Category: State News

Keep a finger on the pulse of Medicaid at the state level. This category offers essential insights into state-specific policies, program enhancements, and initiatives, providing a comprehensive view of Medicaid’s regional impact.

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STATE NEWS – Attorney General Bonta Secures Preliminary Relief Blocking California’s Medicaid Data from Being Used for Immigration Enforcement Purposes

STATE NEWS – Attorney General Bonta Secures Preliminary Relief Blocking California’s Medicaid Data from Being Used for Immigration Enforcement Purposes


Alternative Headline: Court Blocks Medicaid Data Sharing

[MM Curator Summary]: A court blocked DHS from using Medicaid data for immigration enforcement, siding with California and 19 other states. 

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OAKLAND – California Attorney General Rob Bonta today issued the following statement after the U.S. District Court for the Northern District of California granted a preliminary injunction finding California and a multistate coalition were likely to succeed on their claim that the U.S. Department of Health and Human Services’ (HHS) decision to provide unfettered access to individual personal health data to the U.S. Department of Homeland Security (DHS), which houses Immigration and Customs Enforcement (ICE), violated the Administrative Procedure Act’s prohibition on arbitrary and capricious rulemaking. The preliminary injunction blocks DHS from using Medicaid data obtained from plaintiff states for immigration enforcement purposes, and blocks HHS from sharing Medicaid data obtained from coalition states with DHS for immigration enforcement purposes. The preliminary injunction will remain in place either until 14 days after HHS and DHS complete a reasoned decision making process that complies with the Administrative Procedure Act, or until litigation concludes.

“The Trump Administration’s move to use Medicaid data for immigration enforcement upended longstanding policy protections without notice or consideration for the consequences. It sowed a culture of fear that threatens our Medicaid system, caused chaos for states and providers, and created a chilling effect for patients seeking vital emergency medical care,” said Attorney General Bonta. “Today’s preliminary injunction rightfully blocks any sharing of California’s Medicaid data for immigration enforcement for now — and ensures any of the data that’s already been shared is not being used for immigration enforcement purposes. As the President continues to overstep his authority in his inhumane anti-immigrant crusade, this is a clear reminder that he remains bound by the law.”

On July 1, 2025, California led a multistate coalition in filing a lawsuit against the Trump Administration arguing that the mass transfer of Medicaid data violates the law and asking the court to block any new transfer or use of this data for immigration enforcement purposes. The lawsuit highlighted that the Trump Administration’s illegal actions are creating fear and confusion leading noncitizens and their family members to disenroll, or refuse to enroll, in emergency Medicaid for which they are otherwise eligible, leaving states and their safety net hospitals to foot the bill for federally mandated emergency healthcare services. In the limited preliminary injunction order, the court ruled that the Trump Administration’s actions were likely arbitrary and capricious and rulemaking in violation of the Administrative Procedure Act.

Created in 1965, Medicaid is an essential source of health insurance for lower-income individuals and particular underserved population groups, including children, pregnant women, individuals with disabilities, and seniors. The Medicaid program allows each participating state to develop and administer its own unique health plans; states must meet threshold federal statutory criteria, but they can tailor their plans’ eligibility standards and coverage options to residents’ needs. As of January 2025, 78.4 million people were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) nationwide.  

California’s Medi-Cal program provides healthcare coverage for one out of every three Californians, including more than two million noncitizens. Noncitizens include green card holders, refugees, individuals who hold temporary protected status, Deferred Action for Childhood Arrival recipients, and others. Not all noncitizens are eligible for federally funded Medi-Cal services, and so California uses state-only funds to provide a version of the Medi-Cal program to all eligible state residents, regardless of their immigration status. 

Attorney General Bonta led the attorneys general of Arizona, Colorado, Connecticut, Delaware, Hawaii, Illinois, Massachusetts, Maine, Maryland, Michigan, Minnesota, Nevada, New Jersey, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washinton in filing the lawsuit.

A copy of the preliminary injunction order is available here. 

https://oag.ca.gov/news/press-releases/attorney-general-bonta-secures-preliminary-relief-blocking-california%E2%80%99s-medicaid



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STATE NEWS – Louisiana paid nearly $10 million for health care dead Medicaid beneficiaries didn’t receive: audit

STATE NEWS – Louisiana paid nearly $10 million for health care dead Medicaid beneficiaries didn’t receive: audit


Alternative Headline: Louisiana Paid Millions for Dead Medicaid Enrollees

[MM Curator Summary]: Louisiana mistakenly paid nearly $10 million over 6 years in Medicaid benefits for over 1,000 dead people, auditors found.

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A review of how Louisiana keeps its Medicaid rolls up to date found the state paid out benefits for more than 1,000 people over the past six years after they died. Nearly $10 million was paid to managed care organizations over that period, even though no health care services were actually provided.

The Louisiana Legislative Auditor conducted its study as part of Gov. Jeff Landry’s Fiscal Responsibility Program, which he has branded LA DOGE. It looked specifically at how state health officials keep track of when Medicaid beneficiaries die and whether outside data sources could help that process. 

When auditors used those additional sources, they found 1,072 beneficiaries who died between February 2019 and March 2025 and approximately $9.6 million spent collectively on their Medicaid coverage. Auditors said the actual spending figure is higher because their calculations only included dental coverage payments – and not health coverage – for the final eight months reviewed.  

According to the audit report, the Louisiana Department of Health relies on federal and state data sources to identify dead Medicaid beneficiaries. They include Louisiana Vital Records, the Social Security Administration, the Centers for Medicare and Medicaid Services, the state Department of Children and Family Services and the managed care organizations the state pays to deliver Medicaid offerings.

For its analysis, the Louisiana Legislative Auditor’s staff also used obituaries and identified 511 dead Medicaid beneficiaries the state missed in its reviews. Payouts to managed care organizations for this group totaled $5.22 million over the six-year period, and the median time between the beneficiary’s death and the most recent monthly payout to their managed care provider was more than 20 months.

Auditors found 168 more deceased Medicaid beneficiaries through the Social Security Administration’s Death Master File, a source the state health department has not used. The median time between the beneficiary’s death and the latest payment in this group was almost 800 days, according to the audit.   

The Legislative Auditor recommended the Louisiana Department of Health determine whether it should use third-party data sources as part of its eligibility determination process to identify deceased Medicaid beneficiaries. Out of the $9.6 million Louisiana paid for Medicaid services never provided, the audit identified $7.6 million through third-party sources.    

In his July 30 response to the Legislative Auditor, state Health Secretary Bruce Greenstein agreed with the audit’s recommendation and said his department was “in the process of working with the U.S. Department of Treasury to gain the necessary approvals to receive the Social Security Administration Death Master File.” 

The health department was presented with the auditor’s findings in May. In June, approximately $4 million in state payments to Medicaid managed care organizations were to be withheld to recoup part of the money paid on behalf of dead beneficiaries, the audit report said.

This report was updated to correct the name of the state health secretary.

Our stories may be republished online or in print under Creative Commons license CC BY-NC-ND 4.0. We ask that you edit only for style or to shorten, provide proper attribution and link to our website. AP and Getty images may not be republished. Please see our republishing guidelines for use of any other photos and graphics.

https://lailluminator.com/2025/08/12/dead-medicaid/



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STATE NEWS – Medicaid work requirements don’t work for New Mexicans with disabilities

STATE NEWS – Medicaid work requirements don’t work for New Mexicans with disabilities


Alternative Headline: Medicaid Work Rules Threaten Disabled

[MM Curator Summary]: New federal Medicaid work requirements could strip coverage from tens of thousands of New Mexicans, especially those with disabilities.

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Just when we thought we’d seen everything, Congress has thrown down a breathtaking new gauntlet: a national work requirement for people participating in Medicaid.  Every state will now be required to track the employment status of its Medicaid recipients in order to receive federal funding for the program.

We don’t know exactly how New Mexico will enact this new rule.  The “One Big Beautiful Bill” does not prescribe how to set up such a tracking system, and it certainly doesn’t fund it.  But every U.S. state will need the system in place in extremely short order, most likely by late 2026.

There are a lot of unknowns, but what we do know is this: Work requirements don’t work for people with disabilities.

As CEO of Disability Rights New Mexico, I have seen how every year, we provide free legal services to thousands of people with disabilities across our state. We exist, in part, because the systems designed to support people with disabilities are so often unnavigable.

Now, Medicaid will erect a new barrier that many people with disabilities won’t be able to scale.  The new legislation requires that Medicaid recipients prove that they work, volunteer or attend school for 80 hours each month as a demonstration of worthiness for coverage.  If people fail to report, their health care is cut off.  There may be some exceptions to the work requirement for folks with medical issues or parenting obligations. But whether or not they are required to work, we are profoundly uneasy about the ability of many people to navigate a reporting system that requires regular check-ins and submission of documentation. Even if someone is entitled to a medical exemption, they don’t necessarily have the ability to provide regular proof of it.  

Consider the following common scenarios:

A young man with an intellectual disability works in a warehouse, where the predictable routine and structure support his ability to succeed on the job. He is enrolled in Turquoise Care, New Mexico’s basic Medicaid plan. Despite working 80 hours each month, his disability makes it impossible for him to regularly report his work hours to the state. Even though he is meeting the requirements, he loses his health coverage simply because he cannot navigate the reporting system.

A woman with traumatic brain injury meets the medical criteria exempting her from work. However, her disability deeply impacts her executive functioning skills to the point where she is incapable of filling out the exemption forms, scheduling a medical appointment to certify her status and regularly submitting the required documentation. Because of impairments caused by her disability, she loses her health care.

These aren’t hypotheticals. These are real examples of the many disability-related obstacles faced by real New Mexicans. And a lot more people are about to be impacted.

According to New Mexico’s Health Care Authority, HCA, New Mexico has 836,000 enrolled in Medicaid, approximately 40% of New Mexico’s population. Approximately 254,000 Medicaid members would be subject to the bill’s new work requirements. Although the details of exemption requirements have not been disclosed, we can expect a significant number of this group could lose coverage, not because they are unwilling to work, but because the policy ignores real world barriers. HCA estimates that nearly 89,000 will lose coverage for vital health care. We expect that number could be significantly higher, particularly in the rural areas where work and volunteer opportunities are limited. Added to that reality is the limitation of transportation of essential transportation services. As if those were not enough barriers to overcome, there is the new six-month redetermination requirements that pose an additional threat to maintaining continuing eligibility, especially for those with disabilities attempting to continue to meet paperwork requirements.  They will be subject to a confusing and punitive federal reporting mandate.  These individuals will need ongoing support to navigate the new rules and how to follow them.  

We shared these concerns with U.S. Rep. Gabe Vasquez (D-N.M.) at a recent Medicaid roundtable, and he has taken action to try and right the ship on Medicaid. The entire Congressional delegation has been supportive of New Mexicans regarding the consequences of these Medicaid changes.We ask that other state New Mexico lawmakers and state leaders do the same, recognizing the chaos and harm that will be unleashed by this new federal mandate and taking steps to do something about it. We call upon our state’s leaders to develop, fund and support an employment reporting system that is as accessible, inclusive and fair as possible. We cannot allow the Medicaid system to punish the very individuals it was established to support by depriving them of essential health care services.

Our stories may be republished online or in print under Creative Commons license CC BY-NC-ND 4.0. We ask that you edit only for style or to shorten, provide proper attribution and link to our website. AP and Getty images may not be republished. Please see our republishing guidelines for use of any other photos and graphics.

https://sourcenm.com/2025/08/08/medicaid-work-requirements-dont-work-for-new-mexicans-with-disabilities/


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STATE NEWS – Newly released records linked to Hope Florida reignite intra-GOP political battle

STATE NEWS – Newly released records linked to Hope Florida reignite intra-GOP political battle


Alternative Headline: $67M Medicaid Deal Spurs Florida Feud

[MM Curator Summary]: 600 pages of newly released records revealing a $67 million Medicaid settlement in Florida has re-sparked political turmoil — after $10 million went to a nonprofit tied to Casey DeSantis and was used to oppose marijuana legalization.

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The documents reveal details of a $67 million settlement between Florida and the state’s largest Medicaid provider, meant to settle overbilling claims levied against a now-former pharmacy benefit manager.

Hope Florida began under the state Department of Children and Families in 2019 as a program aiming to connect people with local services that would help them become independent of public assistance. | Rebecca Blackwell/AP

TALLAHASSEE, Florida — A trove of records released by Florida Attorney General James Uthmeier has revealed new details about community-based welfare program Hope Florida and its financial and legal dealings, reviving one of the state’s largest political battles this year between Sunshine State Republicans.

The documents reveal details of a $67 million settlement between Florida and the state’s largest Medicaid provider, meant to settle overbilling claims levied against a now-former pharmacy benefit manager. The final drafts of the settlement included a $10 million donation to the nonprofit arm of Hope Florida, an effort spearheaded by first lady Casey DeSantis, which fell under scrutiny amid rumors about her plans to run for governor. The donation was later used to fund the campaign to defeat a marijuana initiative last year.

The roughly 600 pages of emails and drafts obtained first exclusively by POLITICO provided further detail on that settlement — but they don’t address the larger question of how the$10 millionwas steered to killing the marijuana initiative effort, known as Amendment 3. And they come as multiple players in the ongoing saga gear up for their own future political plans.

Scrutiny of Hope Florida and the $10 million donation was led by state House Health Care Budget Chair Alex Andrade (R-Pensacola), who grilled state agency chiefs about Hope Florida during meetings he held earlier this year. Gov. Ron DeSantis has fired back at Andrade with questions about his ties to the medical marijuana industry, which footed the bill for Amendment 3.

Hope Florida began under the state Department of Children and Families in 2019 as a program aiming to connect people with local services that would help them become independent of government-subsidized public assistance. Casey DeSantis began promoting Hope Florida a short time after, and the program later spawned the Hope Florida Foundation, to help raise and distribute money without state restrictions. The $10 million donation from the otherwise-unrelated settlement agreement was by far the largest fielded by the foundation, which otherwise struggled to raise funds and manage key financial tasks, such as filing federal taxes.

The $10 million donation was part of a $67 million settlement offered by the state’s largest Medicaid contractor, Centene, and state lawmakers believe the entire amount should have been returned to the Legislature. Instead, a board overseeing the Hope Florida Foundation donated $10 million toward two nonprofits working to defeat Amendment 3. (Defeating the ballot initiative was a key priority of GOP Gov. Ron DeSantis.)

But the records, some of which were previously confidential under trade secret laws, show the $67 million amount was more than three times the actual loss incurred by the state when it was overbilled.

According to letters sent to the state by Centene, the settlement gave more than $19.4 million to cover the actual loss incurred by the state and another $36.8 million in profits collected by Centene’s former pharmacy benefit manager. There was an additional $10.8 million offered to cover any additional losses or costs associated with the state’s claim. Both sides agreed to cover their own legal costs.

Andrade believes Florida law mandates the entire settlement, including the $10 million donation, be returned to the Legislature. A letter drafted by lawyers from Centene, however, said the entire $67 million settlement was more than three times larger than the state’s actual financial loss.

The Florida settlement stems from an Ohio lawsuit alleging Centene’s former pharmacy benefit manager pocketed tens of millions in drug rebates meant to benefit the state’s Medicaid program. Centene subsequently established a $1.2 billion trust fund to settle similar claims filed by several other states.

“I am hopeful this will help the folks in the governor’s office gain a better understanding of the fact that FL is receiving 3.4 times more than the most aggressive actual damages calculation,” Mississippi lawyer Matthew C. McDonald wrote to Tallahassee lobbyist Crystal Stickle, as detailed in the records. “As we have discussed on multiple occasions, pursuing litigation in FL based on the conduct alleged in Ohio would result in the state recovering far less than is being offered as part of this settlement.”

The records also detail the roles played by several key officials who took part in putting the settlement together. They include emails from Chief Deputy Attorney General John Guard, who is still awaiting Senate confirmation after being nominated by President Donald Trump in late May to become a federal judge. Guard signed off on the finalized settlement in September after he removed the attorney general’s office as the designated recipient of the settlement funds because they involve Medicaid. Guard determined the funds should instead be managed by the state Agency for Health Care Administration, which regulates most of the state’s Medicaid program and is funded by $34.6 billion in federal and state dollars.

Guard, who previously prosecuted cases on behalf of the attorney general’s Medicaid Loss Control Unit, also said the settlement was different from others involving Medicaid funding.

“Normally, the federal share is explicitly detailed in the settlement agreement, and I am not sure AHCA wants us to get the remainder of the money,” Guard wrote in a Sept. 13 email to Andrew Sheeran, the top legal advisor at AHCA. “If it is just going to the Legislature and [general revenue], I can probably make it work, but I believe this is different than I have seen in a settlement with Medicaid monies.”

When Jeremy Redfern, spokesperson for the attorney general’s office, was asked if Guard would offer comment, he said the records spoke for themselves.

Uthmeier, who only met with Centene about the settlement when he was chief of staff for Ron DeSantis, appears to have had minimal involvement based on the records.

Uthmeier was appointed by DeSantis in February to replace former Attorney General Ashley Moody after she was appointed to the Senate. He is now gearing up for a race to keep his position in next year’s elections. Meanwhile, Casey DeSantis has been considering a run for Florida governor and has yet to make a decision.

The controversy and outrage among state lawmakers over Hope Florida’s $10 million donation throughout this year’s legislative session led them to strip funding for the program in this year’s state budget. The state Senate also failed to confirm Children and Families Secretary Taylor Hatch and AHCA Secretary Shevaun Harris due to concerns about the program. But most of the fury died down by the time Ron DeSantis signed this year’s budget at the end of June.

A spokesperson from Uthmeier’s office said the records were able to be released after months of talks with Centene and other lawyers involved with the settlement about releasing drafts of the agreement deemed confidential.

“The documents in question were considered ‘trade secret’ and required consent from Centene to release,” Uthmeier spokesperson Redfern said.

About 60 percent of Florida’s Medicaid budget is covered by federal dollars. McDonald’s letter estimates the overbilling led the state Medicaid program to miss more than $19 million in drug rebates, which is less than one-third of the $67 million offered in the settlement, and only half of the $39 million Andrade told reporters was federal money.

Andrade, the state lawmaker who has led the charge to further investigate Hope Florida, has yet to see the public probes he hoped to spur, though he claims both federal and state officials are investigating the nonprofit arm. In response to a state reporter’s X post on documents related to Hope Florida, Andrade cited a “selective compliance and arbitrary delay in the production of public records” in his own post, also tagging Uthmeier. The state representative has also demanded all of the records provided by Uthmeier’s office to POLITICO.

Andrade said that, even with an inflated settlement amount, the entire sum should have been treated as federal and state Medicaid dollars.

“Any argument to the contrary has come from those trying to cover up the fraud,” Andrade said. “Every legal defendant in the history of litigation has said their settlement offer is more than they believe they owe. This one is no different.”

Andrade had said in April his committee will resume its inquiry of Hope Florida during the legislative session next year. But as of Wednesday, Andrade said he was unsure if state House Speaker Daniel Perez (R-Miami) will make him health care budget chair for another year. He also said AHCA has refused to turn over records he requested several months ago.

“I’m certainly not going to look the other way while James Uthmeier and his office continue to make a mockery of the laws they’re entrusted to enforce,” Andrade said. “Until they produce their public records and act like transparency is important to them again, I obviously have more questions.”

CLARIFICATION: This report has been updated to specify the organizations the $10 million donation was made to.

https://www.politico.com/news/2025/08/06/newly-released-hope-florida-records-reignite-intra-gop-political-battle-00495069




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STATE NEWS – Illinois Removes Nearly 700,000 People From Health Care Plan

STATE NEWS – Illinois Removes Nearly 700,000 People From Health Care Plan


Alternative Headline: Illinois Drops 700K from Medicaid

[MM Curator Summary]: Illinois has dropped nearly 700,000 Medicaid recipients since March 2023, raising concerns about uninsured rates and health care strain.

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Almost 700,000 Americans have been removed from a health care plan in Illinois over a two-year period, data from KFF, a nonprofit health policy research and news organization, has shown.

These Americans have been removed from the state’s Medicaid program as part of the unwinding process happening nationwide after Medicaid coverage was expanded during the COVID pandemic.

Newsweek has contacted the Illinois Department of Public Health via email for comment.

Why It Matters

While some of those disenrolled from the program in Illinois may have access to other forms of health insurance, many risk losing all access to health coverage.

There has been growing concern in recent months about how high levels of uninsured Americans could impact health outcomes, as without coverage, Americans may delay seeking medical care.

This in turn could potentially increase demand for emergency care services, while ramping up costs and worsening chronic and mental health conditions.

What To Know

During the COVID pandemic, some states expanded access to Medicaid, the federal health program for those with limited income and resources, through the Affordable Care Act (ACA).

These states were then forced to keep recipients on the program despite any changes to their eligibility until March 2023 under federal rules.

That month, states were then allowed to start the "unwinding" process, whereby those no longer eligible for the program were rolled off.

In Illinois, there were 3,826,461 covered by Medicaid in March 2023, but by April 2025, that number was 3,146,295, KFF data shows.

However, while this marked a drop of hundreds of thousands of Medicaid recipients, the enrollment levels did not return back to pre-pandemic levels, as they were still 7 percent higher than levels in February 2020.

"The unwinding has taken place over a year and Medicaid enrollment is still higher now than in the pre-pandemic period," Kathleen Adams, professor of health policy and management at the Rollins School of Public Health at Emory University in Georgia, told Newsweek.

There are also variations between states in relation to how quickly the unwinding process is occurring.

While highly populated states like California, Florida, New York and Texas have all seen bigger drops in enrollment than Illinois, there is also a difference in rate between states based on which opted to expand Medicaid.

"Some states that had not expanded Medicaid under the ACA did so recently and many of them show the largest increases in enrollment from their pre-pandemic levels," Adams said.

Differences in how the states approached the unwinding process also had an impact.

Going forward, concerns with Medicaid enrollment are increasing as the Trump administration’s planned changes to the program, under President Donald Trump‘s "big, beautiful bill," will fall into place—such as work requirements impacting eligibility.

What People Are Saying

Adams also told Newsweek: "We are always concerned with the loss of insurance coverage, especially among the lower income and vulnerable groups traditionally served by Medicaid. If these individuals are not able to find a source of other coverage such as Employer Sponsored Insurance or through the subsidized exchanges, they will have lower access to needed health care, face higher costs if they obtain care and could impose costs on the health care system as they are forced to seek care in ERs or other publicly subsidized sources of care."

She added: "The loss of insurance coverage among lower-income and medically fragile individuals, often covered by Medicaid programs, can certainly increase health problems in the US. With the loss of coverage, households lose access to needed services such as preventive and primary care and as well as the services needed to manage chronic conditions. The overall health of the nation can be affected. There would also be increased demand for services from the safety-net system, for example Federally Qualified Health Centers, and increased uncompensated care costs at our hospitals."

What Happens Next

As the unwinding continues, more reductions in enrollment are expected across the country, elevating concerns about how the rates of uninsured Americans could impact health outcomes.

https://www.newsweek.com/illinois-removes-nearly-700000-people-health-care-plan-2109093


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STATE NEWS -Officials predict only 5% of North Dakota Medicaid recipients will be impacted by program changes

STATE NEWS -Officials predict only 5% of North Dakota Medicaid recipients will be impacted by program changes


Alternative Headline: North Dakota Prepares for Medicaid Changes

[MM Curator Summary]: New Medicaid rules in North Dakota could drop 3%–5% of recipients from coverage and raise ACA marketplace premiums by $485 monthly if tax credits expire.

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BISMARCK, N.D. (North Dakota Monitor) — North Dakota is well positioned to deal with changes to the Medicaid program, but the Department of Health and Human Services does expect 3% to 5% of the state’s Medicaid population to get pushed off the rolls by new requirements.

Patient advocates worry that people eligible for Medicaid will lose coverage due to new administrative hurdles, and the loss of Affordable Care Act tax credits may cause further challenges.

North Dakota HHS estimates between 3,000 to 5,000 people who use the Medicaid expansion program will be impacted by new federal rules in coming years, said Sarah Aker, executive director of medical services for the North Dakota Department of Health and Human Services.

“While there will be changes to people’s experiences on Medicaid over the next couple of years as we implement the requirements, we hope they will be good additions to the program,” Aker said. “If people are compliant, if people meet the eligibility requirements, they will stay covered.”

Medicaid expansion was established in North Dakota in 2014 and covers people ages 19-64 who earn up to 138% the federal poverty level, or $21,597 for a single person or up to $44,367 for a family of four.As of June, the state had about 23,000 people enrolled in the Medicaid expansion program out of more than 108,000 total Medicaid enrollees.

Aker said one change stems from new work requirements for Medicaid expansion recipients included in the congressional budget reconciliation package. The new requirements mandate working-age adults between 19-64 years of age complete 80 hours of volunteering, education or work per month, and are set to begin in 2027.

Many people within the Medicaid expansion group are exempt from the new provisions, she added, including pregnant women, people who are medically frail, tribal members, parents and caretakers with children under 14 years of age, recipients with substance-use disorders or mental health conditions that prevent them from working, and cancer patients, among others.

“When you take out all of those exemptions, we think the impact is about 3% to 5% of the total Medicaid population, so a pretty small percentage of that 108,000,” Aker said.

Ben Hanson, North Dakota government relations director for the American Cancer Society Cancer Action Network, questions those numbers, pointing to the federal legislation that cuts a substantial portion of federal Medicaid spending.

“At some point, someone is going to get their health coverage taken away from them,” Hanson said.

Many North Dakota Medicaid recipients are already working, Hanson said. Some people who are part of the Medicaid expansion program are employed by small businesses in the state with under 20 employees that may not be able to offer group health insurance because of the cost, he said

The burden will also increase on those small employers to verify the employment status of their employees at a time when their workforce is already spread thin, he said.

“It’s another layer of paperwork or red tape that we hear so often is not good for business,” Hanson said.

Aker said the first major impact people will see from the changes to the Medicaid program will be during the first six-month eligibility renewal in July 2027.

Shannon Bacon, director of external affairs for the Community HealthCare Association of the Dakotas, said the nonprofit supports community health centers that serve rural, low-income and underserved people.

When states have tried adding work requirements or other steps to prove eligibility in the past, they’ve seen a lot of “procedural disenrollment,” she said. That occurs when someone is still eligible for the program but missed a deadline or were not able to submit the correct documentation to receive an exemption.

“That’s the thing that is going to be the most key during the implementation,” Bacon said.

In addition to the changes to the Medicaid program, Bacon said, Advanced Premium Tax Credits that are part of the Affordable Care Act marketplace are set to expire at the end of the year without congressional intervention.

“In North Dakota, a lot of people are benefiting and may not even realize it from these enhanced premium tax credits under marketplace,” Bacon said.

If those tax credits are not renewed, North Dakotans will pay an average of $485 more per month for health insurance through the ACA, according to KFF.

In 2024, more than 34,000 North Dakotans received Advanced Premium Tax Credits through the ACA marketplace, up from almost 31,000 in 2023.

Retroactive filing dates, also part of the new law, will affect all Medicaid recipients, Aker said.

Before the reconciliation bill was passed, anyone who signed up for Medicaid received a 90-day retroactive date for health care services they were provided, if they qualified for them at the time. That retroactive timeline will be reduced to two months for enrollees in the standard Medicaid program and one month for Medicaid expansion members under the new law.

Still, Aker said, national discussion about a lot of the changes “overstates” their impact on North Dakota.

“There’s a saying we have in Medicaid that if you’ve seen one state’s Medicaid program, you’ve seen one state’s Medicaid program,” Aker said. “And our choices have set us up well to be in compliance with the bill.”

(Story written by Michael Achterling – North Dakota Monitor)

https://www.kvrr.com/2025/08/06/officials-predict-only-5-of-north-dakota-medicaid-recipients-will-be-impacted-by-program-changes/



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STATE NEWS – UofL Health pauses plans for birthing center in south Louisville after Medicaid cuts

STATE NEWS – UofL Health pauses plans for birthing center in south Louisville after Medicaid cuts


Alternative Headline: Medicaid Cuts Halt Louisville Birthing Center

[MM Curator Summary]: Medicaid cuts have forced UofL Health to pause its $20M south Louisville birthing center project indefinitely.

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3 things to know summary – GPT

Suggested new headline: 

UofL Health has indefinitely delayed its $20 million “Birthing Place” project at Mary & Elizabeth Hospital in south Louisville due to recent Medicaid cuts, which threaten the financial viability of adding new labor and delivery services. The planned 21,000-square-foot center would have been the first west of I-65 in 50 years, featuring eight suites for natural and traditional childbirth, plus a dedicated C-section suite.

With 44% of Kentucky births funded by Medicaid, UofL Health says the loss of funding—set to take full effect in 2028—forces a pivot toward opening a Women’s Health Center in the expanded space instead. The project had $8.25M in pledged city support, with $3M received so far, and hospital officials are working with local leaders to ensure sustainable health services for the medically underserved South Jefferson County community.

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5BF Summary – GPT

  • Summary: Medicaid cuts have forced UofL Health to pause its $20M south Louisville birthing center project indefinitely.
  • Key Points:

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LOUISVILLE, Ky. (WDRB) — A new birthing center planned for south Louisville is on hold because of recent cuts to Medicaid. 

The $20 million "Birthing Place" project at UofL Health – Mary & Elizabeth Hospital called for 21,000 square feet of office space near the hospital entrance to be transformed into the first birthing center west of Interstate 65 in five decades. 

Plans for the unit included eight labor, delivery, recovery and postpartum suites that would have focused on natural and traditional childbirth. A specialty suite specifically designed for C-Sections was also part of the plans. 

UofL Health officials confirmed the project is on hold due to recent Medicaid cuts in the following statement: 

"The recent cuts to Medicaid have changed the landscape for health care services in Kentucky. While the most severe cuts do not go into effect until 2028, we must start planning for that future now.

UofL Health is indefinitely delaying the opening of The Birthing Place at UofL Health – Mary & Elizabeth Hospital. 44% of Kentucky births are financed by Medicaid. That funding was instrumental in developing our plans for The Birthing Place at UofL Health – Mary & Elizabeth Hospital. The expected loss of Medicaid funding jeopardizes the viability of bringing labor and delivery services to South Louisville.

UofL Health is still committed to providing robust health care services at Mary & Elizabeth Hospital. We are working with Mayor Craig Greenberg and Metro Council to continue providing health services in the South Jefferson County that have long term sustainability and in the best interest of the community. We will plan on opening a Women’s Health Center in the expanded space and are confident the expanded women services at Mary & Elizabeth Hospital will fill an important gap in a medically underserved area.

Halting these plans is a disappointing, but necessary financial decision. We will continue to monitor the Medicaid landscape and look for opportunities to revisit the project."

The renovation of the space was supported by an $8.25 million grant from Louisville Metro Government. 

David McArthur, UofL Health’s Director of Public Relations, addressed whether than funding will be returned to the city in this written statement:

"To date, we have received $3 million of the pledged amount," McArthur said. "We are working with Mayor Craig Greenberg and Metro Council members to provide health care services to Southern Jefferson County residents that are sustainable and in the best interest of the community."

UofL Health-Mary & Elizabeth Hospital is located on Bluegrass Avenue in Louisville’s Hazelwood neighborhood, off Manslick Road. To learn more about the hospital, click here.


Copyright 2025 WDRB Media. All rights reserved.

https://www.wdrb.com/news/business/uofl-health-pauses-plans-for-birthing-center-in-south-louisville-after-medicaid-cuts/article_857e2439-3506-4c9a-aaed-32ff0f12653d.html



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STATE NEWS – Colorado ran up the tab on Medicaid

STATE NEWS – Colorado ran up the tab on Medicaid


Alternative Headline: Colorado Medicaid Costs Surge, Major Cuts Loom Under Federal “BBB” Law

[MM Curator Summary]: Colorado faces rising Medicaid costs, a tight budget, and looming federal cuts under the “BBB” law that could exceed $2B annually by 2028.

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As Colorado cheerfully expanded Medicaid following massive financial incentives created by the Affordable Care Act, also known as Obamacare, legislators forgot the simple wisdom of the former chairman of the president’s Council of Economic Advisors, Herb Stein, “If something cannot go on forever, it will stop.”

Our new report from the Common Sense Institute, “Colorado Health Policy at a Crossroads: Growth, Costs, and Consequences,” highlights how health care spending has become the single largest budget item in the Colorado state budget — approximately 20% of total general fund spending — and how 182 new health-care bills enacted since 2019 are costing the state more than $850 million a year (of which just over a third is covered by federal funding) in addition to costing the private sector more than $270 million annually in fees and lost TABOR refunds.

While Colorado’s share of the population that is enrolled in Medicaid is lower than the national average at about 20%, our spending per enrollee at $11,263 per year is about $400 higher than average.

At the end of the recent regular legislative session, the legislature’s Joint Budget Committee had to reduce next year’s state spending $1.2 billion to keep the roughly $17 billion budget balanced, with rising Medicaid costs being a key driver of the shortfall. The combination of disabled enrollees and those over 65 with full Medicaid benefits represent less than 10% of the Medicaid population but about 50% of the cost.

 

The legislature found a way to absorb the Medicaid-driven budget shortfall without cutting Medicaid but they will not be able to continue doing so. Difficult choices will need to be made.

And all of that is before the impact of The Big Beautiful Bill Act (“BBB”), which will significantly cut federal funding to states’ Medicaid programs while also increasing states’ Medicaid operating costs. These effects phase in beginning in 2028, so the legislature has a window to handle the inevitable massive budgetary crunch from these changes. Aspects of the BBB’s final impact remain uncertain but it’s likely that the final cost to the state — again, between lower federal revenues and higher operating costs — will exceed $1 billion a year and could exceed $2 billion a year.

There are four ways to address the exploding cost of Medicaid within the state budget: restrict Medicaid eligibility and remove people from the program; reduce the range of treatments that qualify for Medicaid reimbursement to providers; reduce the reimbursement rate, i.e., the amount that the program pays a doctor, nurse, or clinic to provide a particular service; cut spending on other items to absorb some of the increased cost of Medicaid.

The BBB’s work and work-reporting requirements will do some of the work in the first category but not nearly enough to offset other cost increases. As noted, 50% of the program’s cost comes from 10% of the Medicaid population; those who lose benefits due to work (or paperwork) requirements — younger able-bodied people — are not in that part of the population and will not reduce costs significantly. Politically, reducing costs among that 10% of the population will be challenging.

As our report notes, the massive list of health-care bills passed by the state legislature in the past six years reads like a wish-list for those who believe in government-run health care, with little apparent thought about cost. Obamacare essentially bribed states to expand Medicaid by offering a $9 match for every $1 of federal spending in the pool of expansion enrollees. If that number is reduced, especially alongside the BBB phased-in reduction of hospital provider fees which begins in three years, today’s Medicaid finance problems will seem like the good old days.

Legislators ignored Stein’s Law at their peril — and, for Colorado taxpayers, at ours.


https://www.coloradopolitics.com/opinion/colorado-ran-up-the-tab-on-medicaid-podium/article_7c7e9702-1bac-4e34-a5f8-976f9da89145.html



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STATE NEWS – How Medicaid cuts and federal policy changes will impact health care access for Vermont’s noncitizens

STATE NEWS – How Medicaid cuts and federal policy changes will impact health care access for Vermont’s noncitizens


Alternative Headline: Vermont Immigrants Face Coverage Losses Under Federal Cuts

[MM Curator Summary]: Vermont expects hundreds of noncitizens to lose health coverage in 2025–2026 under the “Big Beautiful Bill Act,” with confusion and enforcement fears already reducing care access.

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Medicaid cuts and other elements of the “Big Beautiful Bill Act” will restrict access to health insurance for noncitizens in Vermont in 2025 and 2026. 

Even though some noncitizens will avoid the worst impacts, the confusion alone could inhibit them from accessing care, people working to provide health care for immigrants say. 

“There’s a lot of Vermonters with a whole range of different immigration statuses, and they are the people who are putting on our roofs and helping milk our cows,” Mike Fisher, Vermont’s health care advocate, who helps people navigate the health care system, told VTDigger. “It’s so disheartening to see an attack on their access to health care.”

State health officials shared their predictions of how many immigrants will lose health coverage in the next year and a half, even as they emphasized that the exact implications of the latest federal cuts are still unknown. Medical providers and advocates helping immigrants access health services told VTDigger they’re already seeing patients eschew care due to the bureaucratic complexity and fear of the Trump administration’s federal immigration enforcement. Advocates predict the health system’s administrative burden will only become worse in the months ahead.  

In a hearing with legislative leaders last week, Jenney Samuelson, secretary of the Vermont Agency of Human Services, shared the state’s latest predictions on the scope of the federal cuts impacting immigrant health care. 

She said an estimated 100 legal noncitizens who have been in the country fewer than five years are slated to lose health insurance premium assistance on Jan. 1. The state also expects 400-500 refugees, asylum seekers and nonlegal residents to lose the same assistance at the turn of the year, she said.

Between 500 and 600 Medicaid enrollees who are asylum seekers or refugees are expected to lose eligibility in October 2026, Samuelson told lawmakers.

The increased administrative burden associated with the “Big Beautiful Bill Act” will make it more difficult for noncitizens to access health care, said Naomi Wolcott-MacCausland, program coordinator of the Bridges to Health program, which helps migrant workers access health services.

“Health insurance can be really complicated for anybody, regardless of whether you speak English or don’t have access to the internet,” she said in an interview, and the federal changes will only add to those challenges.

A patchwork of federal and state programs allow some noncitizens with a range of immigration statuses to receive health care. 

In Vermont, the Immigrant Health Insurance Plan allows pregnant individuals and young people not otherwise eligible for Medicaid to enroll in health insurance. 

But many immigrants go without coverage. 

One barrier to insurance, according to Wolcott-MacCausland, is that it is challenging for many immigrant workers to estimate their incomes because industries like agriculture or construction can boom or bust due to uncontrollable factors like weather. 

As the “Big Beautiful Bill Act” causes health insurance subsidies to shrink or disappear altogether, Wolcott-MacCausland said, the changes will disproportionately affect immigrants and those with variable incomes. She said she already sees many workers on temporary visas who are eligible for insurance choose not to enroll due to concerns that their fluctuating income will lead them to owe more money than they expect. 

Federal cuts to services for noncitizens are not the only changes in Washington, D.C., affecting access to health care. Wolcott-MacCausland said increased federal immigration enforcement is causing people to fear going to the doctor. 

“People are delaying care that can in turn result in them being at a really costly emergency department visit,” she said. 

Open Doors Clinic, a free clinic in Middlebury serving uninsured and under-insured local residents, including migrant and immigrant workers, is seeing fewer new patients, according to Julia Doucet, the clinical and program director. She said she is also seeing patients who are choosing to return to the countries where they were born. 

While health workers are already seeing people change their behavior, the full scope of new federal policies is still coming into focus.

“We’re trying like everybody else to understand impacts as the changes are coming down,” Wolcott-MacCausland said. “There’s a lot of unknowns.”

Correction: Due to inaccurate legislative testimony, the immigration status of people losing health insurance premium assistance was misrepresented.

https://vtdigger.org/2025/08/04/how-medicaid-cuts-and-federal-policy-changes-will-impact-health-care-access-for-vermonts-noncitizens/


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STATE NEWS – Goodbye to your healthcare plan: California has eliminated 900,000 beneficiaries from Medicaid

STATE NEWS – Goodbye to your healthcare plan: California has eliminated 900,000 beneficiaries from Medicaid


Alternative Headline: 900K Lose MediCal in CA

[MM Curator Summary]: California has dropped nearly 900,000 MediCal enrollees, mostly for procedural reasons, amid major state and federal Medicaid cuts.

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California has undergone sweeping MediCal coverage losses recently, with nearly 900,000 low-income residents stripped of health insurance during a national unwinding process.

This mass termination directly stems from pandemic-era eligibility reviews resuming and assessed against stricter procedural standards amid broader state and federal funding cuts.

MediCal serves over one in three residents in the Golden State, with approximately 15 million beneficiaries relying on the program for hospital care, mental health services, maternity support, dental and vision care, and long-term services like inhome supportive care.

Now, facing a nearly 19 percent drop in Medicaid funding over the next decade, California is grappling with the rising cost of benefits and workforce shortages.

The disenrollment wave is largely tied to procedural noncompliance during eligibility renewals. Health systems paused annual MediCal eligibility checks during the pandemic, but once they resumed, administrative barriers led to widespread terminations.

Around 90 percent of the coverage losses occurred for procedural reasons, not based on changes in eligibility status.

Who lost coverage

Most people losing MediCal are working-age adults, including undocumented immigrants and low-wage workers who previously qualified under post-pandemic expansions. Seniors and people with disabilities, while somewhat insulated, are still vulnerable as cost-cutting measures threaten optional supports like IHSS (InHome Supportive Services).

About 52 percent of MediCal enrollees are Latino, well above their share of the state population, and many are impacted by new enrollment restrictions and higher documentation requirements-despite high rates of labor force participation. These rule changes disproportionately burden immigrant and Latino communities.

The state legislature recently approved an enrollment freeze for undocumented adults starting January 2026. From 2027 onward those aged 19 to 59 may also face monthly premiums for coverage continuity. A scaled-back version of a previous $100-per-month proposal, these measures aim to cut billions amid a projected $12 billion state deficit.

How 900,000 people washed out of MediCal coverage

The broader federal "Big Beautiful bill", a controversial Republican-led tax and spending package, slashes Medicaid by over $1 trillion nationwide. In California, analysts warn it could leave up to 3.4 million residents without health coverage, with dramatic reductions to SNAP food assistance and provider reimbursement rates that jeopardize service networks.

State officials are requesting billions in additional funds for this shortfall, citing rising costs associated with undocumented immigrant care and expanded eligibility post-2024’s elimination of asset tests. Yet these budget moves also tie arms with federal funding, straining an already stretched system.

https://www.marca.com/en/lifestyle/us-news/personal-finance/2025/08/05/6891d84246163fdc308b4588.html


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