In This Week’s Update:

• Calculating the Value of Marketplace Plans 
• Racial and Ethnic Health Disparities in the States
• Oregon’s Regulation of Corporate Influence on Physician Practices
• Communicating About New State Work Requirements
• Toolkit: Implementing H.R.1 Copay Requirements
• State updates: CA, CO, CT, HI, KY, MD, MI, MO, MS, NC, ND, NE, NM, PA, TX & WV

Calculating the Value of Marketplace Plans
The Centers for Medicare and Medicaid Services released the actuarial value calculator (AVC) for 2027 that measures the percentage of healthcare costs covered in the individual and small group markets. A State Health & Value Strategies (SHVS) blog describes the key AVC changes that state regulators should be aware of, including changes that will substantially increase cost-sharing for enrollees. 

Racial and Ethnic Health Disparities in the States
A Commonwealth Fund report analyzes the way healthcare systems are functioning in every state, evaluates differences in health and healthcare across racial and ethnic groups, and points to factors that may be contributing to these gaps. While the report uses the most recent available data, it does not reflect recent and sweeping shifts in federal policy.

Oregon’s Regulation of Corporate Influence in Physician Practices
A state spotlight from Georgetown University’s Center on Health Insurance Reforms describes how Oregon has emerged as an early example of how states can regulate the growing corporate investment in physician practices.

Communicating About New State Work Requirements
SHVS published a messaging guide to help state Medicaid agencies communicate with residents—including enrollees and applicants—about the work reporting requirements under H.R.1.

Toolkit: Implementing H.R.1 Copay Requirements
SHVS published a toolkit supporting states in understanding and implementing H.R.1’s new copay requirements for certain Medicaid expansion enrollees that meet specific income requirements. The toolkit provides an overview of the requirements, proposes an operational approach to ensure compliance, and reduces states’ administrative burden and potential barriers for enrollees.

State updates: CA, CO, CT, HI, KY, MD, MI, MO, MS, NC, ND, NE, NM, PA, TX & WV

• California’s Department of Health Care Services and Smile, California are raising awareness about Medi-Cal Dental benefit changes taking effect on July 1, 2026, including enrollees aged 19 and older who do not meet federal immigration status requirements no longer receiving full-scope dental benefits and transitioning to emergency-only dental coverage.
• Colorado‘s official health insurance Marketplace released its annual Open Enrollment Report, estimating residents are paying approximately $19 million more per month in premiums compared to plan year 2025.
• Connecticut’s governor signed legislation protecting vaccine access by removing the requirement that the state’s standards be linked to those set by the Advisory Committee on Immunization Practices, and establishing the methods to preserve the current vaccine standards. 
• Hawaii‘s Department of Health is hiring a Rural Health Transformation (RHT) Program project analyst. The state also appointed a new Medicaid Director.
• Kentucky’s overdose deaths decreased for the fourth year in a row, with a 22.9% decrease in 2025 compared with the previous year and a 50.8% decrease from 2021. The 2025 Kentucky Drug Overdose Fatality Report highlights that 2025 saw the lowest number of overdose deaths recorded since 2014. 
• Maryland’s Department of Health launched its Medically Tailored Meals program, a free service that provides tailored, freshly prepared, nutritionally balanced meals to support disease management, reduce hospitalizations, and elevate the quality of life for vulnerable residents.
• Michigan’s Department of Health and Human Services launched a statewide Gun Lock Distribution Map to help residents locate free firearm safety devices and expand access to safe storage resources.
• Mississippi‘s governor established the state’s RHT Program Office and launched the official RHT Program website. The governor also deployed $13,464,444 to support mental health systems for children, youth, and students and expand access to mental healthcare, increase telehealth capacity, support health workforce training, and enhance community‑based education efforts.
• Missouri‘s RHT Office is inviting bids for the Strategic Minor Renovations program, a key initiative under the state’s Transformation of Rural Community Health Care model. 
• Nebraska’s Department of Health and Human Services implemented new work requirements for Medicaid enrollees in the expansion category.
• New Mexico’s Health Care Authority is seeking qualified vendors to support key rural and behavioral health initiatives across the state.
• North Carolina’s governor signed a bill fully funding the state’s Medicaid program, calling on the General Assembly to fix “serious flaws” that eliminate health coverage for nearly 27,000 pregnant women and children who are lawfully present and layers administrative red tape, resulting in eligible residents waiting up to three months to receive healthcare benefits.
• North Dakota’s Health and Human Services hired a tribal liaison and a rural healthcare advisor to help guide the RHT Program. 
• Pennsylvania’s Department of Human Services released the first funding opportunity through the RHT Program, making $25 million available to hospitals, healthcare providers, and rural health facilities to support purchase of supplies, equipment and renovations.
• Texas’ Health and Human Services Commission is making $99 million in federal funding available to rural hospitals to help healthcare providers recruit and retain workers.
• West Virginia’s governor released the first tranche of $28.56 million in RHT Program funding opportunities, now open for eligible organizations to apply.