June 9 Update

In This Week’s Update:

  • One Big Beautiful Bill
  • Coverage Changes in Reconciliation Bill to Impact Non-Citizens 
  • State Innovation Round Up: May 2025
  • Medicaid Cuts Could Increase Maternal Mortality and Jeopardize Women’s Health
  • Projected Outcomes of Removing Fluoride From US Public Water Systems
  • State updates: CA, CO, CT, DC, ID, LA, MA, MD, ME, MN, NJ, NM, NV, NY, OR, PA, RI, VA, VT, WA & WI

One Big Beautiful Bill
Last week, State Health and Value Strategies published an updated toolkit for states, House Budget Bill Medicaid Proposals: State-by-State Estimates of Impacts on Expenditures and Enrollment. Following the passage by the House of the “One Big Beautiful Bill Act” through the budget reconciliation process, Manatt Health updated its toolkit for states which estimates the state-by-state impact over the next 10 years of most of the major provisions in the bill. The estimates take into account the interactions across the provisions included in the Manatt model.

 

Coverage Changes in Reconciliation Bill to Impact Non-Citizens
Also last week, SHVS published a new expert perspective detailing the changes to coverage for non-citizens included in the House reconciliation bill. These changes include elimination of eligibility categories, funding penalties for states that use their own funds to cover non-citizens, and additional verification requirements before coverage can begin. In case you missed it, the National Association of Insurance Commissioners sent a letter to Congress highlighting the challenges for insurance markets stemming from the proposed changes in the bill. Updates follow.

 

State Innovation Round Up: May 2025
SHVS published a new post in our ongoing series, States of Innovation. The post profiles state activity in May 2025, which included states highlighting the value of Medicaid and Marketplace coverage as Congress discusses potential federal cuts, reacting to federal policy, extending Marketplace affordability, efforts to address cost, medical debt, and more. This States of Innovation features updates from Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Dakota, Utah, Vermont, Virginia, Washington, Wisconsin and Wyoming.

 

Medicaid Cuts Could Increase Maternal Mortality and Jeopardize Women’s Health
A new blog post published by the Commonwealth Fund highlights how the proposals to cut Medicaid funding included in the House passed reconciliation bill could put the health and lives of nearly 24 million women at risk. Using data from the Commonwealth Fund’s 2024 State Scorecard on Women’s Health and Reproductive Care, the authors looked at the role Medicaid plays in women’s lives and explored how cuts to Medicaid could significantly worsen women’s health and put their lives at risk. Twenty-four million women rely on Medicaid for everything from maternal health and contraception to vaccinations and cancer screenings. 

 

Projected Outcomes of Removing Flouride From U.S. Public Water Systems
An open access article in JAMA Health Forum shares findings from a cost-effectiveness analysis of cessation of public water fluoridation and associations with oral health outcomes among U.S. children. The analysis used data for 8,484 children (mean age, 9.6 years) from the U.S. National Health and Nutrition Examination Survey for 2013 to 2016 and found that elimination of fluoride would be associated with an increase in tooth decay of 7.5 percentage points and cost approximately $9.8 billion over 5 years. Cessation of fluoridation of U.S. public water systems is projected to worsen oral health in children and to significantly increase national healthcare costs.


State Updates: CA, CO, CT, DC, ID, LA, MA, MD, ME, MN, NJ, NM, NV, NY, OR, PA, RI, VA, VT, WA & WI

  • California
    • Governor Gavin Newsom highlighted the impact of healthcare cuts in the House reconciliation bill, including terminating coverage for up to 3.4 million Californians, a reduction of  $22 billion in federal funding as a result of coverage losses due to work requirements, a cut of at least $4 billion annually for California’s coverage of undocumented residents using state-funds, restricting vital funding mechanisms like provider taxes, and a shut down of Planned Parenthood.
    • The California Department of Health Care Services released data showing that Medi-Cal Community Supports are successful and cost-effective. The data show that Community Supports are reducing avoidable emergency department visits, hospital stays, and long-term care use while showing strong early signs of cost savings. All 12 Community Supports studied are reducing costs, and of these, nine have already demonstrated cost-effectiveness within the initial study period. The remaining three are projected to reach that threshold over a longer study period.
  • Louisiana – The Louisiana Department of Health is promoting early childhood developmental screenings through the Developmental Screening Implementation Training and Support initiative. This program equips healthcare providers with comprehensive resources to integrate the Louisiana Developmental Screening Guidelines into their practices. The guidelines focus on five key domains: general development, autism, perinatal depression, social-emotional development, and barriers to health.
  • Maine – The Maine Department of Health and Human Services published an updated summary of proposed federal changes in the House budget bill and the impact on Maine, including the penalty on federal match due to Maine’s coverage of immigrant populations, work requirements, the moratorium on provider taxes, and the prohibition of federal payments for family planning services and reproductive healthcare. SHVS has updated our expert perspective tracking state estimates of the impacts of proposed federal changes to Medicaid.
  • Maryland
    • The Maryland Health Benefit Exchange is highlighting the impact of the House reconciliation bill on state residents enrolled in Marketplace coverage , including increased premium costs and barriers to enrollment. The elimination of auto-enrollment could result in 43,000 individuals losing coverage, while 24,000 legally present individuals would no longer be eligible.  Additionally, in the absence of extending enhanced premium tax credits (ePTCs) cost increases could result in coverage losses for more than 70,000 people.
    • The Maryland Insurance Administration announced it has received the 2026 proposed premium rates from carriers. In the individual market, carriers are requesting an average rate change of 17.1%, the highest rate increase since implementation of Maryland’s reinsurance program, reflecting the anticipated loss of ePTCs. If Congress were to extend the ePTCs, rate increases would instead reflect an overall average rate change of 7.9%.
  • Massachusetts – The Massachusetts Health Connector published its 2024 annual report to the state legislature highlighting the activities and accomplishments of the Marketplace. Additionally, the new 2024 to 2028 Strategic Plan focuses on simplifying processes, improving user experiences, and making coverage more affordable, particularly for those with chronic conditions.
  • Minnesota – The Minnesota Department of Human Services (DHS) has published a new webpage highlighting the faces of Minnesota’s Medicaid program. The page features stories from the Minnesotans enrolled in the program, their families, and the healthcare providers and county workers employed by the program. DHS invites story submissions from additional Minnesotan enrollees, providers, community advocates, navigators, and county and Tribal staff.
  • New Jersey
  • New Mexico – The New Mexico Health Care Authority and the Administrative Office of the Courts will hold the inaugural meeting of the Behavioral Health Reform Executive Committee established under Senate Bill 3 on Tuesday, June 24. Senate Bill 3 brings together all three branches of government and community leaders to reshape New Mexico’s behavioral health system, and the Executive Committee will guide the law’s implementation and develop strategies to ensure transparency, regional equity, and meaningful public engagement.
  • New York – Governor Kathy Hocul issued a letter to Senate Majority Leader John Thune outlining the impact that the House’s proposed budget would have on residents, and joined Congressman Hakeem Jerffries to sound the alarm. The House bill cuts $13.5 billion in funding for New York’s healthcare economy through cuts to Medicaid and the Marketplace, putting nearly 1.5 million New Yorkers at risk of losing their health insurance. The state also published a new visualization of impacts by congressional district.
  • Nevada – In an effort to better serve Nevadans across all ages and abilities, the Nevada Aging and Disability Services Division (ADSD) has launched a new brand identity. The new brand features a new logo, visuals, and voice that aim to reflect ADSD’s commitment to inclusivity, dignity, and support for all state residents. The goal of this rebranding is to inform as many Nevadans as possible about ADSD’s services and programs and comes after months of research, community engagement, and collaboration with stakeholders to ensure that the new identity resonates with the diverse populations the division serves.
  • Oregon  
  • Pennsylvania – Department of Human Services Secretary Dr. Val Arkoosh, Insurance Commissioner Michael Humphreys, and Pennie Executive Director Devon Trolley highlighted the importance of Medicaid in providing healthcare coverage to millions of Pennsylvanians amid proposed federal cuts to the program, which would terminate coverage for more than 300,000 Pennsylvanians.
  • Vermont – Vermont Green Mountain Care Board, tasked with reviewing health insurance premium rates in the large group and individual and small group markets, announced the 2026 premium rate filings. Requested rate increases from the two participating carriers included a 23.6% and 6.3% increase in the individual market and a 13.7% and 7.5% increase in the small group market.
  • Virginia – Governor Glenn Youngkin signed legislation that requires all hospitals, licensed birthing centers, and free-standing emergency departments to adopt standardized protocols, known as “safety bundles,” for identifying obstetric emergencies for both inpatient and outpatient care.
  • Wisconsin – The Wisconsin Department of Health Services continues to recommend the current COVID-19 vaccine during pregnancy and for every person six months and older to protect from serious COVID-19 illness and to prevent spreading it to others. Wisconsin Medicaid will also continue to cover the current COVID-19 vaccine for eligible Medicaid members, including children and individuals who are pregnant. The state notes: “The recent changes in CDC guidance were not made based on new data, evidence, or scientific or medical studies, nor was the guidance issued following normal processes.”
  • CA, CO, CT, DC, ID, MA, MD, ME, MN, NJ, NM, NY, OR, PA, RI, VA, VT & WA – Leadership of State-Based Marketplaces in 18 states sent a letter to the Senate, describing how the House reconciliation bill restricts access to health insurance and imposes unprecedented restrictions and administrative barriers for consumers to access private health insurance.