Medicaid state-directed payments for hospitals face cuts across 37 states under OBBBA
Hospital state-directed payments (SDPs) in at least 37 states are set to be reduced as part of Medicaid cutbacks in the One Big Beautiful Bill Act (OBBBA), according to a new analysis. Roughly $60 billion in current federal spending on hospital SDPs will come in above the OBBBA’s limits, set at 110% of the Medicare…
CMS ends Medicaid coverage of gender-affirming care for minors
Federal Medicaid funding no longer will be available to cover gender-affirming healthcare for minors, according to a CMS final rule issued Aug. 11. The rule blocks Medicaid and Children’s Health Insurance Program (CHIP) federal matching funds from reimbursing providers for what the rule refers to as “sex-rejecting procedures” in beneficiaries younger than 18 in Medicaid…
Senate Medicaid hearing highlights the debate over federal spending cuts
Cuts to federal Medicaid spending are necessary to streamline the program and don’t necessarily portend tough times for providers, conservative policymakers and analysts argued during a Senate hearing. The Aug. 4 hearing of the Senate Budget Committee included discussion of whether healthcare policies in the One Big Beautiful Bill Act (OBBBA) should be scaled back…
Medicaid provider tax proposed rule could cut payments by $220 billion over 10 years
A proposed rule from CMS implements anticipated changes to the system of provider taxes that help fund supplemental reimbursement in Medicaid. The changes are required under the One Big Beautiful Bill Act (OBBBA, also referred to as the Working Families Tax Cut legislation), with the proposed rule filling in details. The repercussions of the rule…
Medicaid work requirement lawsuit targets CMS exemption rules
July 30 update A federal judge at the U.S. District Court for Massachusetts denied a request for a preliminary injunction of CMS regulations implementing the Medicaid work requirement. The plaintiffs specifically challenged how the regulations defined medically frail as a criterion for an exemption to the work requirement, plus how a specific short-term hardship exception…
Medicaid administrative burden hits providers
Administrative burden is one of the strongest predictors of whether providers remain in Medicaid, according to a recent provider survey. Overall, 28% of providers report dissatisfaction with Medicaid administrative processes, and only 51% say they are satisfied, according to the survey from Gainwell Technologies, a Medicaid program consulting firm. The findings point to a growing…
States boost Medicaid budgets as enrollments decline
Amid ongoing and projected Medicaid enrollment decreases, most states are boosting their Medicaid budget proposals. Nationally, Medicaid enrollment is shrinking. From December 2024 to December 2025, national Medicaid and CHIP enrollment has decreased 4%, from 78.9 million to 75.7 million, according to CMS. That has continued into 2026, with Wells Fargo analysts reporting a 2%…
Federal scoring system spurs state action on certificate-of-need laws
Spurred on by the Trump administration, five states plan to undertake changes in their certificate-of-need (CON) laws this year: Their plans were highlighted in late 2025 applications for a share of the $50 billion Rural Health Transformation (RHT) program, authorized by the One Big Beautiful Bill Act (OBBBA). That law allowed the Trump administration to…
News Briefs: Hospital labor costs rose by almost 40% between 2019 and early 2022
As published in hfm magazine, a monthly roundup of top news for healthcare finance professionals.