Weekly Roundup -
January 21, 2026
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Unmatched Healthcare Insights from 黑料不打烊,
Leavitt Partners & Wakely.
Featured:
Analysis of the Costs and Medicaid Payment Adequacy for Ground Ambulance Services in New York State
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Webinar Replay – 2027 ACA Considerations: Proposed NBPP and Other Key Changes and Trends
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Outlook 2026: ACA Marketplace Trends鈥揂 Conversation with Michael Cohen and Zach Sherman
As the 2026 Affordable Care Act (ACA) Marketplace open enrollment period nears its close鈥攁nd with enhanced subsidies expiring, rates shifting, and consumer behavior evolving鈥攓uestions about enrollment stability, affordability, and operational readiness have rapidly moved to the forefront. Andrea Maresca, Senior Principal, at 黑料不打烊, caught up with Zach Sherman, Managing Director for Coverage Policy and Program Design at 黑料不打烊, and , PhD, who leads much of the federal policy analysis advanced by Wakely, an 黑料不打烊 company, to unpack what they鈥檙e seeing so far.
Q: This year鈥檚 open enrollment period has been unusually complex. At the federal level, what stands out most so far?听
Michael:听The headline is that new enrollment is down sharply, while returning consumers have held steadier than expected. That reflects the reality that the enhanced subsidies are gone, premiums have risen, and consumers are facing higher net costs across听nearly every听market.听
But nuance matters:听The real question now is how many of these plan selections will effectuate鈥攎eaning consumers听pay their first month premium,听and how many will stay enrolled the entire year?听Average effectuated enrollment throughout the year听is what truly听determines听2026 risk mix and market stability.听
Q:听Enrollment appears to vary听considerably from听state to听state.听What听are you hearing from state partners?听
Zach:听It鈥檚 a tale of two markets. StateBased Exchanges (SBEs) are generally seeing less attrition and, in some cases, even modest increases in plan selections. The reason is simple: Many states are doing a lot of heavy lifting to offset the loss of federal support.听
For example,听SBEs perform听earlier and听have听more customized outreach.听We鈥檝e听also seen some states step in and offer state-funded subsidies, which are cushioning the affordability loss in places like New Mexico, Maryland, and California.听
While still early, the data suggest that states with heavy investment in awareness and enrollment assistance, operational support, and affordability are weathering the transition better because they have more tools to stabilize the consumer experience.听
Q:听There鈥檚听been a lot of speculation about how consumers are responding to the end of enhanced subsidies. What are the early signs?听
Michael:听Consumers听appear to be听buying leaner benefits or different metal tiers听to manage premium increases.听
Another underrecognized听but incredibly important听dynamic is that听autoreenrolled听consumers may not听effectuate听coverage once they see the final听outofpocket听premium. That dynamic听won鈥檛听be fully understood until听March, April,听and听even May.听
Q:听Idaho is a particularly interesting early case study. What are you learning from the first state to complete enrollment?听
Zach:听Your Health Idaho鈥檚听open enrollment听finished听on December 15,听and听while they saw a slight increase in听plan selections, state officials听are not celebrating as they听expect a large wave of cancellations鈥攗p to 20,000鈥攄ue to听the expiring subsidies.听
That鈥檚 the clearest early indication that affordability is the defining issue of 2026. States are preparing for higher-than-usual enrollment attrition in quarters one and two (Q1 and Q2), and they鈥檙e thinking hard about customer service capacity as consumers navigate changing net premiums, increased deductibles and out-of-pocket costs, and nonpayment grace periods.听
Q: Are there policy levers听states听can still pull to mitigate affordability challenges going forward?听
Zach:听We鈥檙e听seeing听states explore听options听for mitigating affordability gaps and enrollment losses, including听through听state subsidy programs and increased investment in existing reinsurance programs.听SBEs are听also leaning听on听their core听competencies鈥攖ailored and specific education campaigns and听enrollment and听plan comparison听tools鈥攖o听help their customers cut through the noise and navigate to the best听option听within their听budget.听听
These听aren鈥檛听perfect or听quick听fixes听and听most听states听don鈥檛听have the听resources necessary to backstop听the expiring subsidies, but state leaders increasingly view听doing something听as necessary to stabilize their markets.听
Q: What should health plans, exchanges, and policymakers watch most closely over the next three months?听
Michael:听Effectuation, effectuation, effectuation. The composition of the effectuated population will define 2026 risk.听
Zach:听Agree. In addition, future regulatory action on affordability, eligibility and enrollment processes, and program integrity. The federal government is expected to issue its annual payment notice, the proposed 2027 Notice of Benefits and Payment Parameters, in the near future.听
You can find more insights on the听initial听enrollment听patterns to date in this听黑料不打烊-Wakely paper,听听and register for the听2027 ACA Considerations: Proposed NBPP and Other Key Changes and Trends.听听
Preparing for Change: A Look at Proposed State Fiscal 2027 Budgets
As of January 1, 2026, nine governors had released proposed budgets for state fiscal year (SFY) 2027. With the phase down of federal funding and substantial policy changes approved in the 2025 budget reconciliation act (P.L. 119-21, OBBBA), these proposals offer insights into how governors plan to manage mounting fiscal pressures, navigate new federal mandates, and position their programs for long-term sustainability.听
Today,听黑料不打烊 Information Services (黑料不打烊IS)听published its first preliminary听review of听proposed听SFY听2027听budget proposals.听The听initial听installment includes budgets from听Alaska, Colorado, Florida, Mississippi, New Mexico, South Dakota, Utah, Virginia, and Wyoming, with听the latter two听proposals covering听the fiscal 2026鈥�28听biennium.听
黑料不打烊IS听will听release听periodic听updates听as听additional听governors publish their听budget听proposals鈥攖he听same rolling approach we used听in 2025 (here听and听here).听Because 15听states听enacted 2025鈥�27听biennial听budgets last year, 黑料不打烊IS听also听might听review听substantial听mid-biennium听health-related听adjustments or听supplemental funding.听
The听remainder听of this article听provides a snapshot of several听notable听themes and听emerging trends detailed in the full听report.听
Implementation听of New Federal Requirements听
State leaders are preparing budgets for听SFY听2027听at a time of heightened fiscal stress and structural uncertainty. Entering 2026, governors are听facing听reductions in federal funding,听particularly in Medicaid and Supplemental Nutrition Assistance Program (SNAP)听funding.听In听addition,听they are听preparing for听new federal requirements听that will begin to take听effect听later this year, including听narrower flexibilities for financing and听Medicaid community engagement听policies听and听more frequent eligibility redeterminations.听
Against this backdrop, governors are using FY 2027 budget proposals to听comply with听OBBBA鈥檚 mandates听and听to stabilize their safety听net programs and realign state operations around stricter fiscal realities.听
Medicaid听Work Requirements.听Virginia鈥檚听proposed budget includes听funding to implement federal Medicaid community engagement requirements,听including听a recommendation to add听nine new authorized positions in听SFY听2027 and 12听more听in fiscal听year听2028听to meet workload demands.听In addition,听South Dakota鈥檚 governor proposed amending听the听state鈥檚听2026 budget听to听secure funding听to implement听these听requirements.听
Eligibility and Redetermination.听Several听governors are听proposing听investments to support heightened eligibility checks across Medicaid, SNAP, and听Temporary Assistance for Needy Families (TANF).听For example,听Colorado听Gov.听Jared Polis鈥檚听budget proposes听$19.1 million听to improve听the state鈥檚听eligibility system for programs such as Medicaid,听SNAP,听and听TANF.听Utah鈥檚 proposed budget听includes a recommended allocation of听nearly $16.5 million听to the Department of Workforce Services for 鈥淗.R.听1 Medicaid Eligibility Administration,鈥� and听nearly $10 million听for the 鈥淗.R.听1 SNAP Administrative Services.鈥�听
SNAP Changes.听States are backfilling lost federal funding and investing in error听reduction and听system听modernization.听New Mexico Gov.听Michelle Lujan Grisham鈥檚 proposed budget, for example,听includes $37 million to replace the decrease in federal funding for SNAP administration ($4 million of which will support 150 new full-time positions), as well as $8.9 million for systems improvements to reduce payment errors in SNAP.听South Dakota Gov.听Larry Rhoden鈥檚 proposed budget includes $5.5 million to听offset听a reduction听in听SNAP federal funding.听
Strategic Cost Containment听
Considering OBBBA implementation and the effects that it will have on their budgets, our first review of governors鈥� budget proposals signals that states are taking an aggressive posture toward limiting expenditure growth in 2026 and 2027. Initial proposals include targeted reductions, tighter utilization management, and restrictions on benefits.听
Since the 2025 legislative session, Colorado has taken multiple steps to prepare for declining federal revenue. For example, Governor Polis鈥檚 proposed budget accounts for multiple actions approved through an amended executive order that would reduce spending to brace for OBBBA鈥檚 impacts. Examples include:听
- Reducing provider rates to 85 percent of the Medicare reimbursement rate听
- Establishing limits on Community First Choice services听
- Adjusting听the听home health nursing and therapy services payment听methodology听
- Introducing cost controls for Medicaid benefit categories that have shown disproportionate growth听
- Implementing听a听$3,000 annual cap on adult Medicaid dental benefits听and a听$750 annual cap on dental benefits for individuals in the Cover All Coloradans program听
- Changing听the听Cover All Coloradans behavioral health program from managed care to fee for service听
- Reviewing provider fees听in anticipation of听possible State听Directed Payment approval from the Centers for Medicare & Medicaid Services (CMS)听
Former Virginia Gov. Glenn Youngkin鈥檚 budget鈥攏ow inherited by Abilgail Spanberger following her inauguration January 17, 2026鈥攊ncludes multiple cost-containment proposals, such as:听
- Anticipated adjustments to capitation rates after a review of Medicaid managed care organizations听
- A $2,000 annual limit on adult dental services Medicaid coverage听
- Elimination of听both听automatic rate increases for psychiatric residential treatment facilities and qualifying听addiction听and recovery treatment services providers听and听automatic biennial inflation increases for听medical听assistance听providers听
- Restrictions on听emergency听maternity services to Medicaid听enrollees听who听are ineligible听for Medicaid听because听of their citizenship status听
- Standardized听hourly limits across home and community-based听services听waivers听
- Actions听related to听鈥渆nsuring appropriate utilization鈥� of services,听such as听applied听behavioral听analysis and crisis services听
States听are expected to听include听additional听cost-containment tools throughout 2026 and beyond as OBBBA鈥檚 fiscal effects听become clearer听over the coming months and years.听
What to Watch听
The budget proposals indicate the resources that executive agencies need and preview governors鈥� policy agendas for the year ahead. Stakeholders should track program reductions and rate changes, eligibility system investments, and shifts in care models.听
In addition, some of the announced budget proposals consider federal awards to states under the Rural Health Transformation Program (RHTP).听For example,听the听Alaska听Department of Health听budget request听addresses the state鈥檚听RHTP implementation听plans,听and听Wyoming鈥檚 budget proposal听outlines RHTP priorities.听Many states are听preparing RFP processes听to operationalize their RHTP听strategies and听make听progress on the goals of their initiatives.听
Connect听with Us听
As federal funding uncertainties continue, states and other stakeholders will need to adapt their delivery systems, administrative structures, and financing models throughout OBBBA鈥檚 multiyear rollout. 黑料不打烊 offers expertise, analytics, and strategic advisory services needed to navigate this evolving landscape. For details contact Andrea Maresca and Kathleen Nolan.听
The full state of the states and governor budget report is available to 黑料不打烊IS subscribers. In addition, 黑料不打烊IS maintains a听听that incorporates details of each initiative and the听first year听award.听听
Federal Policy News
Fueled By Weekly Health Intelligence
Congressional Leaders Announce Deal on FY 2026 Spending Including Healthcare Policies
The Senate and House Appropriations Committee the conferenced Consolidated Appropriations Act, 2026. The package includes the last four of the remaining 12 appropriations bills for federal fiscal year (FY) 2026, including appropriations bills for Labor, Health and Human Services (HHS), Education; Defense; Homeland Security; and Transportation, Housing and Urban Development. In the conferenced legislation, as in the and Appropriations Committees鈥� initial versions, HHS funding is appropriated according to the existing structure of the Department, rather than in line with the announced by HHS Secretary Kennedy last year. The bill also funds several agencies proposed for elimination in the , including the Agency for Healthcare Research and Quality (AHRQ), the Substance Abuse and Mental Health Services Administration (SAMHSA), and the Health Resources and Services Administration (HRSA).
The bill provides a total of $116.8 billion to HHS, an increase of $210 million over FY 2025, with the following amounts for key agencies:
- $48.7 billion for the National Institutes of Health (NIH), including $1.5 billion for the Advanced Research Projects Agency for Health (ARPA-H);
- Additionally, in the , appropriators address a by the Trump Administration to implement a 15 percent cap on the amounts NIH will reimburse for 鈥渋ndirect costs,鈥� incurred by grantees. The Appropriations Committees reject this change in the legislation.
- $8.9 billion for HRSA;
- $9.2 billion for CDC; and
- $3.7 billion for Assistant Secretary for Preparedness Response (ASPR).
Additionally, the bill extends mandatory funding for several key public health programs set to expire on January 30, 2026, including:
- The National Health Services Corps;
- The Special Diabetes Program;
- Teaching Health Centers Graduate Medical Education; and
- Community Health Centers.
The following Medicare extenders were also included in the package:
- Increased inpatient hospital payment adjustment for certain low-volume hospitals;
- The Medicare-dependent hospital program;
- Add-on payments for ambulance services;
- Funding for quality measure endorsement, input, and selection;
- Funding for outreach and assistance for low-income programs;
- Work geographic index floor;
- Acute hospital care at home waiver authorities;
- Certain telehealth flexibilities; and
- Delay in Medicare payment reductions to the Clinical Laboratory Fee Schedule under the Protecting Access to Medicare Act.
Notably, the bill also includes several provisions related to the practices of Pharmacy Benefit Managers (PBMs), including a provision requiring PBMs to delink their prices from those for Medicare Part D, a prohibition on spread pricing in Medicaid, and a provision directing the Secretary of HHS to publish a report every two years on enforcement and oversight actions taken by HHS related to PBMs.
Additionally, the legislation reauthorizes several programs related to preventing maternal deaths, sickle cell disease prevention and treatment, Lifespan Respite Care, preventing premature births (PREEMIE), and providers鈥� mental health (Dr. Lorna Breen Health Care Provider Protection). The Mikaela Naylon Give Kids a Chance Act is also included in the package to extend the rare pediatric disease priority voucher.
The House is expected to take up the package later this week. With the Senate out of session this week, members will need to vote on the agreement in the last week of January when they return.
President Unveils 鈥淕reat Healthcare Plan鈥� Framework
On January 15, President Trump released 鈥�,鈥� an outline of several policies intended to lower healthcare costs. In the , the White House calls on Congress to:
- Codify Most-Favored-Nation deals, with voluntarily negotiated deals with HHS/the Centers for Medicare & Medicaid Services (CMS) to be grandfathered in.
- Fund cost-sharing reductions (CSRs) for healthcare plans.
- Require insurers to make the following information public on their websites:
- Rate and coverage comparisons in 鈥減lain English;鈥�
- The percentage of their revenues that are paid out to claims versus overhead costs and profits;
- The percentage of insurance claims they reject; and
- Average wait times for routine care.
- Require providers and insurers that participate in Medicare or Medicaid to 鈥減ublicly and prominently鈥� post pricing and fees.
The plan also calls for ending kickbacks from PBMs to brokerage middlemen, allowing more drugs to be available over-the-counter, and providing money directly to individuals to support the purchase of health insurance. Several of the policies detailed in the President鈥檚 plan have previously been endorsed by Congressional Republicans, including in the Republican Study Committee for a second budget reconciliation bill for the 119th Congress, in which they specifically advocate for appropriating CSRs and directing funding to individuals rather than insurers to support the purchase of health coverage.
HHS Reshapes Federal Vaccine Advisory Committees
On January 13, the US Department of Health and Human Services (HHS) and the Centers for Disease Control and Prevention (CDC) the appointment of two new members, Dr. Adam Urato and Dr. Kimberly Biss, both obstetrician gynecologists, to the Advisory Committee on Immunization Practices (ACIP). The appointments follow HHS Secretary Robert F. Kennedy鈥檚 reconstitution of the panel. Dr. Urato is a maternal-fetal medicine specialist with previous experience participating in FDA advisory panels and has held academic appointments at Harvard Medical School, the University of South Florida, and Tufts University School of Medicine. Dr. Urato argued in a book review in 2021 that vaccine hesitancy is driven by distrust of the medical establishment and has asserted that vaccine safety during pregnancy is uncertain. Dr. Bliss is a Florida-based OB-GYN and has asserted connections between the COVID-19 vaccine and miscarriages and suggested it causes infertility. Acting CDC Director Jim O鈥橬eill also noted that new members will assist the Administration鈥檚 efforts to bring the childhood immunization schedule in line with 鈥済old-standard science鈥� driven by evidence.
Also on January 13, it was reported that HHS leadership at least two voting members from the prior to the scheduled completion of their terms. Veronica McNally and Dr. Wendy Lane, whose terms were set to end in December 2027, were reportedly notified via email that they had been removed from their positions, with the agency noting that the committee could be remade at the discretion of the Secretary.
FDA Issues Draft Guidance on Bayesian Methods in Clinical Trials
On January 12, the Food and Drug Administration (FDA) released a regarding a newly published 听on the 鈥淯se of Bayesian Methodology in Clinical Trials of Drug and Biological Products,鈥� designed to expedite development through the more efficient use of available data. Bayesian methodologies allow for data from a previous study to be combined with relevant new information to draw conclusions about a drug鈥檚 safety and efficacy. As noted by FDA Commissioner Makary, the guidance aims to provide additional clarity regarding the methodologies, which can reduce costs and timelines associated with the development of drugs. Under the guidance, recommendations are provided regarding the appropriate use of these methodology adjustments and how best to submit a report for a clinical study that uses Bayesian analyses. FDA is seeking public comments on the draft guidance until March 13, 2026.
Senate Committee Moves Key Health Legislation Forward
On January 15, the Senate HELP Committee unanimously to advance four bills aimed at improving American families鈥� health. During the markup, committee members favorably approved the amendments and recommended the following bills to proceed to the full Senate for consideration:
- , the Women and Lung Cancer Research and Preventive Services Act;
- , Tyler’s Law;
- , the Rural Hospital Cybersecurity Enhancement Act; and
- , the Protect Infant Formula from Contamination Act.
S. 1157 was approved with a and, if passed, will require a comprehensive interagency review of programs, activities, and strategic plans related to lung cancer to improve outcomes for women. S. 921 was also approved with a and aims to assess hospital emergency department testing for fentanyl and issue guidance based on the results of the study. The third bill, S. 2169, was approved with a and requires HHS to develop a comprehensive workforce strategy to address cybersecurity vulnerabilities in rural health facilities. Lastly, S. 272 was approved with a and establishes new safety and reporting requirements for infant formula manufacturers to prevent contamination events.
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State Policy News
New Hampshire
New Hampshire to Implement Medicaid Premiums July 2026. The New Hampshire Bulletin听听on January 15, 2026, that New Hampshire will implement Medicaid premiums in July 2026. The Department of Health and Human Services (DHHS) estimates the premiums will bring in $23 million in state fiscal year 2027 and $23 million in state fiscal year 2028, not including costs DHHS will incur to update its payment systems. Premiums will range from $60 a month to $270 a month.
New York
New York Governor Proposes $4 Billion State Medicaid Boost to Backfill Federal Cuts. Crain鈥檚 New York Business听听on January 21, 2026, that Governor Kathy Hochul鈥檚 executive budget proposes nearly a $4 billion increase in state Medicaid spending next year to offset federal cuts under the Trump administration. Medicaid spending across all departments is expected to reach $48.5 billion next fiscal year, with the Department of Health footing $38.2 billion. While state funding rises, total Medicaid spending is projected to fall due to a $10.3 billion decrease in federal support. The budget includes major aid for hospitals and safety-net providers, funded largely through the managed care organization (MCO) tax, and highlights savings from recent program reforms to help stabilize the program.
Oregon
Oregon Governor Directs $25 Million Toward Maternity Care. The Oregon Health Authority (OHA)听听on January 20, 2026, that Governor Tina Kotek has directed the agency to distribute $25 million from the General Fund to stabilize and sustain labor and delivery services. Of those funds, $15 million will provide stabilization payments to small rural hospitals and $10 million will be invested into larger hospitals through diagnosis-related group rates, which are reflected in the 2026 coordinated care organization rates. The funding supports a coordinated effort between OHA and the Hospital Association of Oregon.
Texas
Texas Governor Directs HHSC, OIG to Investigate Potential Medicaid Fraud. Texas Governor Greg Abbott听听on January 16, 2026, that he is directing the Texas Office of the Inspector General (OIG) and the Health and Human Services Commission (HHSC) to further investigate potential Medicaid fraud based on the Trump administration鈥檚 recent identification of potential systemic fraud across other state鈥檚 Medicaid programs. OIG and HHSC are to perform additional reviews of Medicaid programs identified by the Trump administration, ensure that all Medicaid managed care organizations (MCOs) have fully staffed Special Investigations Units (SIUs) to conduct mandatory investigations, provide more training to MCO SIUs, perform additional reviews of MCO policies for certain Medicaid services, and complete a utilization review of autism services with a report due in June 2026.
Virginia, West Virginia
Medicaid Director Changes Made in Virginia, West Virginia. Virginia Medicaid Director Cheryl Roberts will depart the Department of Medical Assistance Services (DMAS). Her departure comes as Governor Spanberger opened her administration on January 17, 2026 by signing a 听focused on affordability and federal funding risks. In West Virginia, Governor Patrick Morrisey听听that Christy Donahue has been appointed as the Commissioner of the Bureau of Medicaid Services, which administers Medicaid and the West Virginia Children鈥檚 Health Insurance Program (WVCHIP). Donahue previously served as senior vice president of the Health Plan of West Virginia.
Private Market News
Fueled By
Lilly, Novo Test Direct-to-employer Approach That Could Cut Out PBMs and Lower Costs
The GLP-1 makers are the first to try out this new model, but more companies may follow.
Pharmaceutical companies Novo Nordisk and Eli Lilly are testing a new direct-to-employer model that would allow self-insured companies to negotiate weight loss treatment prices directly with manufacturers. The two companies are with Waltz Health, a digital health company that allows the purchase of drugs at a fixed price. The Waltz Health model integrates fixed pricing with a fulfillment and support ecosystem that aligns with each employer鈥檚 existing benefit structure. Waltz Health provides real-time eligibility screening, pharmacy routing, prescription adjudication and ongoing patient engagement for employees.
IL, PA Extend ACA Marketplace Enrollment Deadlines
and have joined in extending enrollment deadlines for their Affordable Care Act (ACA) Marketplace programs from January 15, 2026, to January 31. Illinois鈥� According to a statement from the Department of Insurance, the state is seeing a record number of individuals shopping for healthcare coverage on its platform. The state is investing is directing 听into navigator grants that provide enrollment support to residents and has focused on strengthening its certified broker network.
The deadline remained January 15 in most states apart from some with alternate deadlines.
Our Insights
Fueled By Experts Across Our 黑料不打烊 Companies
黑料不打烊
Analysis of the Costs and Medicaid Payment Adequacy for Ground Ambulance Services in New York State
Survey data from fiscal year (FY) 2022 suggest that entities that provide ground ambulance services in the State of New York are experiencing reimbursement challenges. 黑料不打烊 (黑料不打烊), contracted with the United New York Ambulance Network (UNYAN) to conduct an independent study of the costs of delivering ground ambulance services in the state and the adequacy of payment for these critical services. The 黑料不打烊-UNYAN survey data highlight the wide variation in costs within the ground ambulance industry in New York and the negative Medicaid margins the industry experiences. These data demonstrate that although ambulance entities of all sizes in New York have negative Medicaid margins, these margins worsen as entity size decreases and entities become more rural. Trends in negative margins appear to be linked to some degree to entities鈥� relative share of 鈥渞esponses without transport鈥� or uncompensated transports. This white paper poses important considerations for policymakers.
Webinar: The ACCESS Model: Essentials for Applicants
CMS鈥檚 new ACCESS model represents one of the most ambitious federal efforts to modernize chronic care through technology-supported services. This national, voluntary, decade-long model creates a new payment pathway for digital health tools, continuous monitoring, behavioral support, and other tech-enabled interventions that complement traditional care. With beneficiaries able to enroll directly and clinicians eligible for co-management payments, ACCESS introduces a fundamentally different approach to chronic condition management across Medicare.
In this webinar, 黑料不打烊 and Leavitt Partners experts will break down what is known today, what to expect in the forthcoming Request for Applications, and what organizations can do to prepare. We will walk through the model鈥檚 four clinical tracks, outcomes-aligned payments, beneficiary engagement expectations, the TEMPO pilot鈥檚 implications for digital device manufacturers, and how it relates to the CMS Health Tech Ecosystem initiative.
Webinar: Meeting the Healthcare Needs of Unhoused People Part 1: Service and Care Responses
Join听黑料不打烊 experts and our featured speakers听for the first of two webinars exploring how current events are impacting people experiencing homelessness and their access to care. This webinar will highlight the model of care for healthcare for the homeless clinics and medical respite care providers and how these services interact with broader systems of care. Additionally, we will explore how the current environment is impacting delivery and financing of care for some of our most vulnerable neighbors.听
Webinar: Meeting the Healthcare Needs of Unhoused People Part 2: State Policy Responses
Recent federal policy changes, such as the 2025 Budget Reconciliation Act (OBBBA), bring significant challenges to听retaining听the Medicaid coverage gains and added 1115听demonstration听services that have been so successful in the last decade. States will be under tremendous pressure to meet new requirements鈥攂ut they also have options to reduce the negative impact on vulnerable populations and the healthcare providers that serve them. Join听黑料不打烊 and our featured experts听for this听webinar听to discuss state-level policy options, share resources, and consider how to move forward in the current environment.听
Webinar: 2027 ACA Considerations: Proposed NBPP and Other Key Changes and Trends
Upon the release of the CMS final 2027 Notice of Benefit and Payment Parameters and the accompanying Letter to Issuers in January, health plans and state policymakers will face critical decisions that shape the next phase of the individual and small group markets.听Join experts from 黑料不打烊 and Wakely for a timely discussion unpacking what the proposed rule means in practice and how stakeholders can begin preparing now.听听
Wakely
Individual ACA Open Enrollment Insights So Far
On January 12, 2026, Centers for Medicare & Medicaid Services (CMS) released updates on the 2026 Marketplace open enrollment. Interest in this year鈥檚 open enrollment has been particularly strong given the significant affordability changes following the end of the enhanced premium subsidies. While information is preliminary, this paper includes several key insights on enrollment patterns to date and key areas to monitor going forward.
RFP Calendar
RFP Calendar
| Date | State/Program | Event | Beneficiaries |
|---|---|---|---|
| Date: DELAYED | State/Program: Texas STAR & CHIP | Event: Implementation | Beneficiaries: 4,600,000 |
| Date: December 2025 - February 2026 | State/Program: Texas STAR Kids | Event: Awards | Beneficiaries: 150,000 |
| Date: January 1, 2026 | State/Program: Wisconsin LTC GSR 2,7 | Event: Implementation | Beneficiaries: 56,000 (all GSR) |
| Date: January 1, 2026 | State/Program: Michigan HIDE SNP | Event: Implementation | Beneficiaries: 35,000 |
| Date: January 1, 2026 | State/Program: Nevada D-SNP | Event: Implementation | Beneficiaries: 88,000 |
| Date: January 1, 2026 | State/Program: Ohio Duals | Event: Implementation | Beneficiaries: 250,000 |
| Date: January 1, 2026 | State/Program: Illinois D-SNP | Event: Implementation | Beneficiaries: 79,000 |
| Date: January 1, 2026 | State/Program: Nevada | Event: Implementation | Beneficiaries: 674,000 |
| Date: January 1, 2026 | State/Program: Massachusetts One Care, Senior Care Options | Event: Implementation | Beneficiaries: 120,000 |
| Date: January 6, 2026 | State/Program: Nevada Children's Specialty | Event: Proposals Due | Beneficiaries: NA |
| Date: January 16, 2026 | State/Program: Wisconsin LTC GSR 3 | Event: Proposals Due | Beneficiaries: 56,000 (all GSR) |
| Date: January 21, 2026 | State/Program: Illinois Tailored Care Management Program | Event: Proposals Due | Beneficiaries: 22,400 |
| Date: February 2026 | State/Program: Illinois | Event: Awards | Beneficiaries: 2,400,000 |
| Date: February 19, 2026 | State/Program: Nevada Children's Specialty | Event: Awards | Beneficiaries: NA |
| Date: June 24, 2026 | State/Program: Wisconsin LTC GSR 3 | Event: Awards | Beneficiaries: 56,000 (all GSR) |
| Date: December 2026 - February 2027 | State/Program: Texas STAR Kids | Event: Implementation | Beneficiaries: 150,000 |
| Date: January 1, 2027 | State/Program: Illinois | Event: Implementation | Beneficiaries: 2,400,000 |
| Date: January 1, 2027 | State/Program: Nevada Children's Specialty | Event: Implementation | Beneficiaries: NA |
| Date: January 1, 2027 | State/Program: Wisconsin LTC GSR 3 | Event: Implementation | Beneficiaries: 56,000 (all GSR) |
| Date: January 1, 2027 | State/Program: Illinois Tailored Care Management Program | Event: Implementation | Beneficiaries: 22,400 |
| Date: January 1, 2028 | State/Program: Wisconsin LTC GSR 4,6 | Event: Implementation | Beneficiaries: 56,000 (all GSR) |
| Date: Fall 2027 | State/Program: Oregon | Event: RFP Release | Beneficiaries: 1,200,000 |
| Date: 2028 | State/Program: North Carolina | Event: RFP Release | Beneficiaries: 2,200,000 |