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Thursday, September 17 · 10 stories
- State Policy · MT
Medicaid Work Requirements Create Medical Exemption Decisions for Disability Enrollees
States implementing Medicaid work requirements must now determine which disability enrollees qualify for medical exemptions, adding administrative burden to existing eligibility processes. The requirements affect cancer survivors and other disabled beneficiaries who attempt to work but face losing coverage when income or work activity triggers reviews. States must review medical cases for a broader population of Medicaid enrollees to adjudicate exemption requests. The policy creates operational challenges for state eligibility systems already managing disability determinations.
- State Policy · ID
Idaho Considers Home and Community-Based Services Cuts Amid Budget Pressures
Idaho lawmakers debated Medicaid cuts in January 2026, including reductions to home and community-based services for people with disabilities. The legislature ultimately adopted a narrower cut to disability services than initially proposed by the governor. Advocates express concern that ongoing state budget constraints and shifting federal positions may lead to further HCBS reductions. The story reflects broader tensions between state fiscal pressures and HCBS program sustainability.
Wednesday, September 16 · 9 stories
- State Policy · CA
California Poll Shows Tight Race on Billionaire Tax to Fund Medi-Cal Cuts
A Public Policy Institute of California poll finds 52% of likely voters support Proposition 40, which would impose a 5% one-time tax on billionaire assets to offset federal Medi-Cal cuts, but slim majorities also back two competing measures (Props. 41 and 42) that would nullify it. Under California law, if competing measures both pass, the one with the most yes votes prevails. The measure has divided labor and liberal groups, with Democratic leaders including gubernatorial candidate Xavier Becerra opposing it. Voters will decide in November 2026.
- State Policy
Pediatricians Report Immigrant Families Avoiding Medicaid, CHIP Amid Immigration Enforcement Fears
Forty percent of pediatricians surveyed by the American Academy of Pediatrics report children in immigrant families are avoiding healthcare due to immigration status concerns, with 31% reporting families avoided applying for Medicaid, CHIP, or food assistance. The survey of over 1,600 pediatricians conducted April-June 2026 found urban pediatricians reported higher rates of families retreating from care (48%) compared to rural providers (32%). A new federal public charge policy effective September 20, 2026 allows immigration officers reviewing green card and visa applications to consider enrollment in Medicaid, CHIP, housing assistance, and food programs as grounds for inadmissibility, which pediatricians say will further deter eligible families from enrolling.
- State Policy · LA
Louisiana Congressional Candidates Diverge on Medicaid Work Requirements, ACA Subsidies
Four candidates competing for Louisiana's 6th Congressional District seat have outlined sharply different healthcare positions ahead of the November 3, 2026 election. Democratic candidates Pat Forbes and Lindsay Garcia support restoring expired Affordable Care Act subsidies and repealing new Medicaid work requirements set to take effect in January 2027, which will require many enrollees to earn $580 monthly or complete 80 hours of volunteer work or school to retain benefits. Republican state Sen. Rick Edmonds opposes restoring ACA subsidies, favors expanded health savings accounts, and supports the work requirements as an incentive for job training. The requirements, enacted by the Trump administration and Congress in 2025, affect certain low-income Medicaid recipients starting January 2027.
- State Policy · AZ
Arizona GOP Gubernatorial Nominee Proposed Medicaid Elimination as State Senator in 2011
Andy Biggs, the Republican nominee for Arizona governor, introduced legislation as a state senator in 2011 to abolish Arizona's Medicaid program, citing unsustainable costs to taxpayers. The proposal sought to end state participation in Medicaid entirely rather than provide health coverage for low-income residents. As a gubernatorial candidate, Biggs' previous position on Medicaid elimination is resurfacing as voters and stakeholders assess his stance on the program. Arizona's Medicaid program currently covers approximately 2.4 million residents, including expansion populations adopted under the Affordable Care Act.
- State Policy · LA
Louisiana Awards Rural Health Grants to Tech Startups
Louisiana received over 200 applications from technology companies seeking $250,000 to $3 million in state funding to address rural health care gaps. The state is directing rural health dollars to unproven startups as traditional providers exit underserved markets. The initiative reflects a broader state-level trend of funding technology solutions where brick-and-mortar providers have closed or left. States are assuming financial and operational risk by investing public dollars in early-stage companies without demonstrated outcomes in Medicaid populations.
- State Policy
State Health and Value Strategies Issues Messaging Guidance on Medicaid Work Requirements
State Health and Value Strategies published Part 2 of messaging guidance for state Medicaid agencies implementing work reporting requirements under H.R. 1. The guidance reflects the June 2026 interim final rule and provides communication templates for explaining requirements, compliance procedures, and exemptions to enrollees, applicants, and community partners. This resource is designed to help state agencies develop clear, standardized communications as they operationalize the federal work reporting mandate. States face enrollee outreach and education obligations as work requirements take effect.
- State Policy · SC
South Carolina Awards $200M in Federal Rural Health Grants as State Cuts Medicaid
South Carolina Governor Henry McMaster announced federal grant awards to rural hospitals and physician practices through the Rural Health Transformation Program, totaling $200 million. The funding comes as the state implements Medicaid budget cuts. Rural healthcare providers will receive grants to support operations and infrastructure amid declining Medicaid reimbursement. The timing of these awards reflects the tension between federal rural health support and state-level Medicaid contraction.
- State Policy · MS
CMS Awards Mississippi $104 Million for Rural Healthcare Technology and Access Expansion
CMS has approved $104 million in federal funding to Mississippi to expand rural healthcare access through technology infrastructure and care delivery improvements. The funding will support telehealth expansion, care coordination technology, and increased provider capacity in underserved areas across the state. Implementation begins in fiscal year 2027. This represents a significant federal investment in Mississippi's rural health infrastructure, particularly relevant for managed care plans and providers serving Medicaid beneficiaries in rural counties where access to specialists and technology-enabled care has been limited.
- State Policy · IL
Illinois and Chicago Sue to Block Trump Green Card Restriction for Medicaid Users
Illinois and the City of Chicago filed suit to block a Trump administration plan that would allow immigration officers to deny green cards to legal immigrants who use Medicaid, SNAP, and other public benefits. The policy would expand the "public charge" rule, giving immigration authorities broader discretion to reject permanent residency applications based on lawful use of safety net programs. The lawsuit challenges the rule as exceeding federal authority and harming state interests. If implemented, the policy could reduce Medicaid enrollment among legal immigrants and their families due to chilling effects, impacting state budgets and coverage levels.
Tuesday, September 15 · 6 stories
- State Policy · AR
Arkansas Sen. Jonathan Dismang Resigns After Two Decades, Medicaid Expansion Architect
Republican Sen. Jonathan Dismang resigned from the Arkansas Senate on Tuesday, September 15, 2026, to join Arkansas Electric Cooperatives. Dismang served nearly 20 years in the legislature, including two terms as Senate president pro tempore, and was a co-architect of Arkansas' private option Medicaid expansion model. His departure removes a key Republican voice who helped design and defend the state's Medicaid expansion approach. The resignation creates a vacancy in legislative leadership with potential implications for Medicaid policy continuity in Arkansas.
- State Policy · VT
Vermont Regulator Orders UVM Medical Center to Cut Commercial Rates 4.4% Amid $75M Deficit
The Green Mountain Care Board voted 3-2 to require the University of Vermont Medical Center to reduce commercial insurance rates by 4.4% ($32.4 million) for fiscal year 2027, setting total patient revenue at $1.916 billion. The decision comes as UVM Health Network projects $75 million in losses this fiscal year and expects another $75 million deficit next year, driven by lower BlueCross BlueShield reimbursement rates and new state drug pricing caps. The network has already cut 140 jobs and plans $140 million in expense reductions. The rate cut primarily affects commercial payers, who account for $1.054 billion of UVM's allowed revenue, while Medicaid reimbursement levels are not addressed in this budget order.
- State Policy · AR
Arkansas Expands Medicaid Waiver Services to Children on Disability Waitlist
Arkansas will provide supportive living services to over 2,400 children with disabilities currently on the waitlist for the Community and Employment Services Medicaid waiver, Gov. Sarah Huckabee Sanders announced September 15, 2026. The state's four PASSE managed care plans must begin offering in-home care services to waitlist families by January 2027 at the latest, at an estimated cost of $17 million. The change responds to sustained public advocacy from families whose children receive coverage through Arkansas's PASSE managed care program but lack access to supportive living services available to waiver enrollees. Arkansas will incorporate the expansion into its federal waiver renewal request next year.
- State Policy · MS
Mississippi Awards $104M in Rural Health Transformation Grants to 167 Providers
Governor Tate Reeves announced $104 million in awards to 167 Mississippi healthcare providers for facility improvements, technology upgrades, and service expansion under the federal Rural Health Transformation Program. The state received nearly $206 million in December 2025 from the $50 billion national program designed to offset federal spending cuts' impact on rural hospitals. Recipients have until July 2027 to use the funds. Additional grant programs totaling over $30 million for workforce development and crisis mental health infrastructure will be awarded within 45 days.
- State Policy
States Struggle to Define Disability Under Medicaid Work Requirements
State Medicaid agencies are determining which medical conditions qualify beneficiaries for exemptions from work requirements, creating inconsistent disability determinations. Some beneficiaries, including cancer survivors, are losing coverage after states conclude they are able to work despite ongoing health issues. The issue affects states implementing community engagement requirements and illustrates the operational challenges of administering medical exemptions at scale. These determinations directly impact coverage continuity for vulnerable populations and create administrative burden for states and health plans managing exemption processes.
- State Policy · NJ
New Jersey Bill Would Increase Medicaid Personal Needs Allowance for Nursing Home Residents
New Jersey legislators advanced a bill to add a cost-of-living adjustment to the monthly personal needs allowance for nursing home residents enrolled in Medicaid. The legislation would increase the allowance that residents retain for personal expenses after Medicaid pays for their care. The bill has moved forward in the legislature but timing for final passage and effective date remain unclear. The change would affect Medicaid long-term care financing and could modestly increase state Medicaid spending while improving residents' ability to cover incidental expenses.
Monday, September 14 · 12 stories
- State Policy
NASHP Hosts Webinar on EMS Post-Overdose Response Partnerships October 14
The National Academy for State Health Policy (NASHP) will host a webinar on October 14, 2026, from 3:00–4:00 p.m. ET focused on expanding emergency medical services partnerships to reduce opioid deaths through post-overdose response strategies. The session will likely address how state Medicaid agencies and health plans can collaborate with EMS providers to implement follow-up interventions after overdose events. For states implementing Section 1115 substance use disorder waivers or managing behavioral health through Medicaid managed care, this webinar may provide operational models for care coordination and overdose prevention initiatives.
- State Policy · VT
Vermont Commentary Calls for Tax Law Changes to Fund Healthcare Coverage Expansion
A Vermont advocacy commentary argues that state tax laws allow wealthy property owners to avoid proposed higher taxes on second homes intended to fund expanded healthcare coverage, including Medicaid. The author proposes closing loopholes that permit married couples to claim separate primary residences in different states and imposing progressive income taxes on earnings over $500,000. The piece responds to Governor Phil Scott's opposition to wealth taxes and broader property tax increases. No specific legislative action is pending, but the commentary frames the debate over how Vermont could finance healthcare expansion.
- State Policy · CA
California Adopts 3.5% Hospital Spending Growth Cap Through 2029
California's Office of Health Care Affordability has adopted a 3.5% annual spending growth cap for hospitals, physician groups, and insurers, effective through 2029. Entities exceeding the cap will face penalties. The framework applies to all payers, including Medicaid managed care organizations contracting with hospitals and physician groups in California. This marks California's first enforceable cost growth benchmark, directly affecting Medi-Cal managed care contract negotiations and capitation rate development.