Implementation of 2025 Reconciliation Law: Medicaid Managed Care Rate Setting Uncertainty & Potential Plan Exits
This policy watch examines recent and anticipated managed care rate setting challenges and the potential implications of MCO exits.
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The White House Takes Another Shot at Changing U.S. Childhood Vaccine Recommendations
Policy WatchExamines the White House’s latest Executive Order seeking to reshape U.S. childhood vaccine recommendations, including a directive to separate MMR vaccines and use a new HHS task force for federal recommendations. It finds that the order is unlikely to have an immediate or sweeping effect on U.S. vaccine policy given courts blocked earlier, similar administration actions, and states are increasingly decoupling their policies from federal recommendations.
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The Future of CDC HIV Prevention Funding for Community Organizations
Policy WatchFollowing reports that CDC is ending Community Based Organization (CBO) funding for HIV prevention, this analysis provides a snapshot of where, to whom, and at what level these community grants were distributed in the past grant cycle. We find community organizations stand to lose significant amounts of funding, especially those located in the south.
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Medicare’s Proposed Cut to 340B Drug Payments Would Hit Safety-Net Hospitals While Benefiting For-Profit Hospitals
Policy WatchThis analysis finds that CMS’s proposed cut to Medicare reimbursement for 340B drugs, and accompanying increase for other outpatient services, would reduce revenues among safety-net hospitals while increasing revenues among for-profit hospitals.
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Medicare Advantage Insurers Deny Prior Authorization Requests for Post Acute Care at Substantially Higher Rates Than the Overall Denial Rate
Policy WatchTwo recent reports find that Medicare Advantage organizations deny prior authorization requests for long-term care hospital, inpatient rehabilitation hospital, and skilled nursing facility stays at higher rates than requests overall. When these decisions are appealed, they are frequently overturned, particularly for skilled nursing facility stays. This may cause delays for Medicare beneficiaries who are particularly vulnerable or have high care needs.
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Medical Frailty and Medicaid Work Requirements: Challenges for People with HIV
Policy WatchThis analysis examines Medicaid work requirements and the implementation of medical frailty exclusions for people with HIV in light of CMS's implementing regulation.
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How Has Projected Medicaid Spending and Enrollment Changed Since Passage of the 2025 Reconciliation Law?
Policy WatchCBO’s latest projections of Medicaid spending and enrollment from February 2026 show how enrollment and spending are expected to change over the next decade, accounting for the historic policy changes and their expected reductions in future federal Medicaid spending, as well as other economic and technical changes. This policy watch compares CBO’s February 2026 projections of Medicaid spending and enrollment to earlier CBO projections.
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Tennessee Plans to Share Data on Children with Disabilities with Immigration Authorities
Policy WatchThis policy watch discusses a recent Tennessee law that requires the sharing of data for applicants and/or enrollees for the state's public assistance programs who do not have a qualified immigration status with immigration authorities, including for those enrolled in the state's Children's Special Services program, which serves children with disabilities.
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Tracking Insurer Participation Changes in the ACA Marketplaces in 2027
Policy WatchThis interactive tracks announced insurer exits from and entries into the ACA Marketplaces for 2027.
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A Closer Look at North Carolina’s Implementation of the 2025 Reconciliation Law Medicaid Provisions and Other Changes Amid Medicaid Budget Shortfalls
Policy WatchThis policy watch provides initial insight into how North Carolina is preparing to implement certain Medicaid provisions of the 2025 reconciliation law and how other policy changes may affect coverage and access to care.