Hello Readers and Happy Summer!
In this edition of Health Policy News, we highlight four articles examining key developments in health policy, Medicaid programs, and healthcare delivery. This month we feature an article exploring the opportunities and benefits for states to evaluate implementation of community engagement requirements. This month edition also explores updates related to H.R. 1 Medicaid implementation, and federal Health Benefit Exchange rules, and how Medicaid supplemental funding supported EMS service expansion in a rural community. Together, these articles demonstrate how evolving regulations, program administration, funding mechanisms, and policy decisions continue to shape coverage, access to care, and service delivery across states and communities.
Federal Medicaid Community Engagement Requirements: Monitoring and Evaluation Considerations and Opportunities for States
As states prepare to implement the Medicaid community engagement requirements established under H.R.1, CMS has released new guidance outlining monitoring and reporting expectations beginning in 2027. While states will be required to track and report key data related to enrollment, eligibility determinations, processing timelines, and compliance, the rule does not require the sort of comprehensive independent evaluations required for Medicaid Section 1115 Waivers. The article explores opportunities for states to build on existing reporting requirements to better understand how community engagement policies may affect coverage, access to care, health outcomes, administrative costs, employment, and other program measures, while identifying lessons learned and informing future policy decisions. To read the full article, Click Here.
H.R.1 Medicaid Implementation Update: Litigation Over the Community Engagement Rule and Recent CMS Guidance
Recent developments related to H.R. 1 Medicaid implementation continue to shape how states prepare for upcoming policy and operational changes. The latest developments include a lawsuit filed by 25 states and the District of Columbia challenging CMS’s Medicaid Community Engagement Requirement Interim Final Rule (IFR); additionally, CMS has released new guidance and proposed rules addressing Medicaid State Directed Payments, Medicaid Section 1115 Waiver budget neutrality, provider taxes, and Medicaid eligibility redeterminations related to immigration status. Together, these developments highlight the evolving federal policy landscape and key considerations for states as they work to comply with new Medicaid requirements and implementation timelines. To reach the full article, Click Here.
Major Provisions of the Exchange Rules On Hold Pending Legal Challenge
The Federal Health Benefit Exchange Rules are once again being challenged in the courts. Similar prior lawsuits in 2021 and 2025, a coalition of municipalities, providers, and small businesses, have filed a lawsuit challenging a number of the provisions of the Notice of Benefit and Payment Parameters for 2027. On July 16, 2026. the judge in the case of City of Columbus v. Kennedy issued a preliminary injunction barring the enforcement of eight of those provisions. For more on the provisions being challenged, the impact of the ruling, and what is likely to come next, Click Here.
What Sandoval County’s Experience Reveals About EMS Sustainability
Through strategic investment and Medicaid supplemental funding, Sandoval County expanded EMS services and created a stronger foundation for emergency care in rural communities. The county serves a large geographic area that includes multiple communities and Tribal Nations, which can present challenges for healthcare delivery and emergency response. To address these needs, county leaders pursued a long-term funding approach to support EMS infrastructure, staffing, and service capacity. To read the full article, Click Here.
Leave a Reply