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 – Minnesota bill cutting free health care for illegal immigrants heads to governor – The Lion

STATE NEWS – Minnesota bill cutting free health care for illegal immigrants heads to governor – The Lion


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Alternative Headline: Minnesota Scales Back Immigrant Coverage

[MM Curator Summary]: Minnesota passed a bipartisan bill to end free health care for undocumented adults to curb spending, while keeping coverage for children.

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Minnesota is poised to repeal much of its free health care for illegal immigrants.

Both chambers of the Minnesota Legislature passed a bipartisan measure this week preventing illegal immigrant adults from receiving free, taxpayer-funded health insurance in Minnesota, Alpha News reports. The bill won’t impact access for illegal immigrant children.

The legislation passed 68-65 in the Republican-controlled House, with one Democrat joining 67 Republicans to provide the 68 votes needed to pass.

Additionally, the Democratic-controlled Minnesota Senate voted 37-30 in favor, with several Democrats joining the body’s Republicans.

“This is about being honest with Minnesotans about how their tax dollars are being spent,” Sen. Jordan Rasmusson, R-Fergus Falls, said on the Senate floor. “We cannot justify spending hundreds of millions on individuals who broke the law to enter the country while we face cuts to special education, nursing homes, and disability services.” 

The vote comes as the House, Senate and Gov. Tim Walz struck a budget deal last month that included repealing health care access for illegal immigrant adults. 

Walz and the then-Democratic-controlled Minnesota Legislature enacted legislation in 2023 making illegal immigrants eligible for the state’s Medicaid program, MinnesotaCare. Now this law will only apply to children. 

Walz is expected to sign the provision into law per the budget agreement. 

Even so, rank-and-file Democrats weren’t happy about it. 

“We didn’t think we were going to have this many people speaking up on the floor today,” state Rep. Maria Isa Perez-Vega, D-St. Paul, said on the House floor. “But thank you for those of you who have said ‘this bill sucks.’” 

However, Medicaid wasn’t invented to provide illegal immigrants with health care, noted state Rep. Jeff Backer, R-Browns Valley. 

“MinnesotaCare was never designed to be a comprehensive healthcare system for undocumented individuals. It was created to serve hardworking, lawful Minnesotans,” Backer said. “We must prioritize Minnesotans and protect their wallets and healthcare.” 

House Democrats attempted Monday to amend the proposal. Their provision would have let illegal immigrants ages 59 and older or those with certain health conditions stay enrolled in the program; it failed on a party-line vote. 

“Members, if we do not stop this, we are creating a deficit in the healthcare access fund,” said state Rep. Kristin Robbins, R-Maple Grove. 

“I know, Democrats, you had an $18 billion surplus that you turned into a $6 billion deficit,” she added. “Well, you are about to do it again for low-income Minnesotans. We cannot afford to create another deficit that will hurt our most vulnerable citizens.” 

https://readlion.com/minnesota-house-senate-send-legislation-cutting-free-health-care-for-illegal-immigrants-to-governor/





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FRAUD – Omaha woman sentenced for billing Medicaid for services she didn’t provide

FRAUD – Omaha woman sentenced for billing Medicaid for services she didn’t provide


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Alternative Headline: Omaha Woman Fined for Fraud

[MM Curator Summary]: An Omaha woman was sentenced for billing Medicaid for services she didn’t provide and must repay over $12,000.

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An Omaha woman was ordered to pay more than $12,000 after she pleaded no contest to Medicaid fraud.

Lisa Mitchell, 57, was found guilty of theft by unlawful taking.

According to the Nebraska attorney general, she billed Medicaid for services she never actually rendered

Mitchell was also sentenced to five years of probation.


She will be excluded from providing or billing for services paid for by any federally funded health program.



 https://www.msn.com/en-us/news/crime/omaha-woman-sentenced-for-billing-medicaid-for-services-she-didnt-provide/ar-AA1Feqkt?apiversion=v2&noservercache=1&domshim=1&renderwebcomponents=1&wcseo=1&batchservertelemetry=1&noservertelemetry=1






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CMS NEWS – Mississippi Medicaid appropriation increases by $58 million for new fiscal year, state support nears $1 billion

CMS NEWS – Mississippi Medicaid appropriation increases by $58 million for new fiscal year, state support nears $1 billion


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Alternative Headline: Mississippi Medicaid Budget Rises

[MM Curator Summary]: Mississippi’s Medicaid budget grows by $58 million as enrollment declines and federal policy changes loom.

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  • Enrollment numbers in the program are on a decline in the Magnolia State.

The Mississippi Division of Medicaid is anticipated to operate off a total budget of $8.4 billion for the new fiscal year which begins July 1. Of that total, the state’s total support sits at about $969.9 million, Senate Medicaid Committee Chair Kevin Blackwell (R) told his colleagues during the recent special session.

“In this bill, we allowed for a deficit of $60 million. Actually, the department thinks it’s going to be about … $120 [million] for next year, but all we could get was the $60 [million] out of the House,” Blackwell described.

For the previous fiscal year, the Legislature set the state support at about $911 million, meaning the new state budget will provide a $58 million increase to the division.

As with all bills this session, Blackwell said, health insurance increases for employees of the Mississippi Division of Medicaid were included in the increase.

Mississippi is one of a handful of states that has not expanded its Medicaid program for able-bodied adults as part of the Affordable Care Act.

According to reports shared by the Mississippi Division of Medicaid, there were 718,028 Mississippians enrolled in June 2024. That number is a decrease from the 904,590 reported in June 2023. According to the state department’s enrollment report from April 2025, 705,097 residents were enrolled in the program, which includes CHIP participants.

Bills to expand Medicaid were considered during the 2024 session, but none made it to the governor’s desk. No bill with that purpose was discussed on the floor of either chamber of the Mississippi Legislature this session.

However, given the proposed changes at the federal level in the Trump Administration’s “big, beautiful bill” making its way through Congress, that could change as a sticking point in Mississippi centered on work requirements. The federal legislation under consideration seeks to make work requirements a key component of the program going forward.

While Mississippi has not expanded its Medicaid program, it does receive one of the highest, if not the highest, Federal Medicaid Assistance Percentage (FMAP) match rates. The state division’s 2024 report shows the program was at 78.42 percent for fiscal year 2024. 

https://magnoliatribune.com/2025/06/13/mississippi-medicaid-appropriation-increases-by-58-million-for-new-fiscal-year-state-support-nears-1-billion/





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STATE NEWS – WA Medicaid data shared with federal immigration authorities, report says • Washington State Standard

STATE NEWS – WA Medicaid data shared with federal immigration authorities, report says • Washington State Standard


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Alternative Headline: WA Medicaid Data Shared

[MM Curator Summary]: Washington’s Apple Health data on immigrants was shared with DHS – along with shared information from CA, IL, and D.C. – raising privacy and legal concerns.

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Washington is one of a few states whose Medicaid data has reportedly been shared with the U.S. Department of Homeland Security, which could use it to potentially track down immigrants without legal status.

The shared information, including names, addresses, and social security numbers, is from California, Illinois and Washington D.C., on top of Washington state, according to the Associated Press. This comes as the Trump administration seeks to ramp up deportations.

Washington provides benefits that mirror Medicaid to immigrants in the U.S. without legal authorization. Enrollment is capped based on available funding, and only state dollars are used to pay for the program. The other states with data handed over offer similar benefits.

The agency that runs Washington’s Medicaid program, known as Apple Health, wasn’t sure “what information was disclosed or how it may have been used.”

“We’ve seen the reports and are deeply concerned about the potential misuse of personal health information belonging to Washington Apple Health clients,” state Health Care Authority spokesperson Katie Pope said in an email on Friday. 

“We are currently working closely with the Governor’s Office and the Attorney General’s Office to understand the scope of what occurred, including what data from Washington has been shared and how many individuals may have been affected,” Pope continued.

As of this spring, nearly 2 million Washington residents were enrolled in Apple Health, including over 850,000 children.

Medicaid, primarily funded by the federal government and run by the states, provides health insurance to low-income residents. 

Federal law prohibits noncitizens from accessing Medicaid, but states can shell out money for programs that cover immigrants. Washington state lawmakers this year earmarked $150 million for this purpose, enough to continue coverage for about 13,000 people. 

California and Illinois have moved to freeze or shut down their similar programs. Republicans in Congress have proposed reductions in federal Medicaid reimbursements for states that provide this kind of coverage to immigrants.

In a statement, Assistant Secretary of Homeland Security Tricia McLaughlin said, “President Trump consistently promised to protect Medicaid for eligible beneficiaries.”

“To keep that promise after Joe Biden flooded our country with tens of millions of illegal aliens CMS and DHS are exploring an initiative to ensure that illegal aliens are not receiving Medicaid benefits that are meant for law-abiding Americans,” McLaughlin continued.

In light of a February executive order from President Donald Trump, the federal Centers for Medicare and Medicaid Services late last month announced it was reviewing state Medicaid data to ensure federal funds weren’t being used on immigrants without legal status. 

“Medicaid is not, and cannot be, a backdoor pathway to subsidize open borders,” Mehmet Oz, the agency’s administrator, said in a statement at the time. “States have a duty to uphold the law and protect taxpayer funds.”

California, Washington and Illinois shared information about noncitizens receiving health coverage, according to the AP, citing a June 6 memo.

“Protecting the privacy of our Apple Health clients is core to our mission, and we take these concerns very seriously,” said Pope, of the Health Care Authority. “We’ll continue to coordinate with state and federal partners to determine the facts and will take appropriate action as we learn more.”

The Centers for Medicare and Medicaid Services are within the Department of Health and Human Services, run by Secretary Robert F. Kennedy Jr., whose advisers ordered the Medicaid data shared with the Department of Homeland Security, the AP reported Friday. They reportedly shared the information despite pushback from federal Medicaid officials.

The sharing came as federal immigration agents conducted immigration raids in California that led to protests. Trump has deployed National Guard troops and Marines in response to the demonstrations.

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://washingtonstatestandard.com/2025/06/13/wa-medicaid-data-shared-with-federal-immigration-authorities-report-says/





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STATE NEWS – Survey shows strong majority of Coloradans back Medicaid as GOP Congress weighs deep cuts to the program

STATE NEWS – Survey shows strong majority of Coloradans back Medicaid as GOP Congress weighs deep cuts to the program


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Alternative Headline: Coloradans Oppose Medicaid Cuts

[MM Curator Summary]:  A strong majority of Colorado voters oppose Medicaid cuts and support social safety programs amid GOP budget proposals.

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With millions of dollars in Medicaid on the table as Republicans solidify their budget bill, the majority of Coloradans say they don’t want the health program for low-income Americans to be cut.

Most Coloradans — 65 percent — oppose cuts to Medicaid, something that may happen if the budget bill passes, according to a new poll. The survey of 675 registered voters was conducted by Magellan Strategies for the health advocacy group Healthier Colorado.

“A majority have a positive regard for Medicaid. A majority think it’s important for their local community. A majority don’t want it cut,” said Jake Williams, Healthier Colorado’s CEO. “A majority are less likely to vote for a candidate who voted to cut Medicaid. So it’s a pretty clear result here.”

He said a proposal from President Donald Trump to raise taxes on those making over $2.5 million a year to help fund Medicaid is broadly popular among Coloradans.

Sixty-three percent of voters in hotly contested Congressional District 8 say they were less likely to vote for a candidate who voted to cut Medicaid, which is known as Health First Colorado.

“Cuts to Medicaid really aren’t showing any sort of support here, no matter really what the subgroup is,” said Courtney Sievers, Magellan’s director of survey research. 

The 8th district’s representative, Republican Gabe Evans, voted for the first version of the bill in the U.S. House, which makes deep cuts. He said he supports protecting Medicaid for vulnerable populations like pregnant women, kids and disabled people.

A spokesperson for Evans pointed out that it’s important to note that the polling also shows that some voters in the district who have an unfavorable view of Medicaid said there’s fraud, waste, and abuse in the Medicaid system and support undocumented people not receiving taxpayer-funded health care.

Pollsters wrote that “a dominant theme — especially among Republican and unaffiliated respondents — was anger or frustration over Medicaid being used for undocumented immigrants. Many said Medicaid should only be for U.S. citizens or legal residents, with some calling for stricter eligibility enforcement." 

Voters were asked if changes being proposed for Medicaid are “more about improving how the program works or more about taking money from Medicaid to use it for other purposes?” Sixty percent statewide and 51 percent in CD-8 said it was more about taking money to use for other purposes; that compared with 22 percent statewide and 29 percent in Evans’ district saying it was about improving how the program works for people.

“People aren’t buying the story that these Medicaid cuts are about making the program better, whether it’s work requirements or other forms of elimination of waste, fraud and abuse,” Williams said. 

Coloradans, including in CD-8, also expressed strong support for other government social safety net programs under threat from cuts in the Republican budget bill. Eighty-three percent statewide said they support the food assistance program called SNAP (Supplemental Nutrition Assistance Program). Eighty-two percent said they support Head Start, a free, federally funded program that provides early learning, health, nutrition, and support services to families with children from birth to age 5.

Most voters and those in CD-8 said they don’t want to see Congress make significant decreases in funding for those programs.

Voters weigh in on other issues

The poll also delved into other health-related questions on things like vaccines and social media.

  • 90% of voters in Colorado believe social media has had a negative impact on the youth mental health.
  • The percentage who believe the impact has been very negative has increased from 49% to 58% since December 2023.
  • 90% of Colorado voters believe there is a growing mental health crisis for children and youth.
  • The percentage who strongly agree has increased from 50% to 62% since December 2023.
  • 72% of voters in Colorado believe vaccines are safe and 76% believe they are effective; a majority (69%) said they do not believe that vaccines cause autism in children.
  • Just 5% of Colorado voters said the cost of childcare is affordable in their area.

https://www.cpr.org/2025/06/13/survey-strong-majority-coloradans-support-medicaid/




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STATE NEWS – Texas clarified when abortions are OK and aligned with RFK Jr. on health this legislative session

STATE NEWS – Texas clarified when abortions are OK and aligned with RFK Jr. on health this legislative session


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Alternative Headline: Texas Health Policy Shifts

[MM Curator Summary]: Texas passed major health bills in 2025, clarifying abortion rules, funding dementia research, and launching new Medicaid and nutrition initiatives.

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The 2025 Texas Legislature proved to be a session of re-calibration, where health care regulations were either tightened or loosened and attempts to delve further into some policy areas were left hanging until the next session.

The past two legislative sessions saw more seismic shifts: a near-total ban on abortion, a massive expansion of the state’s psychiatric hospital system, the teeniest of Medicaid expansions to offer one year of insurance coverage to new moms and a mental health budget boom following the tragic Uvalde school shooting.

That didn’t appear to leave much for the 89th Legislature to do on health, although lawmakers managed to approve a handful of intriguing bills and budget requests while killing other proposals.

Vaccine-hesitant parents successfully lobbied and won easier access to the vaccine exemption form and lawmakers narrowly clarified the state’s near-total abortion bans to give doctors more confidence in performing life-saving abortions.They also passed a historic $3 billion dementia research fund that awaits voter approval in November.

There were also a variety of bills signaling to the Trump administration, particularly U.S. Health Secretary Robert F. Kennedy Jr., that Texas was all on board his priorities to create transparency on food labeling and to stamp out chronic diseases.

The remaining health care cliffhanger is whether Gov. Greg Abbott signs or vetoes a hard-fought ban on THC products in the state. Abbott has until June 22 to veto any legislation passed this session. Otherwise, most of them will go into effect immediately or in September, even without his signature.

Here’s a rundown of how health care fared this past session.

Vaccine choice

House Bill 1586 allows anyone the ability to download a vaccine exemption vaccine exemption form at home. The form allows children to be exempted from being vaccinated to attend public schools. Currently, parents have to contact the Texas Department of State of Health Services and request the exemption form be mailed to them. Critics of the bill fear it would allow vaccine exemptions to flourish, as the state grapples with declining vaccination rates, but proponents say the bill is only meant to make it easier for parents to access a form.

Other vaccine skeptic measures that passed include HB 4076 which bars making patients ineligible as organ transplant recipients solely based on their vaccination status and Senate Bill 269 which requires providers to report patients’ vaccine complications to the national Vaccine Adverse Event Reporting System.

HB 4535 requires health care providers obtain informed consent from patients before a COVID-19 vaccine is administered and that patients receive notice about possible side effects.

Make Texas Healthy Again

Two nutrition bills dubbed Make Texas Healthy Again bills passed.

Texans who receive benefits through the federal Supplemental Nutrition and Assistance Program will no longer be able to purchase soda and candy with their Lone Star card following the passage of SB 379.

SB 25 requires food manufacturers to label foods by 2027 that contain any one of 44 additives or colorings not permitted in food sold in the United Kingdom, Australia, the European Union or Canada.

The state labeling requirements would take effect on Jan. 1, 2027 but a loophole exists that if on Dec. 31, 2026 a snack food producer wants to stick with its existing packaging for another decade, no warning label is needed because the new law “applies only to a food product label developed or copyrighted on or after January 1, 2027.”

The bill also requires elementary, secondary and postsecondary educational institutions to re-prioritize health and exercise. It also forces health professionals to take continuing education courses regarding nutrition and metabolic health. And it will require recess or physical activity for kids in charter schools – physical activity is already required in public schools.

HB 26 creates a pilot program within Medicaid to offer pregnant moms with nutritional counseling and medically-tailored meals.

Reproductive health

Texas banned all abortions three years ago, with a narrow exception that allows doctors to terminate a pregnancy only to save a pregnant patient’s life. Immediately, doctors and legal experts warned that this exception was too narrow and vaguely written, and the penalties were too severe, to ensure women could get life-saving care.

SB 31 says doctors need not wait until death is imminent to intervene, but affirms that the condition must be life-threatening to justify performing an abortion. It will also require doctors and lawyers to take continuing education courses on the nuances of the law.

Legislators passed a bill restricting cities, like Austin and San Antonio, from using taxpayer dollars to assist people who travel out-of-state to have an abortion. But the highest profile anti-abortion bill, SB 2880, which would have allowed anyone who manufactures, distributes, provides or prescribes abortion pills to be sued for $100,000 passed the Senate but stalled in the House.

Mental health

Lawmakers passed bills to expand crisis hotline services and provide loan reimbursement to address the mental health workforce shortage.

After a couple days of debate about the role of mental health professionals in Texas, lawmakers passed SB 646, which broadens eligibility for Texas’ loan repayment assistance program to include school counselors, marriage and family therapists, and other behavioral health professionals.

HB 5342 establishes the 988 Suicide and Crisis Lifeline Trust Fund, which will accept donations, grants and federal funds to maintain or improve the crisis line. Additionally, the bill mandates an annual report on the usage of the crisis centers participating in the 988 network.

Texas lawmakers imposed some restrictions on how minors accessed social media.

SB 2420 sets up requirements for age verification and parental consent before a minor is allowed to download or make purchases within software applications. Under this bill, developers must assign age ratings to their apps, disclose the reason for the rating, and notify the app stores of any significant changes.

Parental consent will not be required for specific emergency or educational applications, such as those providing access to crisis hotlines.

A bill to ban minors from social media altogether failed in the last few days of the legislative session.

Major budget items and agency changes

Several budget items involving health care and services for Texans were also approved.

Among them were an extra $100 million to fund child care scholarships to low income families on a waitlist for child care.

Nearly 95,000 Texas children are on a waitlist for child care scholarships at a time when facilities are closing and the cost of child care in Texas is making it difficult for working parents to make ends meet.

Last year, HHSC asked for $300 million worth of upgrades for its Medicaid and food stamps enrollment system but will? receive less than half that ask, about $139 million. The agency’s request came after Texas and the nation suspended Medicaid rules requiring participants to renew their applications more often during the pandemic and then removed nearly 2 million participants following the pandemic. The improvements will shorten the time between application for health care coverage and food assistance and activation of those benefits.

In Texas, Medicaid is mostly a children’s health insurance program. Only low income children, the elderly and new moms are covered by Medicaid in this state.

There is also a $18 million increase over the next two years for the state’s Early Childhood Intervention (ECI) services which assists families with children up to 36 months who have developmental delays, disabilities or certain medical diagnoses that may impact development.

A $60 million rider was put in to cover Texas’ costs of entering a federal summer lunch program in 2027. The 2023 program would give qualifying parents $120 over the summer months to help pay for lunches when school is out of session. More than 30 states now participate in the Summer Electronic Benefits Transfer program which also goes by the name Sun Bucks.

Lt. Gov. Dan Patrick championed the passage of Senate Bill 5, which creates the Dementia Prevention and Research Institute of Texas, to study dementia, Alzheimer’s disease, Parkinson’s disease and other brain conditions. Modeled after Texas’ cancer institute, the measure received bipartisan support. Abbott has signed the bill but the measure now goes before the voters to approve whether $3 billion in general revenue can be used to fund the project.

The Texas Health and Human Services Office of Inspector General’s office investigates health care and benefit fraud. This year, a handful of bills were passed to help streamline investigations by the office and update salary classifications for OIG officers to those of other Texas law enforcement officers, improving recruiting. This comes as the office has been instrumental in identifying fraud within some of the state’s health benefits systems, leading to firings of some agency employees.

https://www.newsfromthestates.com/article/texas-clarified-when-abortions-are-ok-and-aligned-rfk-jr-health-legislative-session





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STATE NEWS – Georgia’s experience raises red flags for Medicaid work requirement moving through Congress

STATE NEWS – Georgia’s experience raises red flags for Medicaid work requirement moving through Congress


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Alternative Headline: GA Medicaid Work Rule Falters

[MM Curator Summary]:  Georgia’s troubled Medicaid work requirement program raises concerns as Congress weighs a national version that could cut coverage for millions.

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ATLANTA (AP) — Georgia’s experiment with a work requirement for Medicaid offers a test of a similar mandate Republicans in Congress want to implement nationally, and advocates say the results so far should serve as a warning.

Just days shy of its two-year anniversary, the Georgia Medicaid program is providing health coverage to about 7,500 low-income residents, up from 4,300 in the first year, but far fewer than the estimated 240,000 people who could qualify. The state had predicted at least 25,000 enrollees in the first year and nearly 50,000 in the second year.

Applicants and beneficiaries have faced technical glitches and found it nearly impossible at times to reach staff for help, despite more than $50 million in federal and state spending on computer software and administration. The program, dubbed Georgia Pathways, had a backlog of more than 16,000 applications 14 months after its July 2023 launch, according to a renewal application Georgia submitted to the Trump administration in April.

"The data on the Pathways program speaks for itself,” said Laura Colbert, executive director of Georgians for a Healthy Future, an advocacy group that has called for a broader expansion of Medicaid without work requirements. “There are just so many hurdles at every step of the way that it’s just a really difficult program for people to enroll in and then to stay enrolled in too.”

A tax and spending bill backed by President Donald Trump and Republican lawmakers that passed the U.S. House in May would require many able-bodied Medicaid enrollees under 65 to show that they work, volunteer or go to school. The bill is now in the Senate, where Republicans want significant changes.

Pathways requires beneficiaries to perform 80 hours a month of work, volunteer activity, schooling or vocational rehabilitation. It’s the only Medicaid program in the nation with a work requirement.

But Georgia recently stopped checking each month whether beneficiaries were meeting the mandate.

Colbert and other advocates view that as evidence that state staff was overburdened with reviewing proof-of-work documents.

Fiona Roberts, a spokeswoman for the state Department of Community Health, said Gov. Brian Kemp has mandated that state agencies “continually seek ways to make government more efficient and accessible."

The governor’s office defended the enrollment numbers. Kemp spokesman Garrison Douglas said the early projections for Pathways were made in 2019, when the state had a much larger pool of uninsured residents who could qualify for the program.

In a statement, Douglas credited the Republican governor with bringing that number down significantly through “historic job growth,” and said the decline in uninsured residents proved “the governor’s plan to address our healthcare needs is working.”

For BeShea Terry, Pathways was a “godsend.” After going without insurance for more than a year, Terry, 51, said Pathways allowed her to get a mammogram and other screening tests. Terry touts Pathways in a video on the program’s website.

But in a phone interview with The Associated Press, she said she also experienced problems. Numerous times, she received erroneous messages that she hadn’t uploaded proof of her work hours. Then in December, her coverage was abruptly canceled — a mistake that took months of calls to a caseworker and visits to a state office to resolve, she said.

“It’s a process,” she said. “Keep continuing to call because your health is very important.”

Health advocates say many low-income Americans may not have the time or resources. They are often struggling with food and housing needs. They are also more likely to have limited access to the internet and work informal jobs that don’t produce pay stubs.

Republican lawmakers have promoted work requirements as a way to boost employment, but most Medicaid recipients already work, and the vast majority who don’t are in school, caring for someone, or sick or disabled.

Kemp’s administration has defended Pathways as a way to transition people to private health care. At least 1,000 people have left the program and obtained private insurance because their income increased, according to the governor’s office.

After a slow start, advertising and outreach efforts for Pathways have picked up over the last year. At a job fair in Atlanta on Thursday, staff handed out information about the program at a table with mints, hand sanitizer and other swag with the Pathways’ logo. A wheel that people could spin for a prize sat on one end.

Since Pathways imposed the work requirement only on newly eligible state residents, no one lost coverage.

That’s a contrast with Arkansas, where 18,000 people were pushed off Medicaid within the first seven months of a 2018 work mandate that applied to some existing beneficiaries. A federal judge later blocked the requirement.

The bill that passed the U.S. House would likely cause an estimated 5.2 million people to lose health coverage, according to an analysis from the nonpartisan Congressional Budget Office released Wednesday.

Arkansas Republican Gov. Sarah Huckabee Sanders has proposed reviving the work mandate but without requiring people to regularly report employment hours. Instead, the state would rely on existing data to determine enrollees who were not meeting goals for employment and other markers and refer those people to coaches before any decision to suspend them.

Arkansas is among at least 10 states pursuing work requirements for their Medicaid programs separate from the effort in Congress.

Republican state Sen. Missy Irvin said Arkansas’ new initiative aims to understand who the beneficiaries are and what challenges they face.

“We want you to be able to take care of yourself and your family, your loved ones and everybody else,” Irvin said. “How can we help you? Being a successful individual is a healthy individual.”

___

Associated Press writers Jonathan Mattise in Nashville, Tennessee, Andrew DeMillo in Little Rock, Arkansas, and Geoff Mulvihill in Philadelphia contributed to this report.

https://www.wral.com/story/georgias-experience-raises-red-flags-for-medicaid-work-requirement-moving-through-congress/22043746/





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STATE NEWS – Arkansas Officials Propose Rules Aimed at Improving Maternal Health – ACHI

STATE NEWS – Arkansas Officials Propose Rules Aimed at Improving Maternal Health – ACHI


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Alternative Headline: Arkansas Targets Maternal Health

[MM Curator Summary]: Arkansas is proposing new Medicaid rules to expand prenatal access and increase payments for obstetric care, addressing maternal and infant health gaps.

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Arkansas lawmakers last week began the process of reviewing two proposed rules aimed at improving maternal health outcomes in the state. The state Department of Human Services drafted the rules as part of the implementation of the Healthy Moms, Healthy Babies Act, an omnibus law encompassing key components of Gov. Sarah Huckabee Sanders’ maternal health agenda for 2025. The rules would create presumptive Medicaid eligibility for pregnant women and revamp and increase Medicaid reimbursement for obstetric services.

Presumptive Eligibility

Presumptive eligibility is a policy that allows pregnant women to receive temporary coverage while their Medicaid eligibility application is being processed, thereby removing one barrier to beginning prenatal health care that some women face. At least 28 other states provide presumptive eligibility to pregnant women, according to a 2025 survey.

For the best chance of a healthy pregnancy and delivery, a pregnant woman should begin receiving prenatal care in the first trimester, but in Arkansas, nearly 1 in 10 women who gave birth in 2023 had received no prenatal care or care that began late. Inadequate prenatal care is believed to be one many factors contributing to Arkansas’s poor maternal health outcomes. The state has the fourth-highest maternal mortality rate and the third-highest infant mortality rate in the nation. In a 2024 report, the Arkansas Strategic Committee for Maternal Health included presumptive eligibility among its policy recommendations.

In a joint meeting on June 4, the House and Senate Public Health, Welfare and Labor committees reviewed the proposed rule on presumptive eligibility with no objections. The proposed rule states that a pregnant woman who applies for pregnancy Medicaid will immediately receive coverage for prenatal services and services for conditions that may complicate the pregnancy, based on her self-attestation of income and residency. The services must be provided in an outpatient setting. This temporary coverage generally continues through the end of the month following the month in which eligibility is determined. A fiscal impact statement presented to lawmakers estimates that the rule will cost about $1.6 million in the fiscal year that begins July 1, with the state paying about $487,000 and the federal government paying the rest.

The Department of Human Services will work with healthcare providers and community organizations to educate pregnant woman about the availability of presumptive Medicaid eligibility, Elizabeth Pitman, director of the Division of Medical Services for Arkansas Medicaid, told the committees on June 4.

Reimbursement for Obstetric Services

The committees also reviewed without objection a proposed rule that would increase Medicaid reimbursement rates for obstetric services, including prenatal care, labor and delivery services, and postpartum care, by 70%. The increase is intended to improve access to those services in rural areas, which have seen several hospitals close their labor and delivery units in recent years. As of May, Arkansas had 33 birthing hospitals, down from 40 in 2019.

The rule also would require Arkansas Medicaid to reimburse healthcare providers for obstetric services separately rather than in one combined, or “bundled,” payment per delivery. The change is intended to improve the state’s ability to collect data on utilization of prenatal and postpartum services, the committees were told during the June 4 meeting.

The rule is estimated to cost about $38 million in the fiscal year that begins July 1, with the state paying about $12 million and the federal government paying the rest.

Both proposed rules must be reviewed next by the Administrative Rules Subcommittee of the Arkansas Legislative Council and then by the full council before they can be implemented. Since Medicaid is a joint state and federal program, Arkansas also will need to obtain approval for the changes from the federal Centers for Medicare and Medicaid Services. The proposed date for both rules to take effect is July 1.

https://achi.net/newsroom/arkansas-officials-propose-rules-aimed-at-improving-maternal-health/





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STATE NEWS – Federal Budget Bill Could Strip 300,000 In PA Of Medicaid Coverage

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Alternative Headline: PA Rural Medicaid at Risk

[MM Curator Summary]:  Trump’s proposed federal budget — including work mandates and biannual eligibility requirements — could eliminate Medicaid coverage for 300,000 Pennsylvanians and devastate rural health services.

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State officials warn that President Donald Trump’s “big, beautiful bill” could have serious consequences for health care in rural Pennsylvania.

President Donald Trump’s “big, beautiful” budget bill could have a disastrous effect on the health of rural Pennsylvanians and the operations of the hospitals and other medical centers that care for them.

The federal budget proposal, which passed the U.S. House by a one-vote margin in May, calls for nearly $800 billion in Medicaid cuts over the next decade.It also includes a new 80-hour-per-month work or service requirement for Medicaid recipients between the ages of 19 and 64 who aren’t caregivers or who have disabilities. Among other changes, the bill would require verification of coverage eligibility every six months rather than annually.

While supporters of the budget bill argue that it will slow spending and safeguard government programs, critics say the cuts and new requirements will create more paperwork for states and make it harder to access essential care. Opponents also argue the changes would push struggling rural hospitals and other providers to the brink, and force them to scale back services or close entirely.

More than 3 million people in Pennsylvania — 23% — are covered by Medicaid, according to data from the state Department of Human Services, which administers the program. The agency estimates that more than 300,000 would lose Medicaid coverage under the proposal.

Val Arkoosh, secretary of the department, said the bill would not only hurt those losing coverage but “all of us who would face the real-life consequences of crowded emergency departments, increases in the cost of health insurance, and the catastrophic effects on economies and health systems in rural areas.

More than 737,000 Medicaid recipients live in rural counties, where residents are typically older and more reliant on government-funded insurance programs. Such programs reimburse at lower rates compared to private insurance companies and haven’t kept up with inflation.

Cameron County Commissioner James Moate, a Republican, said the Medicaid reimbursement rate should have never been less than 100%.

“That’s why we have struggling hospitals,” he told Spotlight PA.

On average, Pennsylvania hospitals absorb a loss of 18 cents on the dollar for care provided to Medicaid patients, said Nicole Stallings, president and CEO of the Hospital and Healthsystem Association of Pennsylvania, which represents more than 230 hospitals statewide. In rural communities, the average loss is 26 cents on the dollar, she added in a May statement.

“Medicaid plays a vital role in the health of rural residents, and it is important to preserve this funding so that families can continue to access the care they need for healthier lives,” said Douglas Winner, chief financial officer for Penn Highlands Healthcare, a nonprofit system with nine hospitals in rural counties.

Penn Highlands President and CEO Steve Fontaine has told lawmakers that consolidating with other health systems and expanding into new areas has helped facilities survive. This strategy, which has helped Penn Highlands diversify its patient and insurance bases, is why the system expanded into Centre County, where resident numbers are expected to grow, he told lawmakers last year.

Still, the health system has shuttered services and reported operating losses over the past year.

Winner said Penn Highlands is “greatly concerned” about the proposed Medicaid cuts.

“Rural hospitals have experienced substantial cost increases for labor, drugs, and supplies,” he said in a statement. “Coupled with decreasing volumes, inadequate reimbursement rates, and ongoing staffing shortages — recruitment and retention — we are struggling financially.”

Advocates worry the cuts in the federal budget will force rural hospitals to slash services even more or close altogether. And once facilities end a service or shut down, they rarely reopen, Stallings told Spotlight PA.

Community health centers could also be strained. These facilities, also known as federally qualified health centers, provide services regardless of someone’s ability to pay and primarily see patients who use Medicaid and PENNIE, the state’s Affordable Care Act marketplace.

More uninsured people will likely lead to an increase in uncompensated care, said Eric Kiehl, director of policy and partnership for the Pennsylvania Association of Community Health Centers. And these facilities are already strapped for resources, he told Spotlight PA.

A surge in demand could cause these health centers to shutter core services — such as medical, dental, or behavioral health — reduce hours, or close, Kiehl said.

Pennsylvania’s U.S. House delegation voted along party lines on the federal budget bill, with Republicans supporting and Democrats opposing the proposal.

Medicaid spending totaled roughly $44 billion in fiscal year 2023. The federal government provided almost $28 billion of those dollars.

Democratic Gov. Josh Shapiro has said the state won’t be able to make up those dollars to support the Medicaid program. In a statement, Shapiro said he hopes “common sense and a concern for the people of Pennsylvania” will prevail in the U.S. Senate, where Democratic U.S. Sen. John Fetterman and Republican U.S. Sen. Dave McCormick disagree on aspects of the bill.

McCormick did not respond to a request for comment for this story. He has expressed support for the budget bill, which he says will reduce and slow government spending. During a Fox News forum, McCormick said he isn’t advocating for taking benefits from “vulnerable people” but is trying to ensure “people for whom the program was designed” benefit.

Fetterman called the plan “a bad bill,” telling Spotlight PA in a statement: “Republicans want to put more money in the pockets of the ultra-rich at the expense of hundreds of thousands of Pennsylvanians who will lose access to Medicaid if this disastrous bill is passed.”

https://newtownpanow.com/2025/06/11/federal-budget-bill-could-strip-300000-in-pa-of-medicaid-coverage/





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STATE NEWS – Indiana official says he ‘never’ would have pursued long-term care program for Medicaid

STATE NEWS – Indiana official says he ‘never’ would have pursued long-term care program for Medicaid


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Alternative Headline: Indiana Medicaid Program Overruns

[MM Curator Summary]: Indiana’s Medicaid program for seniors exceeded its budget by $300 million and has been criticized for mismanagement and poor provider reimbursement.

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Published June 11, 2025 at 6:00 AM EDT

The top official at the Indiana Family and Social Services Administration said the state’s new long-term care program for Medicaid members over 60 hasn’t met expectations. The statement contradicts claims the agency made under the previous administration, but aligns with concerns providers have raised.

The Pathways for Aging program shifted Medicaid members over 60 into health plans managed by health insurance companies. FSSA Secretary Mitch Roob said the state will end up paying those companies more than $300 million over budget this year.

Roob said he never would have pursued a program like this because it doesn’t make sense for the population it serves.

"It’s very difficult for managed care companies to manage the care of individuals who are in nursing homes," Roob said. "What is the value—what is the value they can have?"

When he served as FSSA secretary in 2006, Roob said he looked into the possibility of managed care for vulnerable populations like those over the age of 60 or children with disabilities. However, he said when he tried to find a managed care program to see what it would look like, he couldn’t find a private insurance program that had a program for those populations.

"[Managed care] is the way most states have chosen to do care today," Roob said. "It provides them a bit of fiscal—short-term fiscal surety. I could not find a popular, managed care program, in the private sector that dealt with fragile populations. I couldn’t find that because the fragile populations are by definition going to be covered by Medicaid."

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Roob said managed care works for pregnant people or people without disabilities because their care is more predictable. But Roob said the previous fee-for-service model used for traditional Medicaid populations, including older Hoosiers, accounts for the ways that their care can be more expensive and less predictable.

"There is a possibility that in the longer term, we will create a better system," Roob said. "In the venture capital world, it’s called the Valley of Death. Getting from here to here has been very difficult. It’s been very painful for everybody involved so far. That pain shows signs of easing, but only signs."

In addition to Roob’s concerns about the program, lawmakers raised additional concerns this year during the legislative session. FSSA was tasked with addressing provider claims processing concerns by the General Assembly before Pathways launched in July 2024. This year, the Indiana legislature also passed legislation targeting similar issues for the second year in a row.

Among other things, House Enrolled Act 1474 set standards for how quickly a managed care organization must pay, deny or suspend a claim from a provider and how much interest is owed if that deadline is not met.

Providers have criticized the claims processing time since the launch of the program.

https://www.lpm.org/news/2025-06-11/indiana-official-says-he-never-would-have-pursued-long-term-care-program-for-medicaid