
A 22-year-old Frankfort woman with severe mental illness has cycled through 20 emergency psychiatric hospitalizations and 336 days in jail over four years, prompting a Franklin Circuit judge to appoint a guardian and call for systemic solutions. The case highlights a documented gap in Kentucky's behavioral health continuum: patients with acute psychosis and co-occurring substance use are repeatedly discharged from short-term psychiatric stays to homelessness or jail because long-term crisis stabilization beds are unavailable, and state psychiatric facilities reject patients based on charge classification rather than clinical need. Mental health advocates cite this as evidence that deinstitutionalization without adequate community-based crisis services has made jails the de facto long-term psychiatric facility for Medicaid-eligible individuals with serious mental illness.
- State Policy · TN
12 Tennessee Rural Hospitals Face Immediate Closure Risk, Report Finds
A Center for Healthcare Quality and Payment Reform report identifies 12 Tennessee rural hospitals at immediate risk of closure due to multi-year losses and limited assets, with 19 additional facilities also at risk. Tennessee ranks 6th nationally for rural hospitals facing imminent closure and has lost 10 rural hospitals since 2015, second only to Texas. The report attributes closures primarily to private insurance reimbursement below cost of care, with Tennessee hospitals also facing potential future Medicaid cuts and the state's decision not to expand Medicaid eligibility. The report does not name specific hospitals but warns that even hospitals remaining open may eliminate essential services.
- State Policy · WA
Washington Proposes Wage Freeze for 80,000 Medicaid Home Care Workers
Washington state and SEIU 775 are negotiating contracts covering approximately 80,000 Medicaid-funded home care workers. The state proposed freezing wages at current levels through fiscal year 2028, maintaining the $37.42 per hour Medicaid reimbursement rate that pays workers $22-25 per hour, citing anticipated budget shortfalls ahead of the 2027 legislative session. SEIU 775 dropped its initial request from a 12% two-year increase to 3% in year one and 5% in year two, warning a wage freeze will reduce caregiver availability for Medicaid long-term services and supports beneficiaries and push more individuals from home care to higher-cost nursing facilities.
- State Policy · MN
Minnesota Nursing Home Minimum Wages Take Effect September 10 After Federal Approval
Minnesota's new minimum wages for nursing home workers received final federal approval and will take effect September 10, 2026, with rates ranging from $19 to $27 per hour depending on role. CNAs will earn $22.50, trained medication aides $23.50, LPNs $27, and all other nursing home workers $19, with an additional $1.50 increase across all categories on January 1, 2027. The state appropriated $37 million with matching federal funds to support the raises, which stem from a 2023 law creating a labor standards board. The nursing home industry has filed federal litigation seeking to dissolve the board, citing concerns about financial viability.
- State Policy · OH
Ohio Governor Issues Executive Order Creating State Certification for Recovery Housing Operators
Ohio Governor Mike DeWine signed an executive order authorizing the Ohio Department of Behavioral Health to establish a statewide certification program for recovery housing operators. The order responds to a nearly 400% increase in recovery houses since 2022, from 356 to over 1,700, amid reports of unsafe conditions and illegal operations, particularly in southern Ohio communities affected by the opioid epidemic. The state has taken legal action against uncertified homes operating illegally, but officials say stronger oversight is needed. The new certification program will allow the state to monitor compliance more consistently and respond more quickly to protect individuals in recovery.
- State Policy · KS
Kansas Police Chief Credits CCBHCs for Reducing Crisis-Related Law Enforcement Calls by 45%
A Kansas police chief reports that Certified Community Behavioral Health Clinics reduced crisis-related police calls in McPherson from 76 in 2022 to 42 in 2025, an over 40% decline. Protective custody placements dropped by more than 80%, and average hospital supervision time decreased by more than three and a half hours per incident. The CCBHC model deploys trained behavioral health professionals to respond to mental health and substance use crises, either at the scene or by accepting direct transport from officers, connecting individuals to care instead of detention.
- State Policy · AL
Alabama ACA Enrollment Drops 23% After Enhanced Premium Tax Credits Expire
Alabama saw 95,000 people — 23% of total enrollment — drop Affordable Care Act marketplace coverage in 2026 after enhanced premium tax credits expired at the end of 2025. The tax credits, which lowered premiums and expanded eligibility to households earning above 400% of the federal poverty level, were not extended by Congress despite advocacy from Democrats during fall 2025 budget negotiations. Without the subsidies, premiums increased 58% on average nationally. The decline affects small business owners, multiple-job holders, and early retirees ineligible for Medicaid or employer coverage — including Alabamians in the Medicaid coverage gap, since Alabama has not expanded Medicaid.
- State Policy · VA
Virginia Reports $2.1 Billion Revenue Increase Despite Federal Job Losses and Medicaid Cuts
Virginia Governor Abigail Spanberger reported a $2.1 billion general revenue fund increase for fiscal year 2026, driven by wage growth and a new data center energy tax projected to generate $600 million annually. The state lost 43,600 jobs, primarily from federal workforce reductions, but withholding revenues remained stable due to wage increases and early retirement patterns. Spanberger warned that federal healthcare cuts put 300,000 Virginians at risk of losing Medicaid coverage, threatening hospitals, clinics, and healthcare access statewide.
- State Policy · MN
Federal Judge Dismisses Challenge to Minnesota Nursing Home Labor Standards Board
A federal judge on Monday dismissed a lawsuit from LeadingAge Minnesota and Care Providers of Minnesota seeking to dissolve the state's nursing home labor standards board, which sets minimum wages and employment standards for nursing home workers. The board, created by the Minnesota Legislature in 2023, comprises worker representatives, industry leaders, and state officials, and in 2024 voted to mandate minimum wages and 11 paid holidays over industry objections. New wage increases take effect in September. The nursing home associations signaled they will appeal, arguing the board structure is unconstitutional and violates federal labor and antitrust laws.
- State Policy · IN
Indiana Expands CCBHC Model to 35 Counties, Aims to Reduce Competency Restoration Costs
Indiana implemented Certified Community Behavioral Health Clinic coverage across eight centers in 35 counties in 2025, following Senate Enrolled Act 1 passed in 2023. The program aims to reduce competency restoration referrals to state hospitals, which currently cost an average of $100,000 per person. Early results show reductions in hospitalizations and incarcerations among participating centers. The state has 57 counties remaining without CCBHC coverage.
- State Policy · MD
Maryland Launches Court-Ordered Outpatient Mental Health Treatment in Baltimore, Select Counties
Maryland's Department of Health on Thursday began implementing its new Assisted Outpatient Treatment program, allowing mental health professionals, family members, or friends to petition circuit courts to mandate treatment adherence for individuals with severe mental illness. The program launches initially in Baltimore City, Anne Arundel County, and Eastern Shore counties, with statewide rollout scheduled for July 2027. Circuit courts can now order patients with conditions like bipolar disorder or schizophrenia to comply with prescribed treatment plans. Disability rights advocates have raised concerns about patient autonomy, while local officials are still working out implementation logistics with state health officials.
- State Policy · MO
Missouri State Medical Association Funds $1.5M PACs Targeting Managed Care Medicaid, Prior Authorization
The Missouri State Medical Association has created two new political action committees with $1.5 million in funding to influence state legislative races ahead of the 2026 elections. The association is actively lobbying to eliminate managed care for Missouri Medicaid recipients and restrict prior authorization requirements for medical services. This represents a dramatic shift in political activity for the 125-year-old organization, which had contributed only $19,625 to political committees since 2001 and made no donations since 2014. The funding immediately positions these PACs among the state's largest political contributors for the 2026 cycle.
- State Policy · NH
New Hampshire Food Insecurity Rises as Federal SNAP Cuts Take Effect
Food insecurity in New Hampshire increased from 10.7% to 11.7% of residents between 2023 and 2024, with child food insecurity rising from 14.4% to 15.5%, according to Feeding America's annual report. Federal SNAP restrictions enacted in the July 2025 One Big Beautiful Bill Act — including work requirements, migrant benefit bans, and funding caps — are now taking effect on a rolling schedule. Food bank officials report rising demand, increased costs, and declining donations, with particular concern about homeless students and working families unable to afford food despite employment. The federal Food Security Survey was canceled in 2025, eliminating the primary data source for tracking hunger trends.
- State Policy
States Increase Home Caregiver Pay as Labor Shortage Intensifies Ahead of Boomer Wave
Several states have raised Medicaid reimbursement for home care aides as the nation faces a projected need for 5 million home caregivers by 2034, up from 4.3 million today. The national median wage for home care aides remains $16.78 per hour ($34,900 annually), contributing to persistent workforce shortages. Ohio and other states have implemented marginal pay increases through Medicaid, but those gains face jeopardy from billions in federal Medicaid cuts scheduled to take effect in 2027 under tax and spending legislation signed by President Trump. The demographic pressure intensifies as 10,000 baby boomers turn 80 daily through the next decade, straining state budgets and home- and community-based services programs.
