State Health and Value Strategies’ States of Innovation series profiles the latest health news at the state level, highlighting what states are working on to achieve better, more affordable, and more equitable health for all. This States of Innovation highlights state activity in May 2024 which includes state efforts to address affordability, increase access to children’s coverage and care, engage the community and advance health equity. States also took action on maternal and reproductive health, access to mental and behavioral health, and coverage for justice-involved populations. This States of Innovation features updates from Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Georgia, Hawai’i, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, Nevada, North Carolina, Oregon, Pennsylvania, Rhode Island and Tennessee.

State updates as of June 7, 2024.

The Child and Adult Core Sets were established to measure the quality of care for Medicaid and Children’s Health Insurance Program enrollees, nationally and at the state level, based on a uniform set of measures. Beginning in 2025, states will be required to report a subset of Child and Adult Core Set measures by race and ethnicity, sex, and geography. This expert perspective highlights the Core Set measures subject to stratification and describes how the Core Sets serve as a critical tool to monitor health disparities. By requiring data disaggregation for key populations of interest, policymakers, advocates and researchers will have a new tool to measure, monitor and inform policies and practices that focus on health equity.

State updates as of May 31, 2024.

States are increasingly identifying and implementing Medicaid managed care (MMC) strategies to confront longstanding and persistent health inequities and improve culturally and linguistically appropriate care. State Health and Value Strategies continues to support states’ efforts with updates to the Compendium of Medicaid Managed Care Contracting Strategies to Promote Health Equity, which describes nine approaches states are taking within their MMC programs to promote health equity. The latest edition features examples from more than 20 states, including Florida, Georgia, New Hampshire, New Mexico, and Rhode Island, five states that are new to the Compendium. This expert perspective highlights an MMC approach that was newly added to the Compendium.

State updates as of May 24, 2024.

State updates as of May 17, 2024.

On April 26, the U.S. Department of Health and Human Services Office for Civil Rights released a final rule interpreting section 1557 of the Affordable Care Act , which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability. This expert perspective reviews the implications of the rule for state policymakers.

As states continue to explore new ways to reach Medicaid and Marketplace members with targeted messages and updates about their coverage, many have incorporated SMS text messaging into their communications plans. This expert perspective highlights strategies and recommendations for states that are considering or currently implementing text messaging in their outreach plans to support states as they look to optimize text messaging in their Medicaid and Marketplace communications and outreach efforts.

The healthcare affordability crisis has resulted in an estimated 100 million Americans, or 41% of adults, holding some form of medical debt. The consequences of medical debt are profound, from financial strain to worsened health outcomes, and there are significant health equity implications. States are moving to eradicate medical debt for low income residents and protect residents from the financial consequences. This expert perspective highlights state action to cancel medical debt and/or prohibit medical debt reporting.