In This Week’s Update:

• New SHVS resources
• Ensuring Continuous Coverage for Pregnant and Postpartum Medicaid Enrollees 
• SNAP Work Requirements Screener
• State Trends in Medicaid Coverage of Doula Services
• Marketplace Enrollment Significantly Decreased in 2026 
• State updates: AZ, CA, IL, MN, MT, NE, NJ, PA, SC, VA & WA

State Health and Value Strategies (SHVS) published three new resources for states:

• How to Talk About Medicaid Work Reporting Requirements: Language Recommendations for State Communicators is intended to support states and key partners as they explain work reporting requirements in H.R.1 and create clear, linguistically and culturally appropriate materials for people enrolled in or eligible for Medicaid.
• Medicaid Budgeting in Hard Times: Lessons Learned from Arizona provides recommendations for state Medicaid programs as they grapple with tighter state budgets and increasing economic uncertainty.
• How States Are Using the RHT Program to Advance Food Is Medicine Interventions highlights select state initiatives and activities that propose leveraging the Rural Health Transformation (RHT) Program to advance Food Is Medicine and other food and nutrition interventions.

Ensuring Continuous Coverage for Pregnant and Postpartum Medicaid Enrollees
A new brief from the Urban Institute analyzes Medicaid claims data to estimate how many pregnant and postpartum women enrolled in the Medicaid expansion category may be at risk of coverage loss under H.R.1. The brief also shares operational challenges states may face in ensuring continuous coverage for pregnant and postpartum enrollees and outlines potential strategies to mitigate coverage disruptions.

SNAP Work Requirements Screener
The Supplemental Nutritional Assistance Program (SNAP) Requirements Screener provides tailored information about whether an individual might be exempt, required to comply, or should consult their state agency about reporting SNAP work requirements. The screener is designed to give a quick, preliminary indication of work requirement status so people can better understand eligibility implications and next steps before contacting a caseworker.

State Trends in Medicaid Coverage of Doula Services
Many states provide Medicaid coverage for doula services to enhance the perinatal health workforce and support access to care. The National Academy for State Health Policy (NASHP) published an updated analysis of Medicaid coverage of doula services and an updated tracker of state Medicaid approaches to doula benefits.

Marketplace Enrollment Significantly Decreased in 2026
CMS released 2026 open enrollment period public use files, which show that overall Marketplace enrollment fell by 4.9%–with variations across states–and more consumers shifted to lower metal level coverage.

State updates: AZ, CA, IL, MN, MT, NE, NJ, PA, SC, VA & WA

• Arizona’s governor announced the launch of the official Arizona RHT Program website. As a reminder, SHVS continues tracking state RHTP implementation.
• California released an impact report on the first year of its Justice-Involved Reentry Initiative. 
• Illinois’ Department of Health launched a “30 Days of Public Health” initiative to raise awareness of the role they play in promoting health equity across the state.
• Minnesota received CMS approval on a five-year extension of the “Minnesota Substance Use Disorder (SUD) System Reform” section 1115 demonstration waiver. The state will continue receiving funds for Medicaid services provided to enrollees primarily receiving treatment and/or withdrawal management services for a SUD while they are short-term residents in facilities.
• Montana’s Department of Public Health and Human Services (DPHHS) launched a new website designed to help residents navigate upcoming changes to the state’s Medicaid program as a result of H.R.1. DPHHS is also seeking proposals to launch and implement the Rural Health Center of Excellence as part of the RHT Program. 
• Nebraska’s Department of Health and Human Services is seeking applications for each of the six newly established RHT Program Health Care Advisory Regions (HCARs) in Nebraska. HCARs are being established across Nebraska to provide structured, region-specific healthcare insights and coordinated input into RHT Programs.
• New Jersey’s governor signed legislation to eliminate selective restrictions for advanced practice nurses practicing in New Jersey. 
• Pennsylvania unveiled Pennsylvania’s Maternal Health Strategic Action Plan, “Healthy Moms, Vibrant Futures.” The comprehensive multi-agency plan is the first in Pennsylvania and contains strategic goals, data, research, and recommendations to combat maternal health disparities.
• South Carolina hosted a stakeholder meeting on the RHT Program, providing an overview of the state’s vision and goals as well as the grant opportunities. SCDHHS also posted a frequently asked questions document on the RHT Program.  
• Virginia’s governor signed several bills to make healthcare more affordable and accessible. The state’s Insurance Marketplace announced that pregnancy is now a qualifying life event for a special enrollment period.
• Washington’s Health Care Authority announced its new Medicaid Director, effective April 1. The governor announced that the state is joining the World Health Organization’s Global Outbreak Alert and Response Network, a coordinated worldwide partnership dedicated to monitoring and responding to global disease outbreaks.