Five states are urging federal officials to delay implementation of new Medicaid work requirements, citing mounting evidence that administrative hurdles, rather than a lack of work activity, are causing eligible beneficiaries to lose coverage.
In an Oct. 1 letter to the U.S. Department of Health and Human Services, the governors of:...National News
A new study of Massachusetts' Medicaid ACOs offers a potential roadmap for improving maternal health. Set clear expectations, give healthcare organizations the resources to meet them and track patients beyond the traditional boundaries of pregnancy care.
The study, published in The Milbank Quarterly, examined how Massachusetts...Arizona News
Arizona is preparing for major changes to its Medicaid program that could affect more than 400,000 adults enrolled through the state's Medicaid expansion. The new rules go beyond work requirements. Beginning in 2027, affected Medicaid recipients will have to renew their eligibility every six months versus annually, creating additional...Arizona News
Medicaid work requirements were included in the One Big Beautiful Bill Act of 2025 (OBBBA) as a means to offset the bill spending, meaning that the goal is for enrollees to lose coverage as a direct result of the program. In Arizona, up to 500,000 enrollees in the Arizona Health Care Cost Containment System (AHCCCS) will be...Available To All
The One Big Beautiful Bill Act (OBBBA) of 2025 made heavy cuts to the bottom line of state Medicaid programs through a number of small directives aimed at curbing federal spending. Most obvious is the implementation of work requirements for Medicaid eligibility, but state-directed payments and provider taxes are also under reform. A new...CMS Rules
The Centers for Medicare and Medicaid Services (CMS) targets new oversight of Medicaid demonstration project spending authorization through Section 1115 waivers. Nearly all states use demonstration waivers, including Arizona.
Late last week, CMS issued the new guidance for upcoming demonstrations beginning January 1, 2027. From that...White Papers, E books, Reports and more
A new white paper from Milliman demonstrates areas for state child welfare agencies to use Medicaid more effectively to support clinical services while easing burdens on state and local budgets.
State child welfare agencies face external pressure to balance rising costs while increasing outcomes of child wellbeing under increased...Arizona News
Medicaid quality measure reform is gaining momentum in the Trump administration as Centers for Medicare and Medicaid Services (CMS) leaders are raising questions about the abundance of metrics.
Center for Medicaid and CHIP Services Director Daniel Brillman said that the high volume of quality measures is burdensome for states and...White Papers, E books, Reports and more
One in five American children has a chronic health condition, with even higher rates among those enrolled in Medicaid and the Children’s Health Insurance Program. The trend raises questions about how to address underlying systemic drivers and whether value-based care models can help improve outcomes for children and youth.
The...National News
CMS is launching a new Healthcare Advisory Committee to provide non-binding recommendations on federal policy and program administration, with a focus on improving care delivery and system performance.
As promoted by the Health & Human Services and the Centers for Medicare & Medicaid Services (CMS), the committee will...CMS Rules
This week, the Centers for Medicare and Medicaid Services (CMS) announced a new payment model that aims to bolster comprehensive health coverage for children with complex medical and behavioral health needs. The Accelerating State Pediatric Innovation Readiness and Effectiveness (ASPIRE) Model is a state-based model that will serve...
A new RAND analysis of the Medicaid provisions in the One Big Beautiful Bill Act suggests Arizona could face some of the largest fiscal and enrollment impacts in the country over the next decade.
The research report published last week finds that expansion states with heavy use of state-directed payments and provider...
The Republican-led Arizona legislature has sent a number of politically-loaded healthcare-related bills to Governor Katie Hobbs's desk so far this session, and may deliver more in the coming weeks.
Arizona Governor Katie Hobbs vetoed nine bills on Friday, one of which would have required hospitals that accept Medicaid to request...
This week, the Congressional Budget Office (CBO) released its ten-year budget and economic outlook, which warned of Social Security insolvency, rising Medicaid spending and record high debt and deficits.
Deficits will exceed $3 trillion by 2036, totaling $24.4 trillion over the next decade and debt will reach 120% of Gross Domestic...
Three national insurers delivered earnings this week that, when taken together, sketch a market still adjusting to higher medical cost trends and shifting program economics.
Humana’s update centers squarely on Medicare Advantage (MA). The company reported fourth-quarter revenue of $32.5 billion and full-year revenue of $129.7...National News
A federal judge has ruled that the Department of Health and Human Services (HHS) may share the personal data of Medicaid enrollees with deportation officials.
In an order issued on Monday, U.S. District Court Judge Vince Chhabria said that the Department of Homeland Security (DHS), which oversees Immigration and Customs Enforcement,...White Papers, E books, Reports and more
Artificial intelligence (AI) is rapidly spreading through state Medicaid programs—mostly through the managed care organizations (MCOs) that administer them. A new Urban Institute report finds these tools are increasingly used for risk stratification, prior authorization, and care coordination, yet few states or health plans explain how...National News
The Centers for Medicare and Medicaid Services (CMS) is accusing states of spending billions on healthcare for undocumented immigrants and pursuing policy avenues for remediating that spending. The accused states are pushing back against the federal government's claims.
In a social media post last Friday, CMS Administrator Mehmet Oz...White Papers, E books, Reports and more
The National Academy for State Health Policy (NASHP) recently ran a learning collaborative for 10 participating states as an opportunity to explore and strengthen policies for improving care in Medicaid Managed Long-Term Care Services and Supports (MLTSS) programs.
The program allowed states to collaborate through roundtables, monthly...National News
States must enforce Medicaid work requirements by January 1, 2027, but the Centers for Medicare and Medicaid Services (CMS) have yet to issue guidance for compliance for states eager to start planning its implementation.
The One Big Beautiful Bill Act (OBBBA) cuts nearly $1 trillion in Medicaid spending over a decade in part by adding...
