In This Week’s Update:
- 15 Years of the Affordable Care Act
- Upcoming State Health and Value Strategies Webinar—New CMS Proposed Rule: ACA Marketplace Integrity
- Potential Medicaid Cuts in the Context of State Budgets
- The Economic Costs of Potential Federal Cuts to Medicaid and SNAP
- The ACA at 15: Lesson for Health Reform
- State updates: AZ, CA, CO, IL, LA, MN, NC, ND, NY, OK, OR & PA
Upcoming State Health and Value Strategies Webinar—New CMS Proposed Rule: ACA Marketplace Integrity
Tuesday, April 1, 2025, 2:30 to 3:30 p.m. ET.
State Health and Value Strategies (SHVS) will host a webinar on CMS’ recently proposed regulation that would require several policy and operational changes for the ACA Marketplaces and insurance rules. SHVS recently published an expert perspective which examines the proposed rule, including the impacts on affordability and benefits, administrative requirements, and eligibility. Comments on the proposed regulation are due by April 11, 2025. During the webinar, experts from the Urban Institute and Georgetown University’s Center on Health Insurance Reforms will provide a detailed overview of CMS’ proposed rule and discuss key operational and policy considerations for states. The webinar will also include a question and answer session during which webinar participants can pose their questions to the experts on the line. Registration (required): https://princeton.zoom.us/webinar/register/WN_vvVqUzszR6GihQ0-e3FGFg
Potential Medicaid Cuts in the Context of State Budgets
Medicaid accounts for a large share of state budgets and can be central to state fiscal decisions. Following years of robust revenue growth, states are now contending with weakening tax revenues, budget shortfalls, and uncertainty in their long-term fiscal outlook. At the same time, there are several options under consideration in Congress to significantly reduce federal Medicaid spending. A new brief from KFF explores the magnitude of federal funding cuts under the House budget resolution and puts the $880 billion in context by comparing the size of the cuts to states’ tax revenues, spending on education, and the number of Medicaid enrollees covered for that cost.
The Economic Costs of Potential Federal Cuts to Medicaid and SNAP
A new report from the Commonwealth Fund and the George Washington University Milken Institute School of Public Health warns that potential budget cuts to Medicaid and the Supplemental Nutrition Program (SNAP) could trigger severe economic consequences across all 50 states and the District of Columbia. If implemented, these combined cuts could lead to one million jobs lost, a $113 billion decline in states’ gross domestic products, and $8.8 billion in lost state and local tax revenue in 2026 alone.
The ACA at 15: Lesson for Health Reform
To commemorate the 15th anniversary of the ACA, The Century Foundation and The Commonwealth Fund hosted an event featuring keynote remarks from Speaker Emerita Nancy Pelosi and video remarks from former President Barack Obama, along with other key leaders involved in the ACA’s design, passage, and implementation. A recording of the event is available.
State updates: AZ, CA, CO, IL, LA, MN, NC, ND, NY, OK, OR & PA
- Arizona – Governor Katie Hobbs announced actions to control costs and protect care at the Division of Developmental Disabilities, while also raising concerns about potential legislative cuts in the state that would see residents with developmental disabilities denied services.
- California
- The Department of Health Care Services (DHCS) applied to the Center for Medicaid and Medicaid Innovation to participate in the groundbreaking Cell and Gene Therapy Access Model. If approved, this multi-year initiative will expand Medi-Cal members’ access to lifesaving gene therapies for sickle cell disease, a severe genetic blood disorder that disproportionately affects people of African descent.
- DHCS awarded $800,000 to two local emergency medical service agencies to foster low-barrier access to clinically proven opioid-use disorder treatment for patients who are at risk of overdose and often do not have access to services in other settings. The grants will enable these two agencies to address substance-use disorder as a treatable emergency condition, utilizing paramedics to identify and treat patients who would benefit from medications for addiction treatment.
- Colorado – Connect for Health Colorado, the state’s official health insurance Marketplace, announced that Nina Schwartz has been named Chief Policy and External Affairs Officer. Congrats Nina!
- Illinois – Governor Pritzker attended a community meeting where advocates, providers, and patients shared their stories on the importance of protecting Medicaid, and the negative impact that cuts would have on their lives. One in four Illinoisans—more than 3.4 million people—receive healthcare coverage through Medicaid and are at risk of losing access or seeing their premiums increase under proposed cuts. This includes coverage for nearly half the state’s children, many people with disabilities, and those living in senior or long-term care facilities.
- Louisiana – The Louisiana Perinatal Quality Collaborative is recruiting pediatric providers—including family practices that provide care for infants—to participate in the next 10-month Caregiver Perinatal Depression Screening (CPDS) Learning Collaborative. The CPDS Learning Collaborative is focused on perinatal depression screening in pediatric practices and identifying resources for those who screen positive.
- Minnesota – The Department of Health Services launched a series of statewide roundtables educating residents on the impact of proposed federal cuts to vital healthcare programs. The series launched at Children’s Minnesota Hospital with a meeting of state officials, doctors, patients, and advocates, highlighting state estimates that Minnesota could lose as much as $1.6 billion annually in federal support for healthcare programs serving a wide swath of residents, including children, those who are pregnant, seniors, and people with disabilities.
- New York – Governor Kathy Hochul signed legislation to strengthen New York’s shield law that protects abortion providers from out-of-state prosecution. The bill enhances New York’s current shield law to allow medical providers to include only the address of the dispensing healthcare practice on the prescription label instead of the name of the provider or practice and requires pharmacies to abide by a prescriber’s request to remove their name from the prescription label.
- North Carolina
- CMS approved “North Carolina Hurricane Helene Public Health Emergency Section 1115(a) Demonstration.” Under the demonstration, the state will receive expenditure authority to provide retainer payments to 1905(a) personal care service providers to serve as relief for those experiencing decreases in utilization and temporary practice closures. The demonstration also grants expenditure authority to provide Healthy Opportunities Pilots services to eligible enrollees, regardless of whether they temporarily evacuated the pilot region due to the hurricane.
- The North Carolina Department of Health and Human Services announced students across the state will soon have access to virtual mental healthcare through Hazel Health. Once Hazel is implemented, any student who is enrolled within participating districts will be able to access one of Hazel’s on-staff, licensed therapists before, during, and after the school day.
- North Dakota – North Dakota Health and Human Services completed its five-year needs assessment to identify new or emerging priorities for the maternal and child health population and is inviting public comment on the draft priorities. The following priority areas were identified: 1) Identify, reduce, or eliminate barriers preventing women from receiving recommended postpartum care; 2) Use statewide resources to educate about and implement infant safe sleep best practices; 3) Expand partnerships with existing community resources to improve access to healthy food options; 4) Improve care coordination to link the pediatric population to essential services and resources; 5) Identify, reduce, or eliminate barriers preventing adolescents from receiving mental health treatment and counseling; and 6) Improve the system of care for children with special healthcare needs.
- Oklahoma – Oklahoma Insurance Department Commissioner Glen Mulready is alerting residents enrolled in ACA Marketplace plans that they could see substantial increases in premiums beginning in 2026 if the federal enhanced premium tax credits are not extended. The state anticipates the average cost of a benchmark silver plan in Oklahoma to increase by 65%, which could lead to a significant reduction in the number of insured individuals in the Marketplace, and lead to adverse selection further driving up rates.
- Oregon – Oregon State Treasurer Elizabeth Steiner called on congressional leaders to protect Medicaid from budget cuts alongside other state treasurers. Treasurer Steiner stated that Medicaid cuts will delay and deny healthcare, raise costs, and push more families closer to financial instability. Budget cuts or cost shifts to the state will eliminate jobs and destabilize the healthcare system, especially in rural communities.
- Pennsylvania – Pennsylvania Secretary of Human Services Dr. Valerie Arkoosh highlighted the nation-leading success of combating Medicaid fraud in the Commonwealth with the partnership of State Inspector General Michelle Henry. Pennsylvania leads all states in the number of cases referred for prosecutorial investigation and saved nearly $500 million in expenditures by reviewing third-party liability.
- CA, CO, CT, DC, ID, IL, MA, MD, ME, MN, NJ, NM, NY, OR, PA, RI, VA, VT & WA – The executives of the 19 State-Based Marketplaces sent a letter to Congress to share their collective experiences that emphasize the value and benefit of the enhanced premium tax credit structure set to expire at the end of this year. The letter notes that the window for action to extend the subsidies is closing, as preliminary rates will begin being released this month.