All stories
Jump to date
Friday, September 18 · 13 stories
- State Policy
States Prepare for Medicaid Work Requirements, Expand Rural Health Programs in August 2026
State Health and Value Strategies compiled state Medicaid and health policy activity from August 2026. States prepared enrollees for upcoming Medicaid work reporting requirements under H.R. 1, awarded additional Rural Health Transformation Program grants, and established rural health advisory councils. Massachusetts returned $14.5 million in dental insurance rebates under state law, becoming the first state to enforce dental rebate requirements. Two states received CMS 1115 waiver approvals, and Oregon secured approval to transition to a State-Based Marketplace. States also acted on vaccine access, reproductive healthcare, healthcare affordability, primary care investment, and medical debt.
- State Policy
NASBO Data Shows State Revenue Trends Shaping FY 2027 Medicaid Budgets
A new brief analyzes state fiscal conditions using National Association of State Budget Officers revenue and spending data to provide context for state Medicaid budget decisions in fiscal year 2027. The analysis examines how current state revenue trends and overall spending patterns are likely to influence Medicaid funding levels and program priorities as states finalize their FY 2027 budgets. The brief is intended to help Medicaid stakeholders understand the fiscal environment in which states are making budget and policy decisions for the upcoming fiscal year.
- State Policy · SD
South Dakota AG Says Ballot Measure Would Auto-Repeal Medicaid Expansion
South Dakota Attorney General Marty Jackley has stated that a constitutional amendment on the November 3 ballot would automatically end Medicaid expansion if federal funding falls below 90%, contradicting Republican lawmakers who placed the measure and claim it would only grant them authority to consider ending expansion. The legal interpretation dispute centers on whether the amendment is self-executing or requires legislative action. The disagreement creates uncertainty for approximately 50,000 South Dakotans who gained coverage under the state's voter-approved expansion.
- State Policy · CT
Connecticut Poll Shows Voter Support for Increasing State Medicaid Spending Amid Federal Cuts
A poll of 602 Connecticut voters found 86% support using state surplus funds to offset federal cuts to social services, including Medicaid, and 54% favor adjusting budget caps to increase funding. An estimated 110,000 low-income adults in the HUSKY D Medicaid program face coverage loss in January 2027 due to new federal work requirements, and hundreds of lawfully present immigrants will lose Medicaid eligibility regardless of work status. Connecticut has run surpluses averaging $1.8 billion annually since 2017, and Governor Lamont created a $550 million fund for one-time assistance but has not committed to ongoing state-funded replacements for federal programs. The state increased nonprofit provider funding by $60 million in fiscal year 2027, but advocates say payments still lag inflation by over $300 million annually.
- State Policy · WV
West Virginia Allocates $855K in Federal Funds to Expand Health Information Exchange
West Virginia will allocate $855,400 in federal Rural Health Transformation Program funds to the West Virginia Health Information Network to expand statewide health information exchange capacity. The funding will support the Connected Care Grid initiative, increasing participation in secure data sharing among healthcare providers and organizations. The allocation is part of West Virginia's $199 million Rural Health Transformation award from CMS in 2026, aimed at strengthening rural healthcare infrastructure. The investment expands provider connectivity for care coordination across the state's rural healthcare delivery system.
- State Policy · MI
Michigan Lawmakers Push Coverage Expansion for Group Prenatal Care Programs
Michigan legislators are advancing bills to require Medicaid and private insurance coverage for group prenatal care services, defined as up to 12 visits in an evidence-based group setting. SB 415, requiring Medicaid coverage, has already been signed into law. Three companion bills extending similar mandates to private insurers remain in committee. Michigan currently operates 39 licensed Centering Pregnancy sites — second-most nationally — through a state health department partnership launched in 2024. The legislation aims to expand access to group care models that combine prenatal visits, education, and peer support for expectant mothers at similar pregnancy stages.
- State Policy · VT
Vermont Regulator Cuts Hospital Commercial Rates 1.2%, Expects $1.94B Revenue Cap
Vermont's Green Mountain Care Board issued budget orders Monday reducing commercial insurance rates charged by hospitals by approximately 1% statewide, with collective commercial revenue capped at $1.94 billion for fiscal year 2027 beginning October 1, 2026. The University of Vermont Medical Center faces the steepest reduction at 4.4%, while only Northwestern Medical Center and Springfield Hospital received 2% rate increases. The orders aim to slow health insurance premium growth in a state where residents pay among the nation's highest premiums, but hospital leaders warn the cuts will destabilize facilities already projecting collective deficits this fiscal year and next. Vermont hospitals have cut $57 million from projected fiscal 2026 expenses as part of a broader plan to reduce spending by $330 million by 2028.
- State Policy · GA
Georgia Remains Among 10 States Without Medicaid Expansion Despite Public Support
Georgia has not expanded Medicaid eligibility under the Affordable Care Act, remaining one of 10 non-expansion states. Public polling shows strong support for expansion among Georgia residents. The article discusses whether recent state proposals represent genuine expansion efforts or delay tactics. The continued non-expansion affects coverage for low-income adults in the coverage gap who earn too much for traditional Medicaid but cannot afford marketplace plans.
- State Policy
Colorado Medicaid Projects Service and Funding Cuts Amid Budget Overruns
Colorado’s Medicaid program is forecasting service reductions and funding cuts as the program significantly overspends its budget. State lawmakers attribute rising costs to multiple converging factors creating financial pressure on the program. The forecast signals potential cuts affecting the state's Medicaid beneficiary population. Specific timing, affected services, and dollar amounts were not detailed in available information.
- State Policy · CA
California Medicaid Rate Increase Expected to Shift Pediatric Care to Home Settings
California implemented a Medicaid rate increase for home-based pediatric care, prompting Aveanna Healthcare to raise caregiver wages and plan January recruiting expansion. The company anticipates hundreds of families will transition medically complex children from institutional settings to home care as a result of improved reimbursement. The rate adjustment addresses longstanding workforce shortages in California's home health sector by enabling providers to offer competitive wages. This shift affects California's Medicaid program, pediatric providers, managed care organizations with LTSS responsibilities, and families of children with complex medical needs.
- State Policy · MA
Massachusetts Reduces Estimate of Members Subject to Work Requirements by 50,000
MassHealth has lowered its projection of members who will be affected by upcoming Medicaid work and education requirements by approximately 50,000 individuals. The revised estimate reflects a recalculation of the member population subject to community engagement rules. The requirements will impose work, education, or volunteer obligations on non-exempt adult Medicaid beneficiaries. The reduction in projected impact suggests either narrower implementation scope or expanded exemption categories compared to initial projections, which will affect state administrative planning and managed care organizations' member engagement strategies.
- State Policy · PA
Pennsylvania Families Sue Shapiro Administration Over Medicaid Caregiver, Travel Restrictions
Four Pennsylvanians with intellectual and developmental disabilities filed a class action lawsuit challenging new Medicaid waiver rules that limit paid hours for family caregivers to 40–60 per week and restrict out-of-state travel support. The Shapiro administration imposed the limits through participation agreements after Commonwealth Court struck down nearly identical policies in February 2026 for failing to follow required rulemaking procedures. The administration gave participants an Aug. 6 deadline to sign new agreements or face involuntary service terminations; over 8,300 beneficiaries had signed by early September. Plaintiffs argue the state is bypassing the regulation process and forcing families to choose between uncompensated caregiving or institutional care.
Thursday, September 17 · 10 stories
- State Policy · CA
California Prop 36 Treatment Mandates Vary Widely by County, Leaving Gaps in Drug Treatment Access
Two years after California voters passed Proposition 36 requiring drug treatment for certain theft and drug offenses, counties are implementing treatment-mandated felony provisions inconsistently — with treatment durations ranging from three months in Ventura County to two years in San Luis Obispo County. Officials who supported the measure acknowledge gaps in the state's treatment infrastructure, with people waiting for services while charges remain pending. Defendants entering plea deals face challenges securing employment with felony convictions on record during court-mandated treatment periods that can extend well beyond residential program completion. The lack of state-funded treatment capacity and standardized implementation protocols has left some individuals the law intended to help falling through the cracks, according to state and local officials.
- State Policy · IN
Indiana Proposes Expanded Resident Rights and HCBS Standards for Residential Care Facilities
The Indiana Department of Health has issued a second public comment notice on proposed amendments to Residential Care Facility regulations. The rulemaking would expand resident rights protections, incorporate federal Home and Community-Based Services setting requirements into state assisted living regulations, and create new eviction procedures for facilities. The proposal affects residential care facilities serving Medicaid HCBS waiver beneficiaries in Indiana. Public comment is now open on the revised proposal, which builds on an earlier version published this year.
- State Policy · TX
Texas Hospitals Regain $12 Billion in Medicaid Funding After Federal Dispute Resolved
Texas hospitals will receive $12 billion in Medicaid funding following resolution of a nearly year-long dispute with CMS. The impasse had threatened hospitals with $27 million in daily losses. The restoration of funds ends uncertainty over supplemental payment programs that support hospitals serving Medicaid and uninsured populations. The resolution allows Texas to continue making these payments under terms acceptable to federal regulators.
- State Policy · VT
Vermont Physician Argues Against Cutting Graduate Medical Education Funding Amid Federal Medicaid Reductions
A Vermont physician defends graduate medical education (GME) investment in response to recent state debate about physician training costs and retention rates. The letter notes that commercial payers are bearing increased GME costs as federal Medicaid dollars decline and federal funding for public health and substance use programs is cut. Vermont's physician retention rate trails the national average, which the author attributes to the state's challenging healthcare climate and reliance on federal grants rather than state funding for residency programs. The letter opposes cutting medical education as a cost-control measure.
- State Policy · WV
West Virginia Legislator Questions $1.17M Rural Health Grant to Wellness Organization
West Virginia awarded Spotted Owl Health Organization $1.17 million in federal Rural Health Transformation program funds to establish employer-based worksite clinics, prompting concerns from Del. Gary Howell that the Kanawha County wellness organization lacks experience in multi-employer healthcare delivery and has never administered grants exceeding $50,000. Health Secretary Arvin Singh defended the merit-based selection and noted the state can claw back funding if performance milestones are not met. West Virginia received $199 million in Rural Health Transformation program funding from CMS for 2026, part of a five-year initiative to expand rural healthcare access.
- State Policy · NH
New Hampshire ACA Marketplace Enrollment Falls 8% After Enhanced Premium Tax Credits Expire
New Hampshire saw 4,868 fewer residents enrolled in ACA Marketplace plans in 2026 compared to 2025, an 8% decline, following the December 2025 expiration of Enhanced Premium Tax Credits. Nationally, enrollment dropped from 21.8 million to 19.2 million. The analysis by KFF used effectuated enrollment data, which reflects both non-enrollment and coverage loss due to non-payment of premiums. The decline coincides with broader federal Medicaid cuts under the One Big Beautiful Bill Act and new state Medicaid premium requirements in New Hampshire, raising concerns among community health providers about access to primary care and emergency department utilization.
- State Policy · OR
Oregon Medicaid Overpaid $4.1M Due to Duplicate Enrollee IDs, Audit Finds
A state audit found Oregon's Medicaid program overpaid up to $4.1 million to healthcare organizations statewide due to duplicate enrollee identification codes that state officials failed to detect and correct. The system errors resulted in improper claims payments when the same beneficiaries were issued multiple IDs. The audit did not specify a timeline for recovery or corrective action, but the findings indicate ongoing financial integrity and claims processing vulnerabilities in Oregon's Medicaid system.
- State Policy · CO
Colorado Pediatric Clinics Close as Medicaid Cuts, Federal Eligibility Changes Hit Children's Coverage
Federal Medicaid cuts totaling $1 trillion and a 2% Colorado state reimbursement rate reduction are forcing pediatric clinic closures and coverage losses for children. Two pediatric clinics within 10 miles of Commerce City have closed entirely due to insufficient revenues. On October 1, 2026, new federal rules will cut Medicaid eligibility for immigrant children, affecting an estimated 7,000 Colorado children. Colorado projects up to 377,000 total Medicaid enrollees at risk of disenrollment, with children representing more than one-third of the state's Medicaid population.
