In This Week’s Update:

• States of Innovation: June 2025
• Medicaid Expansion Improves Cancer Survival Among People in Rural and High-Poverty Communities
• Supporting Families and Improving Care for Children with Medical Complexity
• State and Congressional District Medicaid Estimates
• State updates: AZ, CA, CO, CT, DC, DE, ID, MA, MD, ME, MI, MN, NC, ND, NJ, NM, NY, OR, PA, RI, SC, TX, VA, VT, WA & WI

 

States of Innovation: June 2025
SHVS published the latest post in its States of Innovation series. The series highlights what states are working on to achieve better, more affordable and more equitable health for all. This States of Innovation profiles state activity in June, which included states highlighting the value of Medicaid and Marketplace coverage as the Congressional budget reconciliation process advances. Throughout June, states also advanced policies to improve healthcare affordability and expand access to care such as maternal and infant health, reproductive and women’s health, and mental and behavioral health.

 

Medicaid Expansion Improves Cancer Survival Among People in Rural and High-Poverty Communities 
A study by researchers at the American Cancer Society shows Medicaid expansion significantly improved five-year cause-specific cancer survival and overall survival among people residing in rural and high-poverty communities. The researchers analyzed all tumors diagnosed during 2007 through 2008 (pre-Medicaid expansion) and 2014 through 2015 (post-Medicaid expansion). Researchers stress improvements in long-term survival, especially among high-poverty and rural communities, underscoring the importance of maintaining Medicaid expansion and implementing expansion in the 10 remaining states to broadly cover low-income adults and help reduce disparities in cancer survival outcomes.

 

Supporting Families and Improving Care for Children with Medical Complexity
A Manatt Health white paper on the Family Certified Nursing Assistant (CNA) model of care describes how the model helps keep children with medical complexity in their homes and out of hospital or institutional settings while creating potential cost-savings for states. The Family CNA model has been adopted by a small but growing number of state Medicaid programs (see the paper for the full list) and expands access to home-based healthcare for children with medical complexity by training and reimbursing family members—including parents and guardians—to provide certain types of home care, such as low acuity in-home nursing tasks. The paper highlights the unique benefits of the model, including helping to address workforce shortages, improving the continuity and quality of care, and strengthening families’ agency; and it identifies actions that federal and state policymakers can take to better support family caregivers and expand access to the Family CNA model. 

 

State and Congressional District Medicaid Estimates
SHVS published an updated analysis of the Senate-passed bill, including state-by-state estimates of Medicaid coverage and impacts on Medicaid and hospital expenditures, including estimates at the Congressional District-level.

 

State Updates: AZ, CA, CO, CT, DC, DE, ID, MA, MD, ME, MI, MN, NC, ND, NJ, NM, NY, OR, PA, RI, SC, TX, VA, VT, WA & WI

 

• Arizona – The Arizona Health Care Cost Containment System (AHCCCS) announced the launch of its improved Online Provider Directory, designed to make it easier for members to find AHCCCS-enrolled providers who meet their unique healthcare needs. The directory pulls real-time data from the AHCCCS Provider Enrollment Portal and is updated daily, ensuring users have access to the most current provider information available.
• California – California Attorney General Rob Bonta, leading a multistate coalition, filed a lawsuit challenging the HHS decision to provide unfettered access to individual personal health data to the Department of Homeland Security, which houses Immigration and Customs Enforcement.
• Delaware – Governor Matt Meyer signed Senate Bill 180, which gives authority to the Board of Pharmacy to modernize Delaware’s licensure system, including specific provisions to better prepare for and manage emergencies in the state. The legislation makes it easier for pharmacies to distribute prescriptions efficiently and timely for patients.
• Minnesota – CMS approved Minnesota’s request to amend its section 1115 demonstration, titled “Minnesota Prepaid Medical Assistance Project Plus.” The amendment authorizes the state to extend Medicaid eligibility for individuals under age 26 who were in foster care and enrolled in Medicaid when they aged out of the foster care system. In addition, the amendment enables the state to enroll individuals into the eligibility group serving former foster care children, regardless of whether they are eligible for or enrolled in a separate mandatory eligibility group.
• New Jersey – Governor Murphy signed legislation to permanently eliminate fees consumers were required to pay when they appealed their health insurance carrier’s decisions under the Independent Health Care Appeals Program, an external review program administered by the Department of Banking and Insurance.
• New York – Governor Kathy Hochul highlighted an analysis from the Greater New York Hospital Association and the Healthcare Association of New York State, which estimates a total $8 billion in cuts to New York’s hospitals and health systems alone due to the budget reconciliation bill. Also, New York State of Health published a webpage which highlights the impact of the reconciliation budget bill on New York, including estimated coverage losses of over one million Medicaid enrollees, 730,000 Essential Plan enrollees, and 65,000 to 80,000 enrollees in qualified health plans.
• North Carolina – The North Carolina Department of Health and Human Services hosted a virtual educational briefing for members of the media on Medicaid provisions in the budget reconciliation bill. The briefing outlined the major differences between the House and Senate budget proposals, including how each could affect access to healthcare and nutrition assistance.
• North Dakota – North Dakota Health and Human Services (HHS) is seeking public comment on proposed amendments to two Medicaid children’s waivers that expand access to services for qualifying children. The autism spectrum disorder waiver provides services to eligible children and supports parents in their efforts to maximize their child’s development, while also preventing out-of-home placements. The Medicaid waiver for medically fragile children allows Medicaid to pay for services for children between the ages of 3 to 18 who are medically fragile.
• Pennsylvania 
  • The Shapiro administration released data on how many Pennsylvanians will lose Medicaid and SNAP benefits as a result of the budget reconciliation bill. Statewide, nearly 144,000 Pennsylvanians who receive SNAP could lose their access to critical food assistance, while 310,000 Pennsylvanians could lose Medicaid coverage.
  • Ahead of last week’s meeting of the CDC Advisory Committee on Immunization Practices, Governor Shapiro, Pennsylvania Secretary of Health Dr. Debra Bogen and Pennsylvania Insurance Commissioner Michael Humphreys advised against vaccine recommendation delays in order to protect Pennsylvania families by ensuring timely access to vaccines.
• Rhode Island – Governor Dan McKee signed into law legislation to allow 90-day prescriptions for ADHD medications. Until now, Schedule II drugs were limited to a 30-day supply. Over the last two years as the nation has experienced a shortage of the prescription drugs to treat ADHD, the 30-day limit meant a time-consuming monthly hassle for those who rely on them, sometimes resulting in hours of phone calls and long drives to locate a pharmacy that had the drug at the proper dosage in stock
• South Carolina – Governor Henry McMaster signed a behavioral health restructuring bill, S.2, into law—establishing the Department of Behavioral Health and Developmental Disabilities. The legislation merges the former Department of Mental Health, Department of Disabilities and Special Needs, and Department of Alcohol and Other Drug Abuse Services into a single, cabinet-level agency directly accountable to the governor.
• Texas – CMS approved a five-year extension of the “Healthy Texas Women” section 1115 demonstration. The approval provides new authority for the state to expand the benefit package to include additional postpartum services and move the demonstration from fee-for-service to managed care.
• Virginia – Governor Youngkin and the Virginia Department of Medical Assistance Services announced the launch of the Cardinal Care Managed Care program which aims to modernize healthcare delivery and enhance the care and support provided to Virginians served by the program.
• Washington
  • Insurance Commissioner Patty Kuderer convened the first meeting of an advisory board to examine the insurance industry’s use of AI and make recommendations on policy development, regulatory oversight, and consumer education efforts.
  • The Washington State Health Care Authority (HCA) announced that Fred Meyer is the first major pharmacy chain to participate in HCA’s Lock Up Your Meds safe storage program. The safe storage program supplies participating Washington pharmacies with free medication locking devices to distribute to patients with opioid prescriptions, as part of an ongoing effort to help prevent opioid misuse and overdose deaths in Washington’s communities.
• Wisconsin – The Wisconsin Supreme Court released a decision protecting access to abortion care in the state.
• CO, MA, MD, ME, MI, NC, NM, NY, OR & RI – Following the U.S. Senate’s passage of the budget reconciliation bill, governors in several states issued statements opposing the legislation: Colorado, Maine, Maryland, Massachusetts, Michigan, New Mexico, New York, North Carolina and Rhode Island. Oregon’s state treasurer issued a similar statement.
• CA, CO, CT, DC, ID, MA, MD, ME, MN, NM, NY, OR, PA, RI, VA, VT & WA – Last week, leadership from State-Based Marketplaces in 17 states released a statement on protecting coverage in the Marketplaces by extending the enhanced premium tax credits and rejecting policies in the reconciliation bill that would result in millions of Americans losing their health coverage.