States of Innovation: May 2025
As Congress continues to discuss potential federal cuts to the Medicaid program, states persist in highlighting the value of Medicaid and analyzing the financial and enrollment impacts of cuts. California, Colorado, Illinois, Maryland, Maine, Michigan, New York, and Wisconsin published estimates of potential impacts to their programs and Kansas’ governor sent a letter to the state’s congressional delegation. Arizona, Massachusetts, Minnesota, and Washington held forums to discuss the critical role of the program, while North Carolina highlighted the positive impacts that Medicaid expansion and the Healthy Opportunities Pilots have provided.
States are also highlighting the value of Marketplace coverage, including California, which issued a statement expressing concern about the proposed health provisions in the House reconciliation bill, and Massachusetts, which issued a one-pager on the potential coverage losses that would result from the bill. Leadership of SBMs in 18 states sent a letter to the House, describing how the House budget bill will severely impact the ability of millions of Americans to access affordable health coverage.
States are also calling attention to extending Marketplace affordability, with Maine and New Jersey expressing their support for renewing enhanced premium tax credits. Pennsylvania is sending postcards to inform consumers about potential 2026 cost increases if enhanced premium tax credits expire. In reaction to federal policy, Maryland approved legislation creating a state-based subsidy program to offset potential reductions in federal premium tax credits and established a commission to monitor federal healthcare changes, and Pennsylvania launched consumer protection resources to help residents report scams and address financial and insurance issues, aiming to strengthen protections amid reduced federal consumer protections.
May also saw states take action to improve accessibility, with North Carolina launching a digital resource to support people with disabilities, as well as affordability and efforts to address cost: Massachusetts is limiting the growth of deductibles and co-pays, and Ohio is increasing hospital price transparency. On the topic of community engagement, New Mexico will launch its Beneficiary Advisory Council (BAC) on July 1, while North Dakota is gathering member input to guide its Medicaid Member Engagement Committee and Vermont is recruiting members for its BAC.
Efforts to address medical debt included Connecticut and Rhode Island announcing additional rounds of medical debt forgiveness, and Vermont allocating $1 million to create a medical debt relief program and ban credit reporting of medical debt.
Accessibility
North Carolina launched a digital resource to support people with disabilities in the workforce. The North Carolina Department of Health and Human Services (NCDHHS) announced the launch of a digital resource to support people with disabilities in the workforce. This new resource will help North Carolinians navigate programs such as Medicaid, social security disability insurance, and food and nutrition services.
Affordability and Efforts to Address Cost
Massachusetts is limiting the growth of deductibles and co-pays to control health costs. Governor Maura Healey announced her administration is taking action to control health costs for patients. Commissioner of Insurance Michael Coljouw issued regulatory guidance that requires insurance companies to limit the growth of deductibles and co-pays at the rate of medical inflation, effective January 2026. This effort is the result of legislation signed this year that increased the Commissioner’s consideration of affordability during a review of the merged market.
Ohio is increasing hospital price transparency. The Hospital Price Transparency Act signed into law at the start of 2025 is now in effect. The new law requires each hospital to publish a list of all standard charges for all hospital items or services and a consumer-friendly list of standard charges. Alternatively, hospitals can fulfill the requirement for a list of standard charges by providing a qualifying internet-based price estimator tool. The state is charged with monitoring each hospital’s compliance with the act’s requirements and in cases of noncompliance, to impose penalties, including fines.
Community Engagement
Michigan released survey results that will inform upcoming procurement decisions and improve behavioral health service delivery. The Michigan Department of Health and Human Services (MDHHS) released results from its survey soliciting feedback on specialty behavioral health service delivery by Prepaid Inpatient Health Plans (PIHP). MDHHS received more than 2,600 responses representing a variety of individuals with lived experience of the Medicaid program and other stakeholders. The survey results will be used to inform four strategic pillars of the upcoming procurement for the state’s contracts. PIHPs are responsible for making sure people receive the behavioral healthcare services and support they need and manage the network of behavioral healthcare providers including Community Mental Health Service Providers.
New Mexico will launch its Beneficiary Advisory Council on July 1. New Mexico Medicaid announced it will launch its Beneficiary Advisory Council on July 1, a new opportunity for Medicaid members, caregivers, and family members to help shape the future of New Mexico’s Medicaid program.
North Dakota is gathering Medicaid member input to guide its Medicaid Member Engagement Committee. The state is seeking Medicaid member feedback to inform its Medicaid Member Engagement Committee (MMEC). They recently hosted a virtual listening session and are also inviting input on Medicaid and recommendations on best practices for the MMEC via a survey and upcoming focus group. Focus group attendees will be offered a $50 gift card to show appreciation for their participation.
Vermont is recruiting individuals to join its new Beneficiary Advisory Committee. The Department of Vermont Health Access (DVHA) is seeking current and former Medicaid members, or family members and caregivers of members, to join the Beneficiary Advisory Committee (BAC). The BAC is a new advisory body made up entirely of people with direct Medicaid experience.
As a reminder, SHVS published an issue brief on how to fairly compensate Medicaid members for their time and expertise without adversely affecting their eligibility for Medicaid. SHVS also published template materials designed to support state agencies in recruiting members for the BAC. States can customize the content of the materials, which include a recruitment flyer, social media graphics, core messages, website copy, and newsletter copy.
Expanding Access to Care
California has submitted an application to CMS to update its benchmark plan. California Governor Gavin Newsom, through the Department of Managed Health Care, submitted an application to CMS to update California’s benchmark plan. The new benchmark plan would expand coverage requirements for essential health benefits in the individual and small group markets starting in 2027, following CMS approval. That expanded coverage would include fertility treatments, annual hearing exams and hearing aids, and mobility devices such as walkers, manual and power wheelchairs, and scooters.
Colorado’s new healthcare laws expand access for agricultural workers, mandate no-cost prenatal visits, and eliminate cost-sharing for breast cancer imaging. Governor Jared Polis signed several healthcare bills into law: SB 25-128 helps ensure agricultural workers have access to healthcare providers when working on their employer’s private property; SB 25-118 requires health insurance plans to cover at least three prenatal care visits without cost-sharing; and SB 25-296 ensures that people are not charged cost-sharing for any diagnostic or supplemental imaging related to breast cancer screening as long as the services are provided according to evidence-based guidelines. HB 25-1309 codifies gender-affirming care (GAC) treatments in statute and prohibits a health plan from denying or limiting medically necessary GAC.
Connecticut has expanded benefits for firefighters to include free, enhanced cancer screenings. Connecticut Governor Ned Lamont and Comptroller Sean Scanlon announced that effective May 1, the state expanded the benefits it provides to firefighters to include free, enhanced cancer screenings. This new benefit comes in response to evidence that firefighters, due to their repeated exposure to smoke, toxic chemicals, and carcinogens in the line of duty, have a greater prevalence of cancer diagnoses and cancer-related deaths than the general population.
New Jersey enacted legislation requiring state-regulated health insurers to cover biomarker testing for personalized health insights and disease risk assessment. New Jersey Acting Governor Tahesha Way signed legislation requiring state-regulated health insurers to cover biomarker testing, which analyzes an individual’s unique biological indicators to provide insights into their health status or risk of certain diseases like cancer.
North Carolina is expanding student loan repayment incentives for primary care physicians practicing in rural counties. The North Carolina Department of Health and Human Services is expanding student loan repayment for rural healthcare providers through the North Carolina Primary Care Physician Incentive program to support healthcare access among its large rural populations. North Carolina’s rural population is the second largest in the country, with more than 4.6 million people living in rural counties. The program is open to primary care physicians in independent private practices located in Tier one and Tier two counties based on North Carolina’s County Distress Rankings.
Extending Marketplace Affordability
Maine is highlighting its support for renewing enhanced premium tax credits. The Maine Department of Health and Human Services Office of the Health Insurance Marketplace announced its support for renewing the enhanced premium tax credits for consumers of the health insurance Marketplace. On average, enhanced premium tax credits lower monthly premiums for Maine consumers by nearly $180. Without them, the typical monthly cost would rise from $179 to around $358.
New Jersey urged Congress to extend enhanced premium tax credits. Department of Banking and Insurance Commissioner Justin Zimmerman sent a letter to New Jersey’s congressional delegation urging them to extend the expiring federal enhanced premium tax credits. New Jersey would lose more than half a billion dollars in enhanced premium tax credits, and 454,016 New Jerseyans–88% of Marketplace consumers–would see their premiums increase if the tax credits were allowed to lapse. The state has created fact sheets on the impacts by congressional district and the impact on the state overall.
Pennsylvania is sending postcards to inform consumers about potential 2026 cost increases if enhanced premium tax credits expire. Pennie, the state’s official health insurance Marketplace, is sending consumers postcards with information about cost changes coming for 2026 if the enhanced premium tax credits expire. The postcards highlight that unless Congress acts, Pennie enrollees may pay more for their health coverage and direct consumers to more information on affordability.
Washington insurers requested a 21.2% average rate increase for 2026. The Office of the Insurance Commissioner announced that 14 health insurers have requested an average rate change of 21.2% for the state’s 2026 individual health insurance market. According to the Washington Health Benefit Exchange, as many as 80,000 people will terminate coverage if the enhanced premium tax credits are not extended, and health plans took this into account when creating their request for 2026. Based on the assumptions in the initial requested rate changes, renewing the tax credits could reduce the proposed rate changes by as much as 6.4%.
Highlighting the Value of Medicaid
Arizona raised concerns about proposed federal Medicaid cuts and their potential impact on coverage and funding statewide. Governor Katie Hobbs and healthcare providers across Arizona joined together to highlight the proposed federal Medicaid cuts and the impact on both funding and coverage for people in the state.
California updated estimates of the number of people whose coverage would be terminated under the House reconciliation bill. Governor Newsom announced new estimates from the state demonstrating the impact of the House reconciliation bill, which could result in up to 3.4 million Californians having their health coverage terminated and put more than an estimated $30 billion in federal funding at risk–”gutting the foundation of California’s healthcare safety net.”
Colorado released an updated fact sheet estimating the impact of federal Medicaid reductions. The Colorado Department of Health Care Policy & Financing released an updated fact sheet with estimates of the impact of federal Medicaid reductions. The state will continue to update the fact sheet as the bill progresses through the Senate. The state also published a webpage with relevant information about the impact of potential funding cuts to Medicaid.
Connecticut’s governor signed a declaration allowing the Connecticut General Assembly to appropriate funding to keep Medicaid fully funded for fiscal year 2025. Governor Ned Lamont announced that he has signed a declaration enabling the Connecticut General Assembly to adopt legislation appropriating the funding necessary to keep Medicaid fully funded for the remainder of the 2025 fiscal year. This is the first time a declaration of this kind has been issued since 2007, when Governor M. Jodi Rell signed a similar declaration. To contain costs, the announcement notes that Governor Lamont has proposed repealing the GLP-1s for weight loss only and that the Department of Social Services also plans to provide stronger oversight of pharmacies to ensure patients receive the medication they need, without waste.
Illinois presented an analysis detailing the potential financial and enrollment losses the state could face from proposed federal Medicaid cuts. The Illinois Department of Healthcare and Family Services held a presentation about the impact of Medicaid in the state and an analysis of what Illinois stands to lose if Congress implements cuts.
Kansas’ governor urged the state’s congressional delegation to oppose proposed federal Medicaid cuts. Kansas Governor Laura Kelly announced that she sent a letter to the Kansas Congressional delegation, requesting that they “protect Kansas from the looming federal Medicaid cuts that threaten quality and affordable healthcare access for the most vulnerable Kansans.” Under the latest plan proposed by Congress, the Kansas Medicaid program could lose up to $1 billion in federal funding within the first year alone.
Maryland released a fact sheet outlining the effects of proposed federal Medicaid cuts on the state’s residents. The Maryland Department of Health released a new fact sheet that details how some of the federal policy proposals designed at cutting Medicaid would impact Marylanders.
Maine published a blog post and analysis highlighting the potential impacts of proposed federal Medicaid cuts. The Department of Health and Human Services released a blog post highlighting the impact of federal Medicaid proposals on the state as well as a more detailed analysis on the potential impacts to Maine at the county level.
Massachusetts’ leaders highlighted concern about the House reconciliation bill. Governor Maura Healey, Senator Elizabeth Warren and Senator Ed Markey joined together to highlight concerns about the House reconciliation bill to cut $1.75 billion from the Massachusetts healthcare system. The bill passed by the House would terminate coverage for 250,000 Massachusetts families, seniors, veterans and people with disabilities.
Michigan released a report on the impact of proposed federal Medicaid cuts and data on how pregnant women and people with disabilities would be impacted. The Michigan Department of Health and Human Services (MDHHS) released a new report on the impact of federal proposals to cut Medicaid. The report found that the proposed cuts would terminate healthcare coverage for 700,000 Michiganders and was compiled in response to Executive Directive 2025-3 from Governor Gretchen Whitmer, which directed MDHHS to identify the potential impact proposed cuts to Medicaid would have on Michiganders’ health. Governor Whitmer also released data on how pregnant women and Michiganders with disabilities will be impacted by Medicaid cuts. If enacted, the cuts would strip billions of dollars from Michigan’s healthcare system that supports expecting moms and Michiganders with disabilities.
Minnesota concluded a statewide roundtable series highlighting the harm proposed federal healthcare cuts could cause to Medicaid. Governor Tim Walz and state officials wrapped a series of statewide roundtables highlighting proposed federal healthcare cuts. From late March through late April, the state convened seven roundtable discussions connecting with people across Minnesota to discuss significant damage to Medicaid and healthcare funding if Congress moves forward with proposed cuts.
New York released new figures on the impact of the House budget bill and detailed congressional district breakdowns of the projected funding losses. Governor Kathy Hochul announced new figures from the state on the impact of the House budget bill, estimated to result in a $13.5 billion loss annually for New Yorkers and the healthcare economy. The state has also released a congressional district breakdown of anticipated funding losses.
North Carolina highlighted that Medicaid expansion has provided affordable coverage to over 650,000 residents and its Healthy Opportunities Pilots are generating significant healthcare cost savings. The North Carolina Department of Health and Human Services (NCDHHS) hosted a symposium highlighting the impact Medicaid expansion and the Healthy Opportunities Pilots are having on the health and well-being of North Carolinians. Since Medicaid expansion began in 2023, more than 650,000 newly eligible North Carolinians have gained access to affordable healthcare through Medicaid expansion. Additionally, the NCDHHS highlighted how following the implementation of the first of its kind Healthy Opportunities Pilots, the state is seeing $1,020 in annual healthcare costs savings per Healthy Opportunities enrollee.
Washington presented on the potential impacts of federal Medicaid proposals. The Washington Health Care Authority held a presentation about the impact of federal proposals on Medicaid in the state. The policies examined include work requirements, reducing the federal match rate for services and administration, and reducing the use of state directed payments and provider taxes.
Wisconsin released a report modeling the effects of congressional budget cuts on Medicaid. The Wisconsin Department of Health Services published an analytic report modeling the impact of congressional budget cuts on Wisconsin Medicaid. The policies examined include work requirements, per capita caps on federal spending, and a reduction to the administrative and technology federal match.
Officials in several states issued statements about the House reconciliation bill and how the provisions will cut funding for state Medicaid programs and reduce enrollment. Governors in several states (California, Colorado, Connecticut, Michigan, Minnesota, New Jersey, New Mexico, New York, & Washington) issued statements about the passage of the House reconciliation bill and how the provisions will cut funding for state Medicaid programs and reduce enrollment. Oregon’s State Treasurer and New Jersey’s Human Services Commissioner issued similar statements.
SHVS published a toolkit, developed by Manatt Health, providing state-by-state data on the potential impact of key cuts under consideration in Congress. SHVS hosted a webinar highlighting the toolkit as well as a two-part webinar series to discuss the Medicaid and Marketplace provisions under consideration by Congress as part of the budget reconciliation process.
SHVS is also tracking the states that are publicly reporting their estimates of proposed cuts to Medicaid. The expert perspective highlights state agencies that have estimated and quantified the potential impacts of various proposals on enrollment and spending. SHVS will continue to regularly monitor published estimates from states and update the expert perspective. SHVS also published an expert perspective on national analyses with 50-state estimates.
For those looking to learn more about how the cuts being discussed in Congress would impact children, the latest episode of Heather Howard’s podcast the Princeton Pulse explores how proposed cuts would impact the health, development and future prosperity of the more than 37 million children who rely on Medicaid and CHIP.
Highlighting the Value of Marketplace Coverage
California’s State-Based Marketplace expressed concern about the proposed health provisions in the House reconciliation bill. Covered California issued a statement on the proposed health provisions in the House reconciliation bill and the impact of the expiration of the enhanced tax credits.
Massachusetts’ State-Based Marketplace reported that the House reconciliation bill could terminate 85,000 enrollees from coverage, potentially doubling the state’s uninsured population. The Massachusetts Health Connector, the state’s official health insurance Marketplace, published a one-pager summarizing the impacts of the House reconciliation bill on the Marketplace. Over 85,000 enrollees will have their insurance terminated and residents will lose $750 million per year in federal support for health coverage through the Health Connector. Alongside other changes in the bill, Massachusetts could see its uninsured rate double to over 400,000 residents.
Leadership of State-Based Marketplaces in 18 states sent a letter to the House, describing how the House budget bill will severely impact the ability of millions of Americans to access affordable health coverage. Leadership of State-Based Marketplaces in California, Colorado, Connecticut, D.C., Idaho, Massachusetts, Maryland, Maine, Minnesota, New Jersey, New Mexico, New York, Oregon, Pennsylvania, Rhode Island, Virginia, Vermont, and Washington sent a letter to the House, describing how the House budget bill will severely impact the ability of millions of Americans to access affordable health coverage.
SHVS recently hosted a webinar reviewing proposed changes in the House reconciliation bill to policies governing the Affordable Care Act Marketplace and what they might mean for health insurance Marketplace and Division of Insurance officials.
Maternal and Infant Health
Missouri is hosting statewide in-person networking events for providers and community partners to share information on benefits and resources available to pregnant individuals and families. MO HealthNet, the state’s Medicaid program, is hosting a series of in-person networking opportunities across the state for providers and community partners to learn about benefits, incentives, and resources available to pregnant individuals and their families, including individualized case management, doula coverage, non-emergency medical transportation, and more.
Utah passed legislation requiring the Department of Health and Human Services to cover doula services through Medicaid. Legislation passed by the Utah Legislature and signed by Governor Spencer Cox requires the Department of Health and Human Services (DHHS) to apply for a Medicaid state plan amendment authorizing coverage of doula services. The legislation requires DHHS to establish training and registration requirements for doulas providing services to Medicaid program enrollees.
Virginia highlighted efforts to improve maternal mental health. Governor Glenn Youngkin highlighted steps taken to improve maternal mental health in Virginia since he came into office, including implementing the “Right Help, Right Now” behavioral health transformation plan, Executive Order 32 Re-establishing the Maternal Health Data and Quality Measures Task Force, extending postpartum Medicaid coverage, and providing $2.5 million to fund Perinatal Health Hub Pilot Programs.
For information on how states can leverage payment to improve maternal health outcomes, see the SHVS issue brief Maternal Health Providers: Enhancing Health Equity Through Payment Parity.
Medicaid Innovations
Connecticut announced a three-year agreement to raise wages for direct care workers in nursing and group homes. Governor Ned Lamont announced that his administration has reached a three-year agreement with SEIU 1199 NE that will result in significant wage increases for direct care workers in Connecticut’s nursing homes and group homes. As a result, the union has withdrawn its plans to strike. The agreement includes incremental increases in Medicaid for nursing homes and group homes and creates a pathway to increase wages for certified nursing assistants to $26 per hour by 2028.
Delaware announced the creation of the Delaware Food is Medicine Committee. Governor Matt Meyer announced the establishment of the Delaware Food is Medicine Committee, a statewide initiative to improve health outcomes, lower healthcare costs, and strengthen local food systems. Lieutenant Governor Kyle Evans Gay will chair the committee, leading a diverse team of leaders from healthcare, agriculture, research, and community organizations to develop Delaware’s first statewide Food is Medicine framework. The committee will draw on proven models implemented in other states.
Louisiana is piloting a consent-based verification system to simplify Medicaid income verification. Beginning this month, the Louisiana Department of Health is piloting a new consent-based verification (CBV) system to streamline income verification for Medicaid members across the state. CBV allows individuals to securely authorize access to their wage and income data directly from employers or payroll providers and forgo manual submission of pay stubs.
Massachusetts’ MassHealth nutrition services program reduced emergency room visits and hospitalizations among participants. According to a recent study, the nutrition services program of MassHealth, the state’s Medicaid and Children’s Health Insurance Program, has had positive results. Findings show that participating individuals were significantly less likely to go to the emergency room or be hospitalized compared to those who did not participate. The program also resulted in cost savings for MassHealth.
Medical Debt
Connecticut announced that over 100,000 residents will be notified of medical debt elimination. Governor Ned Lamont announced that more than 100,000 residents will receive notice that some or all of their medical debt has been eliminated under the second round of the state’s medical debt relief initiative. In this round $575,000 in American Rescue Plan Act funding was leveraged to eliminate more than $100 million.
Rhode Island announced an additional $3.5 million in medical debt forgiveness for over 3,200 residents. General Treasurer James A. Diossa announced that an additional $3.5 million in medical debt, held by over 3,200 Rhode Islanders, has been forgiven through the state’s Medical Debt Relief Program. To date, the program has relieved more than $10 million in medical debt, helping more than 6,000 Rhode Islanders.
Vermont enacted legislation allocating $1 million to create a medical debt relief program and ban credit reporting of medical debt. Governor Phil Scott signed legislation that appropriates $1 million to the state treasurer for the purpose of creating a medical debt relief program and prohibiting a credit reporting agency from reporting medical debt. While signing the bill, Governor Scott sent a letter to the general assembly stating, “with a looming healthcare crisis and our growing crisis of affordability in Vermont, we should anticipate this debt financing program to grow which raises significant concerns about future appropriations…we will need to manage this program effectively and pair it with real reforms.”
For more information on state efforts to prohibit medical debt reporting and eliminate existing debt, see the SHVS expert perspective Mapping State Efforts to Address Medical Debt and a Health Affairs Forefront article which examines the burgeoning trend of state efforts to cancel medical debt for just pennies on the dollar. SHVS also published a state spotlight profiling North Carolina’s Comprehensive Medical Debt Relief and Reform Incentive Program.
Mental and Behavioral Health
Arkansas is restricting prior authorizations for crisis stabilization units. Arkansas Governor Sarah Sanders signed into law HB1320, which prohibits certain prior authorizations for crisis stabilization units unless authorized by the insurance commissioner.
California announced $3.3 billion in grants to create over 5,000 residential treatment beds and 21,800 outpatient slots. California Governor Gavin Newsom announced $3.3 billion in grant funding to create over 5,000 residential treatment beds and more than 21,800 outpatient treatment slots for behavioral healthcare services. Administered by the California Department of Health Care Services, the Proposition 1 Bond Behavioral Health Continuum Infrastructure Program Round 1: Launch Ready awards will expand access to care for Californians experiencing mental health conditions and substance-use disorders, including those experiencing homelessness.
Colorado enacted legislation expanding behavioral healthcare access for veterans and military families. Colorado Governor Jared Polis signed legislation expanding access to behavioral healthcare services for veterans and military-connected families. The bill expands the veterans’ mental health services program to provide grants to local nonprofit organizations to establish and expand community behavioral health programs.
Massachusetts launched a $25 million scholarship program to support graduate students pursuing degrees or certificates in behavioral health fields. The Healey-Driscoll administration announced that they have launched a two-year $25 million scholarship program for graduate students completing degrees or certificates in behavioral health fields.
Michigan is offering student loan repayment incentives to providers who start or expand opioid-use disorder treatment programs. As part of efforts to increase access to substance-use disorder treatment, the Michigan Department of Health and Human Services is offering student loan repayment to providers if they begin providing or expand opioid-use treatment programs.
North Carolina reported that its Peer Warmline achieved a 99% satisfaction rate among callers seeking emotional and mental health support. NCDHHS released a new dashboard highlighting the success of North Carolina’s Peer Warmline. The Warmline is a free resource for people experiencing emotional difficulty, mental health issues, substance-use challenges, or for those who just need to talk with someone who understands what they are going through. Since launch, Warmline counselors have received more than 67,000 calls, and 99% of callers who responded to a recent survey expressed satisfaction with the support they received.
South Dakota launched a partnership to provide free, anonymous naloxone distribution through strategically placed boxes. The state has begun a new initiative through a partnership with Emily’s Hope to offer free and anonymous naloxone distribution to South Dakotans. Placement of naloxone boxes will be aligned with the state’s data-driven naloxone saturation efforts, in collaboration with the South Dakota Department of Social Services and the South Dakota Department of Health, prioritizing locations statewide with higher rates of overdoses.
Virginia announced that fentanyl-related deaths in the state have declined over 46% since their peak in 2021, according to new data. Governor Glenn Youngkin announced that new data from the Virginia Department of Health, Office of the Chief Medical Examiner show fentanyl-related deaths in Virginia declined 44% year over year and are down over 46% from a peak in 2021.
Wisconsin is soliciting public input through a survey to help develop a statewide action plan aimed at improving mental health services across the state. The Governor’s Interagency Council on Mental Health is seeking public input on how Wisconsin can continue working to improve the mental health of residents. Individuals can make recommendations via a survey. The council connects the dots across 10 state agencies to create a statewide action plan to address Wisconsin’s mental health crisis. The plan will include recommendations to expand prevention efforts and increase access to mental health services when and where people need them.
Mitigating the Health Effects of Climate Change
North Carolina is distributing fans statewide to eligible residents through the Operation Fan Heat Relief program. The North Carolina Department of Health and Human Services’ Division of Aging is partnering with North Carolina area agencies on aging and local service providers to distribute fans statewide to eligible recipients through the Operation Fan Heat Relief program.
For more information on state efforts to mitigate the health impacts of extreme heat, see this Health Affairs Forefront article.
Reproductive and Women’s Health
Idaho issued guidance on legislation requiring health insurance plans to cover additional preventive breast cancer screenings at no cost. The Idaho Department of Insurance published Bulletin 25-03 to provide guidance on House Bill 134, which requires health insurance plans to provide additional preventive breast cancer screenings at no cost to members for in-network services.
Pennsylvania state agencies launched a survey to better understand women’s challenges with health insurance and to emphasize the importance of accessing preventive health services. The Pennsylvania Insurance Department joined the Department of Health, the Department of Human Services, and the Department of Drug and Alcohol Programs to launch a new survey to identify challenges and questions women have about their health insurance benefits, and to remind women about the importance of access to preventive health services.
Virginia enacted legislation directing the Health Insurance Reform Commission to review coverage for infertility treatment. Governor Youngkin signed House Bill 1609, which requires the Health Insurance Reform Commission to consider coverage for the diagnosis and treatment of infertility and for standard fertility preservation procedures in its 2025 review of the essential health benefits benchmark plan.
States React to Federal Policy
California reaffirmed the state’s commitment to enforcing consumer protection laws in healthcare. Insurance Commissioner Ricardo Lara issued a formal notice to all health insurers in the state to reaffirm the California Department of Insurance’s commitment to enforcing all state laws that protect consumers’ rights to equitable, accessible, culturally competent healthcare amid federal rollbacks. The notice reminds insurers that all state consumer protection laws remain in effect, including coverage and anti-discriminatory requirements for women, students, youth, immigrants, people of color, and the LGBTQIA+ community.
Maryland approved legislation creating a state-based subsidy program to offset potential reductions in federal premium tax credits. Maryland Governor Wes Moore approved legislation establishing a state-based health insurance subsidies program to mitigate the impact of a potential reduction in federal advance premium tax credits for calendar years 2026 through 2028, implemented under the Maryland Health Benefit Exchange. The legislation states that if the advance premium tax credits are extended for calendar years 2026 and 2027, this legislation will be abrogated. Governor Wes Moore also signed legislation establishing the Maryland Health Insurance Coverage Protection Commission to monitor and assess the impact of potential and actual federal changes to healthcare programs, and to provide recommendations for state and local action to protect access to coverage.
Minnesota launched a data dashboard to track federal funding disruptions. Governor Tim Walz announced a new data dashboard Minnesotans can use to track disruptions and cancellations of federal funding and their impact on services available to Minnesotans. The dashboard is updated each weekday as funding disruptions and cancellations occur, as well as to reflect funding restored by court orders.
Pennsylvania launched a centralized consumer protection hotline to strengthen protections amid reduced federal consumer protections. Governor Josh Shapiro announced a new, centralized consumer protection hotline, website, and email address to make it easier for Pennsylvanians to report scams and resolve financial and insurance issues. The initiative is intended to protect consumers and fill the void left by weakened federal consumer protections.
Services for Children and Youth
California launched the Mobile Vision Services Program to offer free vision screenings, exams, and glasses. The Department of Health Care Services (DHCS) launched the Mobile Vision Services Program, which provides no-cost vision screenings, exams, glasses, and eyewear fittings onsite at California schools to low-income students ages 4 through 18. DHCS contracted with Vision To Learn, a charitable mobile optometry provider, to provide mobile optometry services.
Kentucky announced over $1.9 million in grants to support children with cancer and their families. Governor Andy Beshear and Lieutenant Governor Jacqueline Coleman joined leaders from the Kentucky Pediatric Cancer Research Trust Fund Board to present more than $1.9 million in financial and psychosocial support grants for children living with cancers and their families.
Waiver and State Plan Amendments, Requests and Approvals
Alabama Medicaid is seeking public comment on proposed renewals for the Intellectual Disabilities and Living at Home Waivers. Alabama Medicaid issued a request for public comment on the proposed renewals for the Intellectual Disabilities and Living at Home Waivers. These waivers provide home and community-based services to individuals who, but for the provision of such services, would require Intermediate Care Facility for Individuals with Intellectual Disabilities level of care.
Arizona is hosting listening sessions to gather input on the renewal of its section 1115 Medicaid demonstration waiver. The Arizona Health Care Cost Containment System will host listening sessions regarding the renewal of the state’s section 1115 Medicaid demonstration waiver for community members, stakeholders, and all interested parties. The waiver authorizes programs including but not limited to the managed care delivery system; the Arizona Long Term Care System; Targeted Investments 2.0; the Parents as Paid Caregivers Program; KidsCare Expansion; Housing and Health Opportunities (H2O); and more.
Georgia submitted an application to extend its Pathways to Coverage demonstration, proposing changes including reducing activity reporting from monthly to annual. Georgia submitted an application to extend the Georgia Pathways to Coverage demonstration which provides Medicaid coverage to low-income adults ages 19 through 64, who are not otherwise eligible for Medicaid coverage. As a condition of eligibility, applicants and enrollees must complete a minimum of 80 hours of qualifying activities, unless they require a reasonable accommodation due to a disability. The state is proposing to reduce the reporting requirement from monthly to annual, add qualifying activity types, add a retroactive coverage policy, remove the premiums and Member Rewards Accounts, and update copayments to align with the state Medicaid plan.
Idaho received CMS approval to amend its Behavioral Health Transformation Section 1115 Demonstration. CMS approved an amendment to the “Idaho Behavioral Health Transformation Section 1115 Demonstration.” This amendment allows the state to end the authority that currently permits legally responsible individuals to provide 1905(a) personal care services (PCS). CMS’ approval of this amendment allows the state to revert to how it operated its 1905(a) PCS program prior to the COVID-19 public health emergency and is in compliance with Medicaid state plan requirements for 1905(a) PCS.
Iowa submitted a request to extend the Iowa Wellness Plan section 1115 demonstration. Iowa submitted a request to extend the Iowa Wellness Plan section 1115 demonstration to continue providing coverage to the new adult group, and to continue demonstration elements including premiums, healthy behaviors, a waiver of non-emergency medical transportation, and a waiver of retroactive eligibility for certain enrollees. The demonstration also provides dental benefits for adults and children through a managed care delivery system known as a Prepaid Ambulatory Health Plan.
New York submitted an amendment request to its Medicaid Redesign Team section 1115(a) demonstration to establish a new Medicaid Buy-In Program. New York submitted an amendment request to its New York Medicaid Redesign Team section 1115(a) demonstration. The amendment would authorize an 1115 demonstration program that would become the state’s new Medicaid Buy-In Program for Working People with Disabilities, to help more working individuals with disabilities qualify for Medicaid.
CMS approved amendments to five family planning section 1115 demonstrations to include STI/STD screening as a family planning service and, for four of them, STI/STD diagnosis as a related service, while also approving extensions for three other family planning demonstrations. CMS approved amendments to five family planning section 1115 demonstrations to identify sexually transmitted infection (STI)/sexually transmitted disease (STD) screening as a family planning service and, for four demonstrations, STI/STD diagnosis services as a family planning-related service. The five demonstrations that had amendments approved are: Georgia Planning for Healthy Babies; Mississippi Family Planning; Montana Plan First; Oregon Contraceptive Care; and Wyoming Pregnant by Choice. Three family planning demonstrations, Alabama Plan First, Florida Medicaid Family Planning Waiver, and Washington Family Planning Only Program, had extensions approved.