In This Week’s Update:

• Taylor et al. v. Kennedy: Lawsuit Challenging Changes to Medical Frailty
• Engaging Enrollees and Communities in Work Requirements Rollout
• Rural Communities Face Barriers to Work Requirements Compliance
• State Guidance for Evaluating Who Is Subject to Work Requirements
• Replicable State Model for Building Trust in Public Health
• State updates: CO, DC, DE, LA, MA, MD, MI, MN, MO, NC, NM, NV, NY, PA, SC, SD, WA & WV

Taylor et al. v. Kennedy: Lawsuit Challenging Changes to Medical Frailty
Five Medicaid enrollees, several medical professional and physician advocacy organizations, and the city of Columbus filed a lawsuit challenging key provisions of an interim final rule implementing Medicaid work reporting requirements and a new medical frailty definition.

Engaging Enrollees and Communities in Work Requirements Rollout
Effective communication and outreach will be critical as states prepare to implement Medicaid work reporting requirements. State Health & Value Strategies (SHVS) published a toolkit with practical strategies for engaging Medicaid enrollees in work reporting requirements implementation decisions.

Rural Communities Face Barriers to Work Requirements Compliance
A Georgetown Center for Children and Families issue brief outlines how Medicaid work reporting requirements place rural communities at a heightened risk of coverage loss and financial distress. The brief highlights how rural barriers to employment, transportation, and digital resources and elevated rates of chronic disease and disability will make qualifying for an exemption or meeting additional administrative requirements difficult.

State Guidance for Evaluating Who Is Subject to Work Requirements
SHVS published a toolkit that uses real-world scenarios to show how states can apply the law’s stepwise process to determine whether an individual is subject to work reporting requirements and evaluate them for an exception or compliance. Each scenario walks through the evaluation hierarchy, data verification, and noncompliance process for specified exclusions, mandatory and short-term hardship exceptions, and qualifying activities.

Replicable State Model for Building Trust in Public Health
SHVS published a state spotlight highlighting how North Carolina is building trust in public health by grounding its communication strategy in data, centering real people, and aligning messages in state and local systems.

State updates: CO, DC, DE, LA, MA, MD, MI, MN, MO, NC, NM, NV, NY, PA, SC, SD, WA & WV

• Colorado’s Department of Health Care Policy and Financing (HCPF) will host a webinar providing updates on federal changes to Medicaid coverage due to H.R. 1, including how HCPF is preparing and what stakeholders can expect in 2027. Staff will review resources and communication tools to support enrollees, share key updates, and discuss how HCPF will track the impact of H.R. 1. The Division of Insurance released the final approved premium information on private health insurance plans for 2027, which will increase an average 10% in the individual market. Financially assisted residents will see an estimated net premium increase of $20 per month from 2026 to 2027 due to a law enacted this year to provide relief to residents.
• Delaware‘s governor and the Department of Health and Social Services announced nearly $23 million in Rural Health Transformation (RHT) Program funding for three Federally Qualified Health Centers to strengthen healthcare delivery and access for the communities they serve.
• District of Columbia‘s renewal of its section 1115(a) demonstration was approved by the Centers for Medicare & Medicaid Services (CMS), authorizing a title change to reflect the broadened scope and pre-release behavioral health services.
• Maryland‘s Health Benefit Exchange (MHBE) is partnering with Code for America to streamline eligibility and enrollment processes for Medicaid enrollees and caseworkers ahead of federal Medicaid requirements. The partnership will upgrade government technology and workflows and draw on expertise from Maryland Medicaid and nonprofit organizations focused on civic technology. The governor, Department of Human Services, and Department of Health informed SNAP and Medicaid enrollees of new federal work requirements, outlined steps residents can take, and highlighted available state resources in a letter and other notices.
• Michigan’s Department of Health and Human Services awarded $1.5 million to five organizations to help address community violence and strengthen intervention services for groups with the highest likelihood of involvement in firearm violence.
• Missouri‘s Department of Health and Senior Services and Department of Social Services are investing up to $4.2 million to grow the rural emergency medical services workforce by expanding training programs and increasing the number of certified professionals.
• New Mexico’s Health Care Authority selected five organizations to lead bringing better healthcare to rural, frontier, and Tribal communities by helping them access doctors, specialists, and other care close to home and collaborating to identify needs, set priorities, and develop plans for accessible care.
• New York‘s governor announced awards for the Healthcare Access Loan Repayment Program, a $48.3 million student loan repayment initiative designed to expand access to care for Medicaid enrollees and individuals who are uninsured while attracting providers in critical, high-demand roles. The program provides significant financial incentives to qualifying healthcare professionals who commit to four years of employment serving vulnerable populations.
• North Carolina‘s Newborn Screening Program will screen for two additional disorders, Infantile Krabbe Disease and Guanidinoacetate Methyltransferase Deficiency. These screenings are critical for early detection and treatment of many rare, severe, and treatable disorders before symptoms appear. The Department of Health and Human Services expanded donor human milk access sites, making it easier for families to obtain and donate pasteurized donor milk.
• Pennsylvania‘s Insurance Department approved 2027 health insurance premium rates with an average increase of 15.97% and 10.28% in the individual and small group markets, respectively. The Department of Human Services and the Indiana University of Pennsylvania signed an agreement to educate and train students for future roles in rural healthcare at Clarks Summit State Hospital.
• South Caroilna‘s Department of Health and Human Services opened a public input survey on the RHT Program to assess rural health and gather perspectives from residents and healthcare providers.
• South Dakota’s governor awarded 12 Certified Community Behavioral Health Clinic modernization and infrastructure grants, totaling more than $13 million.
• West Virginia‘s governor awarded $291,403 to the WVU Medicine Center for Nursing Education to expand nursing education capacity and address critical nursing shortages, and $500,000 to CHANGE, Inc. to strengthen healthcare delivery, improve chronic disease management, and support healthcare providers serving patients in certain counties.
• Louisiana, Minnesota, and Nevada‘s section 1115(a) demonstrations were approved by CMS, providing coverage for a targeted set of services to certain people who are incarcerated for up to 60 days prior to their expected release date.
• Massachusetts and Washington‘s Health Connector and Health Benefit Exchange announced Marketplace enrollees in the states will not be affected by CMS’ announcement that 750,000 enrollments through the Federal Marketplace will be terminated.