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Maternal and Infant Health in State Rural Health Transformation Proposals Set Promising Priorities in an Uncertain Landscape
All 50 states applied for CMS’ Rural Health Transformation (RHT) program, a $50 billion fund borne from a need to reassure members of Congress during the final debate over H.R. 1 that Medicaid cuts would not decimate their states’ rural health systems. As previous blogs have detailed, the RHT program presents a unique opportunity for…
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Community Health Workers are a Focus of Rural Health Transformation Applications
Awards for the Rural Health Transformation (RHT) program were released on December 29, 2025, and state applications with proposals for the funds have been made public, covering a range of activities aiming to increase access to care, develop infrastructure, and enhance workforces. As we’ve written about previously, community health workers (CHWs) are a critical workforce…
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How are H.R. 1 Cuts and Changes to Medicaid and SNAP Playing out in 2026 State Legislative Sessions So Far?
Following the enactment of the largest Medicaid cuts in history, we anticipated a flurry of Medicaid activity in state legislative sessions. State legislators were left to fill the budget holes made by H.R.1, figure out how to implement H.R.1-mandated policies like work reporting requirements, and (hopefully) mitigate some of the associated coverage losses. Ten state…
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Prenatal Care: The Silent Maternal Health Emergency Hidden in New CDC Data
A new report from the Centers for Disease Control and Prevention (CDC) offers a look at concerning new trends in prenatal care access. From 2021-2024, prenatal care initiated during the first trimester of pregnancy declined, while those receiving care later or no prenatal care increased, as shown below. The share of pregnant women who received…
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CMS Weaponizes Fraud Against Medicaid in Minnesota: The State Fights Back
On March 2, the state of Minnesota filed a lawsuit against the Centers for Medicare & Medicaid Services in federal district court. The case, State of Minnesota v. Oz, is in response to two actions taken by CMS against the state for what CMS says is the state’s failure to control fraud against its Medicaid…
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CMS Releases Guidance on 6-Month Medicaid Renewals for Expansion Adults
Guidance on implementing six-month renewals for the Medicaid adult expansion group, as required by H.R. 1 was sent to state Medicaid directors earlier today (March 6, 2026). The delayed guidance (which was due by December 31, 2025) has kept states waiting for key details that are needed to set state policy, make system changes, and…
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The Rural Health Transformation Fund: Political Rhetoric Meets Bipartisan Concern as the Program Moves Forward
The Trump administration frequently highlights investments in rural health care. While the federal budget bill H.R. 1 (often referred to as the “One Big Beautiful Bill”) passed last year did establish the Rural Health Transformation Fund (RHTF) to inject much-needed capital into rural communities, the same legislation includes deep cuts to the Medicaid program—including billions of dollars…
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Protected: Webinar: Multi-Year Continuous Eligibility: Implementation, Key Findings, Future Implications
There is no excerpt because this is a protected post.
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CCF Welcomes Adriana Kohler to Our Team
Earlier this week, CCF welcomed Adriana Kohler to our team. Many of us know Adriana from her years as one of our state Finish Line partners in Texas where she served as the Policy Director of Texans Care for Children for many years. We are thrilled that Adriana is joining us to work on a…
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CMS Weaponizes Fraud Against Medicaid in Minnesota: Part 2
At a White House press conference last Wednesday, Vice President J.D. Vance, newly tasked with leading a war on fraud, announced that “we have decided to temporarily halt” $259 million in federal matching payments to the state of Minnesota due to fraud against its Medicaid program. He emphasized: “…we don’t want to do this. We…
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Wisconsin Passes 12-Month Postpartum Medicaid Extension, Leaving Arkansas as the Last State Without It
About a third of maternal deaths occur between one week and one year postpartum. The American Rescue Plan Act provided states with the option to extend postpartum Medicaid and CHIP coverage from 60 days to 12 months and the Consolidated Appropriations Act of 20223 made this option permanent. From 2021 to 2025, 48 states and…
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New State-by-State Medicaid and CHIP Tracker Shows Declining Enrollment as H.R. 1 Cuts Loom
Georgetown CCF has been closely tracking Medicaid and CHIP enrollment periodically over the past decade, – most recently as states began “unwinding” continuous coverage protections put in place during the pandemic. Now, as states prepare to implement H.R.1, including mandatory work reporting requirements and more frequent renewals for people covered through Medicaid expansion, while mixed-status…
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Fact Checking Homeland Security Claims About Immigrants and Medicaid Coverage and Why U.S. Citizen Children Will Suffer Harsh Consequences
On February 17, 2026, the Department of Homeland Security (DHS) posted a statement on X about Medicaid coverage for immigrants that is stunning when you consider how many inaccuracies are crammed into just four sentences. Here are five key inaccuracies in the X post. Mischaracterizing “non-citizen” households The DHS X post reproduces a KFF data graphic…
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The Federal Rural Health Transformation Fund: “Likely to Treat Symptoms But Not Deliver a Cure”
The most recent annual analysis on rural health from the health care consulting company Chartis had some interesting insights on rural hospitals, rural health and the federal Rural Health Transformation Fund (RHTF), a part of the H.R. 1 budget bill passed by Congress last year. While the entire report is worth a read, here are some…
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CMS Releases Long-Awaited EPSDT Behavioral Health Toolkit for States
Say Ahhh! readers will recall that when we blogged about the behavioral health section of the Center for Medicare & Medicaid Services (CMS) landmark 2024 EPSDT guidance, we noted that CMS had an additional EPSDT behavioral health resource in the works — an EPSDT Behavioral Health Services Toolkit. Now, over two years later, that toolkit…
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State by State Medicaid and CHIP Enrollment Data
This tracker shows enrollment data for Medicaid and the Children’s Health Insurance Program (CHIP) in all 50 states and DC, from January 2025 to the most recent month available. Data include total Medicaid/CHIP enrollment, as well as enrollment for children, adults, and Medicaid expansion. Historical data are also included to provide additional context for state…
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Medicaid Managed Care: The Big Five in Q4 2025
The Q4 2025 results for the “Big Five” Medicaid managed care companies are now available. These publicly-held companies—Centene, CVSHealth/Aetna, Elevance, Molina, and UnitedHealth Group—together control about half of the Medicaid managed care market, so their performance matters to tens of millions of Medicaid beneficiaries. (The results for prior quarters in 2025 are here, here, and…
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Florida Bill Would Waste Money on a Lose-Lose Plan to Punish Very Low-Income Parents
As readers of the SayAhhh! Health Policy blog know, states that have taken up the Affordable Care Act’s (ACA) Medicaid expansion are now mandated to impose a punitive work reporting requirement as of January 1, 2027. Florida has not taken up the expansion and covers very few adults, but Florida legislators are considering a bill…
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FY26 Appropriations Act Funds Maternal Health Initiatives, Falls Short of Investments Needed to Address Maternal and Infant Mortality Crisis
On February 3, Congress passed and the President signed into law H.R. 7148, the Consolidated Appropriations Act, which includes funding levels for the Federal Fiscal Year 2026 (FFY26) Labor, Health and Human Services, Education, and Related Agencies (LHHS). These funding levels will continue through September 30, 2026. The appropriations measure provides critical funding for key…
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Implementing Costly Medicaid Work Reporting Requirements: Who Will Foot the Bill?
Introduction The budget reconciliation bill enacted in July 2025 (H.R. 1) includes two major changes to federal Medicaid law that will impose large implementation costs on most states. One mandates the states that extend Medicaid coverage to low-income (“expansion”) adults require those adults to report 80 hours of work or community service per month. The other…
