On February 26, President Trump signed an executive order (EO), Implementing the President’s “Department of Government Efficiency (DOGE)” Cost Efficiency Initiative. The EO introduces new requirements and limitations for “covered contracts and grants.” This expert perspective discusses the EO and why it is unlikely to impact mandatory healthcare program spending, such as federal Medicaid matching payments, or premium tax credits provided through the Marketplace.

State updates as of February 28, 2025.

The Supreme Court is scheduled to hear oral arguments on April 21 on a case, Kennedy v. Braidwood Management, Inc., that could substantially weaken the Affordable Care Act’s guarantee of no-cost preventive services in private insurance. This expert perspective describes how states can take action to preserve no-cost preventive services coverage in their regulated markets through legislative or administrative means, including by shoring up their essential health benefits benchmarks, leveraging standardized plans, and using the bully pulpit to identify carriers and insurance products that retreat from today’s coverage.

State updates as of February 21, 2025.

State updates as of February 14, 2025.

State updates as of February 7, 2025.

State updates as of January 31, 2025.

State updates as of January 24, 2025.

On January 15, 2025, the Centers for Medicare & Medicaid Services released updated State Health Official letter and Frequently Asked Questions guidance, replacing a previously issued SHO letter and FAQs on the requirement in the Consolidated Appropriations Act, 2023 that states provide 12 months of continuous eligibility for children and youth under the age of 19 in Medicaid and the Children’s Health Insurance Program, effective as of January 1, 2024.

State updates as of January 17, 2025.