Blog
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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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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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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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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…
