Blog
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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
[Editor’s Note: Read Part 2 of “CMS Weaponizes Fraud Against Medicaid in Minnesota series here.] 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”…
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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…
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Proposed Public Charge Rule Could Increase the Number of Uninsured Children by More than 25 Percent
Georgetown CCF just submitted our comments on the Trump Administration’s proposed rule to lift current rules used to determine whether an immigrant is likely to become a “public charge”. The proposed rule would replace carefully crafted existing regulations with almost unlimited discretion for Department of Homeland Security (DHS) officers to “use their judgment” to determine…
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Medicaid Managed Care in 2025: The Year That Was
The lead story of 2025 is the enactment of H.R. 1, which will dramatically alter the Medicaid coverage and financing landscape over at least the next three years. The primary target of the law’s Medicaid cuts were the 41 states (including DC) that have elected to cover the expansion adults; of these, 34 contract with…
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School-Based Health Services Remain Critical to Keeping Kids Healthy in 2026: New Toolkit Offers a Guide
In Partnership With: Medicaid covers essential student health services, including mental and behavioral health care. From funding school health staffing, direct services and screening programs, to covering assistive equipment and technology for students with disabilities, Medicaid helps to ensure students are able to learn and thrive. As readers of Say Ahhh! know, earlier this year,…
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Getting MAGI Right: When Does Social Security Income Count?
When the Affordable Care Act was implemented, we released a primer on the basics of MAGI – how rules for counting household size and income to determine eligibility for Medicaid and CHIP were changed to align with Marketplace subsidies. The move to MAGI has brought about a number of changes in Medicaid and CHIP, but…
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ACIP’s Hepatitis B Recommendation Threatens Future Vaccine Access Issues for Children and Families
Last week, the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) met for two days to discuss, among other topics, the hepatitis B vaccine. Specifically, the committee heard presentations on and discussed the initial dose of the vaccine, typically given to babies within the first 24 hours of life, before…
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Congress Reauthorized the SUPPORT Act, Now Comes the Hard Part
On December 1, President Trump signed into law the SUPPORT for Patients and Communities Reauthorization Act of 2025, extending a number of substance use disorder (SUD) prevention, treatment, and recovery programs through fiscal year 2030. The bipartisan bill—which passed the House 366-57 in June and the Senate by unanimous consent in September—reauthorizes critical programs including…
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CMS Guidance on Medicaid Work Requirements Leaves States Hanging
CMS released preliminary guidance on H.R. 1’s mandatory Medicaid work requirements on December 8. The much-anticipated guidance fell far short of answering all the questions states need answered, but it did acknowledge that implementing the Medicaid work reporting requirements mandated by the One Big Beautiful Bill (H.R. 1) will be a “serious undertaking for states…
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The Clock is Ticking. Can Congress Prevent an Imminent Spike in Marketplace Premiums on January 1?
Congress has returned to Washington, D.C. from its Thanksgiving break, but has yet to resolve the debate on whether or how to extend enhanced premium tax credits (ePTCs) scheduled to expire on December 31. These enhanced subsidies make coverage more affordable for millions of Americans who buy plans in the Affordable Care Act (ACA) Marketplaces. The clock…
