Expert Perspectives

Aug 28, 2025 

Rural Health Transformation Program: State Strategies for Lasting Impact

The federal budget reconciliation legislation, H.R.1, includes $50 billion for a Rural Health Transformation Program, which offers an opportunity for state health leaders to double down on efforts to improve access and transform systems of care for rural communities—but doing so will require both vision and innovation. This expert perspective details key considerations for states as they design their transformation plans to apply for the fund.

Aug 15, 2025 

Medicaid Work Reporting Requirements: Implementation Basics and State Decision Points

The enactment of H.R.1 establishes mandatory work reporting requirements for certain Medicaid enrollees, marking the first federal mandate making Medicaid eligibility conditional on work or other qualifying activities in the program’s history. This expert perspective provides state Medicaid officials with essential implementation details, identifies affected populations, outlines compliance pathways, and provides information on state choices for implementing work requirements.

Aug 1, 2025 

New Federal Rules Affecting Coverage of Treatment for Gender Dysphoria: Considerations for States

The Department of Health and Human Services proposed, and then finalized, a regulation prohibiting health insurers from treating so-called “sex trait modification procedures” as an essential health benefit (EHB) under the Affordable Care Act. This expert perspective describes the regulatory changes to EHB policy and discusses key considerations for state officials charged with implementing the policy.