Medicaid & eligibility policy

States Push Back on Medicaid Funding Threat

The Midterms and Medicaid: Oversight, Repair and What Doesn't Change

NASHP Overview: State Strategies for Medicaid Pharmacy Benefit Management

Explore how state Medicaid agencies are changing pharmacy benefit management strategies to improve transparency, reduce costs and oversee PBMs.

Medicaid enrollment falls 7.4% across five major insurers

1115 Waiver Watch: A Look at Budget Neutrality Policy Changes

This brief discusses key Medicaid policy changes included in CMS budget neutrality guidance and identifies open questions about how the policy changes may be clarified and how they may affect states with existing 1115 waivers or states interested in applying…

20.4 million as of June 2025 according to the MBES report

How are States Handling Short-Term Hardship Exceptions to Medicaid Work Reporting Requirements?

Medicaid Work Requirements: What the Court Ruling and CMS’s Appeal Mean for Your January 1 Implementation Plan

States are preparing to implement the Medicaid work and community engagement requirements set forth in the Centers for Medicare & Medicaid Services (CMS) interim final rule issued on June 2, 2026. States are expected to implement the mandates by January 1,…

STAT+: States sue Trump administration again to delay Medicaid work requirements

The Trump administration is facing another lawsuit over its sweeping changes to Medicaid less than a week after a federal judge ruled that implementation of work requirements would cause “irreparable…

Four states target Medicaid work rules in new lawsuit

Medicaid Payment Transparency Rules: State Reporting Requirements and Limitations

This brief describes the transparency requirements that took effect in July 2026, uses T-MSIS data to assess the share of FFS spending and claims captured by certain reporting requirements, and discusses limitations of the new transparency requirements.

State Leaders Discuss Medicaid Program Changes at NASHP’s 2026 Annual Conference

Explore how states are navigating federal Medicaid changes while strengthening program efficiency, access, accountability, and quality.

Medi-Cal Cuts Could Push Older Adults, People with Disabilities Off of Coverage

4 states sue CMS over Medicaid work requirement funding threat

When Medicaid’s Data Can’t Verify Eligibility, Members Shouldn’t Lose Coverage

When verification fails and an eligible member loses coverage, treatment can be interrupted, medications can go unfilled and manageable conditions can become medical emergencies.

Court vacates CMS medical frailty restriction in Medicaid work requirement

In a ruling considered favorable to Medicaid beneficiaries and providers, a federal court sided with plaintiffs’ argument that CMS exceeded its authority in regulations defining the medical frailty exemption to the Medicaid work requirement. An Oct. 29…

Also covered by Modern Healthcare

Georgia Helped Inspire the Medicaid Work Rules. Its Own Rules Could Soon End.

For years, Georgia was the only state to require some Medicaid enrollees to work to obtain and keep coverage. Those rules could expire just as the federal Medicaid work requirements they helped inspire roll out across most of the country.

Also covered by Modern Healthcare, KFF Health News

AMC physicians face biggest SDP cuts: study

Physicians employed at academic medical centers (AMCs) garner the largest boosts from Medicaid state-directed payments (SDPs) and stand to lose the most from coming cuts, according to recent research. The analysis of SDP-approved preprints from 2023 to 2025…

Considerations for Implementation of Medicaid Community Engagement Requirements

How States Can Leverage Medicaid Family Planning Programs to Keep People Covered Following HR 1 Implementation

Also covered by The Milbank Memorial Fund

Court strikes ‘medically frail’ definition in Medicaid community engagement requirements

Court Blocks CMS’s Narrower Definition of Medical Frailty Under Medicaid Work Requirements

Millions of Low-Income Children Are Losing Both Medicaid/CHIP Coverage and SNAP Benefits

Q3 2026 hospital earnings show ACA coverage losses and rising Medicaid risks

Changes to federal coverage and Medicaid financing are manifesting in hospital volumes, payer mix and earnings both currently and in projections, according to Q3 2026 investor calls held recently by hospital companies. The most immediate issue is that…

STAT+: Federal judge rejects new Medicaid ‘frailty’ definition for work requirements

A judge ruled that federal regulators exceeded their authority in narrowing the exceptions to Medicaid work requirements for people with medical issues.