The budget reconciliation process is continuing to move forward in Congress and includes developing proposals in the House to identify $880 billion in federal savings over the next ten years, the vast majority of which will need to come from Medicaid. To support states in informing and validating their own fiscal and program impact estimates of federal policy changes, Manatt Health has developed, with support and input from State Health and Value Strategies, a new toolkit providing national and state-by-state data on the potential impact of key cuts under consideration in Congress. This expert perspective provides an executive summary of the toolkit and has been updated to include estimates of state-by-state impacts of making work requirements a condition of Medicaid eligibility.

On February 26, President Trump signed an executive order (EO), Implementing the President’s “Department of Government Efficiency (DOGE)” Cost Efficiency Initiative. The EO introduces new requirements and limitations for “covered contracts and grants.” This expert perspective discusses the EO and why it is unlikely to impact mandatory healthcare program spending, such as federal Medicaid matching payments, or premium tax credits provided through the Marketplace.

On January 15, 2025, the Centers for Medicare & Medicaid Services released updated State Health Official letter and Frequently Asked Questions guidance, replacing a previously issued SHO letter and FAQs on the requirement in the Consolidated Appropriations Act, 2023 that states provide 12 months of continuous eligibility for children and youth under the age of 19 in Medicaid and the Children’s Health Insurance Program, effective as of January 1, 2024.

On December 10, 2024, the Centers for Medicare & Medicaid Services released an updated CMCS Informational Bulletin (CIB) that refines CMS’ descriptions of opportunities for states to cover clinically appropriate and evidence-based services and supports that address health-related social needs (HRSN) in Medicaid and the Children’s Health Insurance Program. This expert perspective summarizes the CIB.

On November 14, 2024, CMS released its second installment in its series of Medicaid and CHIP guidance intended to support state efforts to verify eligibility and conduct renewals in compliance with federal Medicaid and CHIP requirements. A new expert perspective summarizes the latest CMCS Informational Bulletin and accompanying slide deck which address the continued use of unwinding-related section 1902(e)(14) waivers beyond the previously established expiration date of June 30, 2025.

On September 26, 2024, the Centers for Medicare & Medicaid Services (CMS) released comprehensive guidance, accompanied by a summary slide deck, reinforcing and clarifying federal Medicaid requirements regarding Early and Periodic Screening, Diagnostic, and Treatment (EPSDT). This expert perspective provides an overview of CMS’ new EPSDT guidance, which represents CMS’ most comprehensive discussion of EPSDT requirements in over a decade.

On September 9, the Centers for Medicare & Medicaid Services (CMS) released a new collection of federal Medicaid and CHIP reporting templates designed to assist states in monitoring Mental Health Parity and Addiction Equity Act (MHPAEA) compliance in Medicaid and CHIP. Informal public comment is requested by December 2, 2024. This expert perspective reviews the reporting templates to highlight considerations for states and support the formulation of comment submissions.

In today’s dynamic digital landscape, state Medicaid agencies and Marketplaces have various tools to reach their audiences efficiently and effectively with important information. WhatsApp, a globally adopted direct messaging platform, has risen in popularity with users in the U.S. and shown increased potential for reaching specific populations. While WhatsApp is commonly used as a direct-to-consumer tactic, this expert perspective explores strategies and best practices for states that are interested in using WhatsApp in their member outreach and support efforts.

On July 23, 2024, the Centers for Medicare & Medicaid Services released a State Health Official letter, “Provisions of Medicaid and CHIP Services to Incarcerated Youth.” The letter provides implementation guidance on the Consolidated Appropriations Act, 2023 requirements that states provide specific services for children and youth eligible for Medicaid and CHIP and involved in the juvenile justice system. The SHO letter also offers states the option to provide full scope Medicaid and CHIP services to justice-involved eligible children and youth. The effective date for the provisions in the SHO letter is January 1, 2025. This expert perspective reviews the SHO letter in detail and highlights key considerations for states. 

On June 26, 2024 the Centers for Medicare & Medicaid Services (CMS) released the Notice of Funding Opportunity (NOFO) for the Transforming Maternal Health (TMaH).  This expert perspective summarizes the key takeaways pertaining to the model. CMS recommends that states submit a letter of intent to apply for the TMaH model and these optional letters of intent are due on August 8, 2024. Applications to participate in the model are due on September 20, 2024.