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States Mull Pursuit of Rural Health Transformation Money

Support to grow their health care workforce, including new or expanded medical education programs to attract doctors and nurses. Doing more to address chronic medical conditions. Better coordination of care and greater use of technology. Making greater use of telehealth. Improving the local transportation infrastructure as a means of improving access to care. These are among the ideas that health care officials from almost every state discussed recently at a networking workshop held last week by the Health Policy Futures Lab to discuss how states might approach crafting proposals seeking a portion of the first half of the $50 billion [...]

2025-10-07T15:50:11-04:00October 8, 2025|Medicaid, Telehealth|

Medicaid Work Rule May Hit Chronically Ill

The introduction of a work requirement for Medicaid eligibility may have the greatest impact on Medicaid beneficiaries with chronic illnesses. According to a new analysis of the approximately five million people who are likely to lose their Medicaid eligibility between now and 2034 because of the new work requirement introduced in the FY 2026 budget reconciliation bill (the “One Big Beautiful Act Bill,”) more than 85 percent have at least one chronic medical condition and more than 40 percent have at least three such conditions.  The percentages rise, moreover, among current Medicaid beneficiaries over the age of 50. Some of [...]

2025-10-07T13:44:24-04:00October 8, 2025|Medicaid|

Dispute Resolution Continues Despite Shutdown

The No Surprises Act’s Independent Dispute Resolution process continues during the federal government shutdown. The Centers for Medicare & Medicaid Services has issued a notice advising disputing parties to continue submitting disputes for resolutions but warns that a prolonged shutdown could affect the timeliness of the resolution of those disputes. Learn more from this CMS notice.  

2025-10-07T11:52:54-04:00October 7, 2025|Centers for Medicare & Medicaid Services|

Federal Health Policy Update for October 3

The following is the latest health policy news from the federal government for September 26 to October 3.  Some of the language used below is taken directly from government documents. Health Care During the Government Shutdown With the federal government technically without spending authority now that FY 2026 has begun without an approved FY 2026 budget, the federal role in health care will change in some respects and be greatly reduced in others. Medicare and Medicaid will continue to function; previous legislation ensures Medicaid funding through the first quarter of FY 2026.  States will continue to receive federal funding to [...]

Health Care During the Government Shutdown

With the federal government technically without spending authority now that FY 2026 has begun without an approved FY 2026 budget, the federal role in health care will change in some respects and be greatly reduced in others. The Department of Health and Human Services anticipates reducing its workforce by 40 percent during the federal government shutdown while the Centers for Medicare & Medicaid Services anticipates furloughing nearly half its staff.  The Office of Management and Budget has issued a memo encouraging agencies to consider making at least some and possibly many of these furloughs permanent. Medicare and Medicaid will continue [...]

New Medicaid Work Requirement Could Slam Hospital Finances

The Medicaid work/community engagement requirement included in the “One Big Beautiful Bill” Act could cost hospitals millions of dollars –  losses that could translate into potential declines of 11.7-13.3 percent in hospital operating margins, according to a Commonwealth Fund analysis based on Urban Institute data. Not all current Medicaid participants are subject to the new work and community engagement requirements but between 5.5 million and 6.3 million people are expected to lose their Medicaid benefits as a result of those requirements.  Among them, some will be newly unemployed; some will be unable to find work; and some will be employed [...]

2025-09-26T12:02:19-04:00October 1, 2025|hospitals, Medicaid|

Hospitals to Face More Readmissions Penalties in 2026

Hospital readmissions penalties will increase, as will the size of the typical penalty, in the coming year. Beginning in FY 2026, the proportion of hospitals that will be penalized at least one percent for excessive readmissions under the Centers for Medicare & Medicaid Services’ Hospital Readmissions Reduction Program will rise from seven percent of all hospitals to eight percent.  The number of hospitals penalized less than one percent will decline. Hospitals that care for the highest proportions of dually eligible Medicare/Medicaid patients will see their penalties increase slightly. The penalties levied in FY 2026 will reflect hospital performance between July [...]

2025-09-26T10:48:58-04:00September 30, 2025|Centers for Medicare & Medicaid Services, Medicare|

MACPAC Meets

Members of the Medicaid and CHIP Payment and Access Commission met recently in Washington, D.C. The following is MACPAC’s own summary of its two days of public meetings. MACPAC’s September 2025 meeting began with a summary of Public Law 119-21, an Act to Provide for Reconciliation Pursuant to Title II of H. Con. Res. 14 (2025 Budget Reconciliation Act, P.L. 119-21). This legislation included several provisions affecting Medicaid and the State Children’s Health Insurance Program (CHIP). In this session, staff provided a summary of the Medicaid and CHIP-related provisions in the 2025 Budget Reconciliation Act. Staff then presented on work [...]

Federal Health Policy Update for September 25

The following is the latest health policy news from the federal government for September 19-25.  Some of the language used below is taken directly from government documents. Federal Funding for Fiscal Year 2026 Telehealth and Acute Hospital Care at Home Program Flexibilities Many current telehealth flexibilities and authorization for the Acute Hospital Care at Home program will expire on September 30 unless Congress extends them.  The following is CMS’s current guidance on these programs if they are not extended by September 30: The CMS Acute Hospital Care at Home web page advises stakeholders that The Acute Hospital Care at Home [...]

Looking at Potential Health Coverage Losses

Changes adopted in the FY 2026 budget reconciliation bill (“the One Big Beautiful Bill” Act) could result in a significant increase in the ranks of the uninsured across the country. According to an Urban Institute analysis supported by the Commonwealth Fund, if current expanded health insurance premium tax credits end with the beginning of the new federal fiscal year on October 1, 4.8 million more people would become uninsured, a 21 percent increase. 3 million fewer people across the U.S. would get subsidized marketplace coverage. Premiums would soar.  For people earning less than 250 percent of poverty (about $39,000 for [...]

2025-09-18T16:37:45-04:00September 22, 2025|Affordable Care Act, deficit reduction|
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