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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…
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Self-Help Tools and Tutorials Are Critical to Implementing Medicaid Work Reporting Requirements
Last week we updated our scan of Medicaid renewal tutorials and self-help tools in advance of implementation of semi-annual renewals for the Medicaid expansion group starting in 2027. For all enrollees, not just expansion adults, it’s important for states to keep these resources updated and relevant. And it’s not too early to start thinking about…
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Fact-Checking Dr Oz’ Claims About Rural Health Investments
CMS Administrator Mehmet Oz makes two statements in this short video that are not correct: Rural areas and small towns need assistance with health care affordability, quality and accessibility. The Rural Health Transformation Fund, despite its origin as a political maneuver to enable passage of the 2025 federal budget reconciliation law (HR1), means substantial help…
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Critical Threats to Child and Family Health Intensify in 2026: Here is What We are Watching at CCF
The policy landscape for child and family health has undergone a dramatic transformation following the passage of H.R. 1, the budget reconciliation bill known as the One Big Beautiful Bill Act, and related policy changes enacted during the first year of the Trump administration. As we enter the second year of this administration, the Georgetown…
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CCF Welcomes Longtime Collaborator Steven Lopez to our Team
We are all looking for some good news in 2026 and we have some to share with you. Steven Lopez, MPP/MPH joined Georgetown University Center for Children and Families as a McCourt School of Public Policy Research Fellow. Steven has been a long-time friend and collaborator of CCF’s from one of his prior gigs at…
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Let’s Start a Conversation about Data to Monitor the Impact of H.R. 1’s Work Reporting Requirements
Monitoring the implementation of work reporting requirements in Medicaid will be incredibly important to assessing the policy’s impact, identifying bottlenecks or glitches in the system, and enabling rapid response to address problems. We have a baseline of data from the Medicaid performance indicators, which have been in place since 2014, and were expanded to more…
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New CMS Guidance on H.R. 1’s Restrictions of State Directed Payments
On February 2, 2026, the Centers for Medicare & Medicaid Services (CMS) issued new guidance implementing section 71116 of H.R. 1 (the “One Big Beautiful Bill Act” or P.L. 119-21), which restricts state-directed payments (SDPs) to hospitals and other health care providers. Under SDPs, states may require Medicaid managed care plans to increase provider rates or…
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CMS Issues Final Rule Implementing H.R. 1’s Prohibition of Certain Uniformity Waiver Provider Taxes
On January 29, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a final rule implementing the H.R. 1 provision prohibiting certain “uniformity waiver” provider taxes that states use to support their Medicaid programs. (The rule is scheduled to be published in the Federal Register on February 2, 2026). Nearly all states use taxes…
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CMS Quietly Releases Medicaid State Improper Payment Rates for 2025: How Did Minnesota Do?
With little fanfare, CMS earlier this month released a Fact Sheet on improper payments in Medicare, Medicaid, CHIP, and the Marketplaces in 2025. With even less fanfare, CMS this week posted Medicaid improper payment rates for 17 states, including Minnesota. To its credit, CMS did not conflate Medicaid improper payments with fraud against Medicaid. In the…
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Medicaid Data Sharing Crisis: Will HHS Break the Law to Help ICE?
When people share information with a health care program, they very reasonably expect their personal information will be used for their health care, and otherwise kept private. However, recent moves by the Department of Health and Human Services (HHS) in Medicaid threaten to violate this trust – and quite possibly a judicial order – to…
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Maximizing the Use of Self-Help Resources Should Be a Priority as HR 1 Policies Are Implemented
As the 41 states that expanded Medicaid to low-income adults under the Affordable Care Act, approach the implementation of H.R. 1’s federally mandated semi-annual renewals, we thought it would be helpful to review how states handled the daunting task of outreach during the unwinding of the pandemic-era Medicaid continuous coverage provision. During the unwinding, we…
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State Title V Programs Should Invest More in Maternal and Infant Health and Wellbeing
A recently released report, The Role of the Title V MCH Services Block Grant in Improving Maternal and Infant Health, examines the fiscal investments for pregnant women and infants made by Title V Maternal and Child Health (MCH) Services Block Grant programs in the 59 states and territories. Co-authored by Arden Handler, myself, and Nautica…
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House Republican Study Committee Pushes for Second Budget Reconciliation Bill and More Damaging Medicaid Cuts
On January 13, the House Republican Study Committee (RSC) unveiled its plan for a second budget reconciliation bill for this Congress, in addition to H.R. 1 (the “One Big Beautiful Bill Act” or P.L. 119-21) which was enacted on July 4, 2025. The plan includes a number of proposals to cut Medicaid, on top of…
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CMS Weaponizes Fraud Against Medicaid in Minnesota
On January 6, 2026, the Centers for Medicare & Medicaid Services (CMS) Administrator, Dr. Mehmet Oz, sent a letter to the Governor of Minnesota, Tim Walz, notifying him that his state’s Medicaid agency was “operating its program in substantial noncompliance” with federal requirements to “ensure sufficient controls to prevent, detect, and address fraud, waste, and…
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Maternal Health Field Lost a Courageous Leader Due to Complications of Childbirth
On January 1, 2026, Dr. Janell Green Smith of South Carolina died from childbirth complications at 31 years of age. Dr. Green Smith was a nurse-midwife, doctor of nursing practice, adjunct professor, maternal health professional and advocate. Dr. Green Smith developed severe pre-eclampsia during her pregnancy and delivered her daughter via cesarean section in late…
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HHS Announces Changes to Recommended Vaccine Schedule for Children
Vaccines and immunizations are safe, effective ways to prevent serious illness by teaching the body’s immune system to recognize and defend against harmful germs. For children and adolescents, vaccines are typically given according to the child and adolescent immunization schedule. The schedule shows which vaccines are recommended by age and offers guidance on intervals for…
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The Supreme Court’s Gambit to Take Away Health Care Rights (And More Bad News for Medicaid)
In November of 2022, Medicaid legal and policy experts sat on edge as the Supreme Court heard oral arguments in a case called Talevski, which threatened to do great damage to Medicaid rights. There was a collective sigh of relief when the Court ultimately ruled to uphold Medicaid rights in the case. But most of…
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Children and Youth with Significant Behavioral Health Needs Will Benefit from New Legal Settlements by States Committing to Provide Intensive Home and Community Based Services
Children and youth with serious behavioral health conditions are too often placed in psychiatric residential treatment facilities and psychiatric hospitals due to their challenging behaviors and complex needs. They are also often involved in multiple child-serving systems, such as the child welfare, juvenile justice and special education systems. Medicaid covers 4 in 10 children and…
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The Perfect Storm: How Immigration and Medicaid Policy Changes Are Exacerbating a Student Mental Health Crisis
Before the current wave of immigration policy changes, America’s children were already in crisis. Youth mental health had deteriorated to the point that in 2021, the U.S. Surgeon General issued a public health advisory and the American Academy of Pediatrics, the American Academy of Child and Adolescent Psychiatry, and the Children’s Hospital Association took the…
