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Friday, June 26 · 2 stories
- State Policy
Young Children's Uninsurance Rises Faster Than School-Age Peers Pre-2025
Analysis shows young children experienced faster uninsurance growth compared to school-aged children prior to 2025 Medicaid enrollment declines. The trend emerged before recent federal policy changes including Trump administration actions and H.R. 1 proposals. The data suggests underlying coverage gaps for young children independent of current redeterminations. States may need targeted outreach and enrollment strategies for families with young children to reverse the trend.
- State Policy · CT
Connecticut Medicaid Spending Rose in 2024 but Remained Lowest Per-Member Cost
Connecticut's Medicaid program experienced spending increases in 2024 while maintaining the lowest per-enrollee costs compared to commercial insurance markets in the state. The data shows Medicaid's cost efficiency persisted despite upward spending pressure. The comparison encompasses all insurance market segments operating in Connecticut. Medicaid managed care organizations in the state continue to deliver care at lower per-member costs than commercial carriers, though absolute spending grew year-over-year.
Thursday, June 25 · 5 stories
- State Policy · IL
Illinois Law Restricts Out-of-State Access to Abortion, Gender Dysphoria Records
Illinois Governor J.B. Pritzker signed the Reproductive Health Records Privacy Act on June 24, 2025, requiring abortion services and gender dysphoria diagnoses to be separated from patients' electronic medical records and limiting disclosure to out-of-state entities. The law takes effect July 1, 2027. Healthcare providers, including Medicaid managed care organizations, must implement new record-keeping protocols to segregate these specific health information categories and establish controls preventing out-of-state disclosure.
- State Policy · CA
California Replaces Mental Health Services Act with New Behavioral Health Services Act
California has replaced the Mental Health Services Act (MHSA) with the Behavioral Health Services Act (BHSA), changing how counties allocate mental health funding. The BHSA modifies funding allocation requirements and county spending priorities for mental health and substance use disorder services. The change affects how counties structure behavioral health programs and redirect existing MHSA revenues. California Health Care Foundation has published resources detailing the differences between the two funding frameworks.
- State Policy · KY
Kentucky Directs Opioid Settlement Funds to Rural Substance Use Services
Eastern Kentucky is using opioid settlement funding to support programs addressing substance use disorders, housing instability, and food insecurity in rural communities. The initiative targets regions heavily affected by the opioid crisis with integrated support services. No specific implementation timeline or funding amount is provided in the reporting. This represents Kentucky's approach to deploying settlement resources for behavioral health infrastructure in underserved areas.
- State Policy · FL
Florida AG Opens Antitrust Investigation Into CVS Pharmacy Practices
Florida Attorney General Ashley Moody has launched an investigation into CVS Health for alleged anticompetitive pharmacy practices. The probe examines whether CVS is using its integrated pharmacy benefit manager and retail pharmacy operations to disadvantage competitors and increase drug costs. This investigation follows similar state-level actions targeting PBM practices and comes amid broader scrutiny of vertical integration in the pharmacy supply chain. The inquiry could result in enforcement actions, consent agreements, or legislation affecting how PBMs operate in Florida's commercial and Medicaid markets.
- State Policy · NM
New Mexico Behavioral Health Restructuring Causes Regional Implementation Conflicts
New Mexico is experiencing confusion and conflicts as it implements a new regional structure to rebuild its behavioral health infrastructure. State officials are working to repair the system, but the restructuring has created challenges at the community level. The article does not specify implementation timelines or affected populations. This matters for Medicaid managed care organizations because behavioral health network adequacy and provider coordination are core contractual requirements, and state infrastructure changes can disrupt existing MCO networks and referral pathways.
Wednesday, June 24 · 4 stories
- State Policy · MI
Michigan Erases $74M in Medical Debt Through Nonprofit Partnership
Michigan has eliminated over $74 million in medical debt for 71,871 residents through a partnership with nonprofit Undue Medical Debt, bringing the state's total debt relief to more than $200 million. Governor Gretchen Whitmer's office announced the initiative on June 22. The program targets qualifying residents with medical debt, though specific eligibility criteria and coverage periods were not detailed in the announcement. This marks Michigan's continued expansion of its medical debt relief efforts using state budget allocations to purchase and forgive outstanding hospital and provider balances.
- State Policy · WV
West Virginia Prepares for Federal Medicaid Work Requirements with New Website
West Virginia's Department of Human Services launched an information website and is requesting Medicaid recipients update their contact information ahead of new federal Medicaid work requirements taking effect in 2026. The state is preparing to implement work requirements that will affect certain Medicaid enrollees, though specific eligibility criteria and exemptions have not been detailed. The initiative signals active state-level preparation for federal policy changes that will require states to verify work activity for non-exempt adult Medicaid recipients.
- State Policy · PA
Pennsylvania Projects $5.6 Billion Budget Deficit, May Tap $8 Billion Rainy Day Fund
Pennsylvania faces a $5.6 billion budget deficit for fiscal year 2026-27, according to the Independent Fiscal Office. Governor Shapiro's budget proposal projects using $4 billion from the state's rainy day fund, assuming new revenue from legalizing marijuana and taxing skill games. Without new revenue sources, the state will need to drain reserve funds, implement spending cuts, or use accounting maneuvers to balance the budget by the June 30 deadline. Senate Republicans have discussed cutting Medicaid and SNAP spending, though specifics have not been provided. The state has already drawn down $6.6 billion from reserves over the past two fiscal years.
- State Policy · LA
Planned Parenthood to Reopen Louisiana Clinic After Medicaid Funding Cut Closures
Planned Parenthood plans to open a New Orleans clinic later this year and begin telehealth services this summer, following the closure of its two Louisiana clinics last fall. The closures resulted from Trump administration Medicaid funding cuts. The reopening represents a return of Planned Parenthood services to Louisiana after a multi-month gap in availability. The organization will phase in brick-and-mortar and virtual care access.
Tuesday, June 23 · 4 stories
- State Policy · ME
Maine GOP Group Petitions DHHS for Stricter MaineCare Anti-Fraud Rules
Lead Maine, a Republican-led advocacy group, submitted over 3,500 signatures petitioning the Maine Department of Health and Human Services to adopt new anti-fraud rules for the state's MaineCare program. The group, led by State Rep. Laurel Libby, argues the proposed changes would strengthen oversight of MaineCare providers and taxpayer spending. The petition seeks mandatory rulemaking to establish additional fraud prevention and program integrity requirements. If the petition meets statutory requirements, DHHS would be required to initiate a formal rulemaking process, including public comment periods and potential implementation timelines.
- State Policy · KY
Kentucky Medicaid Director Lisa Lee Discusses People-Centered Policy Approach
The National Academy for State Health Policy spotlighted Kentucky Medicaid Director Lisa Lee, who outlined her people-centered approach to shaping the state's Medicaid program. Lee discussed strategies for improving health outcomes across Kentucky's Medicaid population through policy design focused on beneficiary needs. The interview covered her leadership vision and priorities for the state's program. Kentucky operates a managed care delivery system serving over 1.6 million beneficiaries through five contracted MCOs.
- State Policy · MI
Michigan House Speaker Proposes Hospital Cost Review Board, 10% Price Caps
Michigan House Speaker Matt Hall introduced legislation establishing a state hospital cost review board with authority to cap healthcare prices and restrict hospital consolidation. The bill would impose a 10% reduction on certain hospital prices and create new regulatory oversight of hospital costs. The Michigan Health & Hospital Association opposes the measure, arguing it would worsen affordability challenges. If enacted, the law would apply to all hospitals operating in Michigan, including those contracting with Medicaid managed care organizations.
- State Policy · NV
Nevada Enacts AI Restrictions for Mental Health and Emergency Services
Nevada has enacted regulations limiting artificial intelligence use in mental and behavioral health situations and emergency planning, despite federal opposition to AI regulation. The state joins a small group of jurisdictions implementing AI guardrails in healthcare settings. The restrictions affect how providers and plans can deploy AI tools in clinical decision-making for mental health services and crisis response. Implementation details and effective dates were not specified in available reporting.
Monday, June 22 · 3 stories
- State Policy
Advocacy Group Recommends Using State Advisory Councils to Track Work Requirement Implementation
The National Health Law Program published guidance recommending that state advocates use Medicaid Advisory Committees and Beneficiary Advisory Councils to monitor implementation of work requirements mandated under recent federal legislation. The organization cites the rapid timeline states face to implement these changes as creating monitoring challenges. The guidance aims to help advocates track how states operationalize the new requirements through existing advisory body structures. While the article provides advocacy strategy recommendations, it does not detail specific work requirement provisions, state implementation timelines, or federal enforcement mechanisms.
- State Policy · MI
Michigan Medicaid Expansion Linked to Better Health Outcomes, Financial Stability
A University of Michigan study found that the Healthy Michigan Plan improved health care access, health outcomes, and financial stability for low-income adults enrolled in the state's Medicaid expansion program. The findings arrive as Congress prepares to implement new Medicaid work requirements starting January 2027, which will require many expansion enrollees nationwide to document employment or other qualifying activities. The study provides evidence of expansion's impact as policymakers debate work requirement policies.
- State Policy · OH
Ohio projects 51,000 job losses, $5.3B economic impact from Medicaid cuts by 2029
A new analysis projects Ohio will lose 51,000 jobs and $5.3 billion in economic activity by 2029 due to Medicaid and food assistance cuts enacted in 2025 federal spending legislation, combined with the expiration of Affordable Care Act subsidies. The projections reflect the full phase-in of these policy changes over the next several years. The analysis highlights state-level economic consequences of federal budget decisions affecting health coverage programs.
Friday, June 19 · 1 story
- State Policy · IN
Indiana Proposes Major Revisions to Residential Care Facility Rights and Eviction Rules
The Indiana Department of Health published proposed amendments to regulations governing residential care facilities, addressing resident rights, residency agreements, and involuntary evictions under 410 IAC 16.2-5. The proposal represents one of the most significant updates to Indiana's assisted living regulatory framework in recent years. The changes are intended to align Indiana's rules with current standards, though the effective date and comment period are not specified in the available excerpt. The revisions will affect assisted living providers and may impact Medicaid managed care organizations that contract with residential care facilities for long-term services and supports.
Thursday, June 18 · 3 stories
- State Policy · CA
California DMHC Finds 70 Knox-Keene Violations in Commercial Plan Behavioral Health Audits
The California Department of Managed Health Care identified 70 Knox-Keene Act violations across three investigation rounds involving commercial health plans' delivery of behavioral health services for mental health and substance use disorder treatment. The violations indicate systemic failures in timely access to care. While these investigations targeted commercial plans regulated under Knox-Keene, the findings may signal enforcement priorities that could extend to Medi-Cal managed care plans, which are also subject to DMHC oversight and similar network adequacy standards for behavioral health.