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Tuesday, July 7 · 6 stories
- State Policy · IN
Indiana Maintains Medicaid Funding Block to Planned Parenthood After Federal Ban Expires
Planned Parenthood remains excluded from Indiana's Medicaid program despite the recent expiration of a federal prohibition on Medicaid payments to abortion providers for non-abortion services. The organization reports it is still unable to receive reimbursement for covered Medicaid services in Indiana. The continued funding block appears to rely on state-level policy even after federal restrictions lapsed. This affects Medicaid beneficiaries' access to family planning, preventive care, and other covered services through Planned Parenthood clinics in Indiana.
- State Policy · NY
New York Medical Aid in Dying Act Takes Effect August 5, 2026
New York's Medical Aid in Dying Act becomes effective August 5, 2026, establishing a legal framework for terminally ill adults to request and self-administer life-ending medication. The law, introduced in January 2025 and amended in February 2026, affects health plans, providers, and facilities operating in New York's Medicaid program. Managed care organizations must prepare compliance protocols, update provider contracts, and clarify coverage policies before the effective date. The law represents the latest state-level expansion of medical aid in dying, joining ten other states with similar statutes.
- State Policy · SC
South Carolina Behavioral Health Agency Eliminates 248 Positions in Reorganization
South Carolina's Department of Behavioral Health and Developmental Disabilities eliminated 248 positions as part of a reorganization, resulting in 47 layoffs. The department was created in 2025 to consolidate mental health and developmental disabilities services. The restructuring affects state agency capacity to oversee behavioral health and developmental disabilities services, including programs delivered through Medicaid managed care organizations. The changes take effect immediately as part of the department's operational consolidation.
Monday, July 6 · 2 stories
- State Policy · OH
Ohio Economists Split on Medicaid Fraud Prevention Bill Awaiting Governor Signature
Ohio's Senate Bill 315, passed by the General Assembly in June 2026, awaits Governor DeWine's signature. The legislation requires the Ohio Department of Medicaid to suspend payments under certain fraud-prevention circumstances and includes other anti-fraud measures. A panel of economists is divided on whether these provisions will effectively reduce Medicaid fraud. The bill's implementation timeline depends on the governor's action.
- State Policy · AR
Arkansas Begins Pre-Enforcement Review of Medicaid Work Requirements
Arkansas has started verifying whether Medicaid expansion enrollees meet work requirements mandated by new federal law, though enforcement does not begin until January 1, 2027. The state is conducting a 'soft launch' to assess compliance among hundreds of thousands of enrollees before penalties take effect. Enrollees who do not currently meet work requirements will not lose coverage during this pre-enforcement period. This represents Arkansas implementing federal work requirement authority ahead of the mandatory compliance date.
Thursday, July 2 · 3 stories
- State Policy
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.
- State Policy · NV
Nevada Medicaid Cuts Surface as 2026 Election Issue for GOP Governor
Federal cuts to Medicaid and SNAP programs are becoming a central issue in Nevada's 2026 gubernatorial race, potentially affecting Republican Governor Joe Lombardo's reelection bid. The state, a key battleground with significant Medicaid enrollment, faces voter concern over healthcare affordability as federal funding reductions take effect. The political dynamics may influence state policy decisions on Medicaid expansion, managed care contracts, and benefit design as the election approaches. Nevada's Medicaid managed care organizations should monitor how electoral pressure shapes state budget negotiations and program priorities.
- State Policy
States Face Coverage Loss Risk as CMS Narrows Medically Frail Definition for Work Requirements
State Medicaid agencies report concerns that sick and disabled enrollees will lose coverage under a narrowed federal definition of "medically frail" used for work requirement exemptions. The change stems from legislation President Trump signed last year requiring states with Medicaid expansion to implement work requirements. State officials fear the tightened criteria will disqualify many enrollees who previously qualified for exemptions, forcing them into compliance or disenrollment. The policy directly affects how managed care organizations identify and retain vulnerable members.
Wednesday, July 1 · 5 stories
- State Policy · CA
California Schools Face Delays Implementing Newsom Mental Health Initiative Five Years After Launch
Five years after Governor Gavin Newsom launched an initiative to center mental health services in California public schools, many schools have struggled to implement the program and hundreds have not yet begun participation. The initiative aimed to transform schools into hubs for youth mental health services, but implementation challenges have delayed rollout across the state. The slow adoption affects access to behavioral health services for Medicaid-eligible children who rely on school-based care. No specific timeline for expanded implementation was reported.
- State Policy · WA
Washington State Launches WA Cares Long-Term Care Insurance Program July 1
Washington's WA Cares Fund, the nation's first publicly administered long-term care insurance program, begins providing coverage on July 1, 2026. The program offers eligible workers up to $36,500 in lifetime benefits for long-term services and supports, funded through a 0.58% payroll tax. Dozens of applications have already been submitted. The launch follows years of legislative debate and program delays since the payroll tax collection began in 2023.
- State Policy · NJ
New Jersey Legislature Passes Employer Fee Targeting Firms With 50+ Medicaid-Enrolled Workers
New Jersey lawmakers approved legislation imposing fees on employers with at least 50 workers enrolled in Medicaid, projected to generate $145 million in state revenue. The fee targets companies whose employees rely on public coverage, effectively shifting costs to employers for their workforce's health benefits. The measure now heads to the governor for signature. This represents a novel state financing mechanism that could affect Medicaid managed care enrollment patterns and employer benefit decisions.
- State Policy · MT
Montana Lacks Staff and Data Systems as Medicaid Work Requirements Near Implementation
Montana's health department has not hired the staff needed to review work requirement applications and lacks access to claims data required to verify medical exemptions as implementation approaches. The state only recently identified qualifying diagnoses for exemptions. These operational gaps raise questions about the state's readiness to administer work requirements without inappropriate coverage losses. The timing and specific effective date are not specified in the available content.
- State Policy · WI
Wisconsin Postpartum Medicaid Extension Takes Effect July 1, Covering 16,000 Mothers
Wisconsin's 12-month postpartum Medicaid coverage extension becomes effective July 1, 2026, extending coverage from the previous 60-day limit. The state became the 49th to adopt the extension when legislation was signed in March 2026. The Wisconsin Department of Health Services estimates the policy will provide continuous coverage to approximately 16,000 mothers annually. The extension addresses maternal health outcomes and coverage continuity for postpartum enrollees in Wisconsin's Medicaid program, including managed care plans.
Tuesday, June 30 · 2 stories
- State Policy
NASHP Releases Five-State Behavioral Health Workforce Policy Academy Results
The National Academy for State Health Policy published findings from a multi-state policy academy focused on strengthening the behavioral health workforce. Five states participated in the initiative to develop and implement workforce development strategies. The report includes success stories and resources documenting state-level approaches to addressing provider shortages and building capacity. The findings are relevant to Medicaid managed care organizations operating in states that participated or considering similar workforce development partnerships with state agencies.
- State Policy · IN
Indiana Medicaid Enrollment Drops 174,000 Children in Three Months
Indiana lost 174,000 children from Medicaid between January and April 2025, a 20% decline that represents the steepest percentage drop in the nation, according to Georgetown University's Center for Children and Families. The state also recorded the third-highest absolute enrollment decline nationally during this period. This drop follows the end of continuous enrollment protections that were in place during the COVID-19 public health emergency. Indiana's redetermination process appears to be resulting in significantly higher disenrollment rates than most other states.
Monday, June 29 · 5 stories
- State Policy · TN
Tennessee Law Mandates Immigration Data Sharing for Children's Special Services Enrollees
Tennessee enacted legislation requiring state agencies to share data on public assistance program applicants and enrollees without qualified immigration status with federal immigration authorities. This requirement extends to the Children's Special Services program, which serves children with disabilities. The law affects eligibility and enrollment processes for state public assistance programs, including Medicaid-adjacent services. The policy creates operational challenges for managed care organizations and providers serving mixed-status families, potentially reducing program participation and complicating outreach and enrollment activities.
- State Policy
NASHP Releases Model Legislation Tying State Drug Pricing to Medicare Negotiated Rates
The National Academy for State Health Policy published revised model legislation allowing states to reference Medicare Maximum Fair Prices negotiated under the Inflation Reduction Act when setting prescription drug payment rates for state programs. The model act would apply to state-funded programs including Medicaid fee-for-service and potentially managed care pharmacy benefits. States can adapt the model to tie reimbursement rates to Medicare's negotiated prices for high-cost drugs, creating potential benchmark pricing constraints. The legislation offers states a mechanism to leverage federal negotiating power for prescription drug cost containment.
- State Policy · CA
California Grants Staffing Waivers to 23 Psychiatric Hospitals After New Nurse Ratio Rules
California's Department of Public Health approved temporary waivers for 23 of 35 psychiatric hospitals required to comply with new nurse-to-patient ratios that took effect June 1, 2026. The regulations mandate one nurse per six adult patients and one nurse per five youth patients in psychiatric units. The waivers allow non-compliant facilities to continue operating while they work toward meeting staffing requirements. This affects Medicaid managed care organizations with behavioral health carve-ins or delegated inpatient psychiatric contracts, as network adequacy and access standards depend on participating hospitals maintaining operational capacity.
- State Policy · ID
Idaho Behavioral Health Council Recommends Rural Opioid Funding Priority
Idaho's Behavioral Health Council is recommending that the state legislature direct opioid settlement funds toward rural communities in upcoming funding decisions. The council, which includes representatives from all three branches of state government, will present project proposals prioritizing rural areas. This recommendation comes as Idaho determines allocation of settlement funds received from opioid litigation. The focus on rural communities reflects ongoing challenges in accessing behavioral health services in non-urban areas of the state.
- State Policy · CA
California Report Examines Undocumented Residents' Medi-Cal Access Under Enforcement Climate
A California Health Care Foundation report based on interviews with 39 undocumented Californians analyzes how recent Medi-Cal eligibility expansions interact with heightened immigration enforcement concerns. The qualitative research explores coverage enrollment decisions, trust barriers, and healthcare access patterns among undocumented individuals now eligible for Medi-Cal under California's eligibility expansions. The report documents how immigration policy uncertainty affects enrollment behavior and continuity of coverage even when individuals are legally eligible for benefits. Findings inform outreach strategies and enrollment retention efforts for managed care plans serving this population in California.