Weekly StateVitals Update: Volume 36 (September 8, 2025)
National
NASHP Annual Conference This Week. Happening this week is the National Academy of State Health Policy (NASHP) annual conference in San Diego, CA. NASHP is a nonpartisan organization that works with state elected officials and administrative staff on providing policy technical assistance, publishing state health policy research and analysis, and facilitating spaces for state healthcare officials without official associations (i.e., facilitates collaboration amongst state leaders of state-based exchanges and prescription drug affordability boards). The conference is providing ample coverage of the state implications from passage of the federal reconciliation package that stands to reform state Medicaid financing mechanisms. Additionally, the conference is focused on providing information and insights related to incentivizing new care models, trending efforts in behavioral health interventions, maternity care coverage and access, and healthcare consolidation, among other topics.
FDA COVID-19 Vaccine Guidance Creates Friction With States. Following the U.S. Food and Drug Administration’s (FDA) decision to update its COVID-19 vaccine guidance, existing state requirements on vaccine administration have limited access to vaccines for some consumers. Notably, the new FDA guidance authorizes Pfizer, Moderna and Novavax vaccines for all seniors and for younger adults and children with certain qualifying health conditions. However, there are a number of states with existing guidelines in place that require licensed providers and healthcare facilities to adhere to federal guidelines in administering vaccines. CVS has found in their own operational review that they are unable to vaccinate individuals who fall outside of the eligible population as defined by the FDA in Massachusetts, Nevada and New Mexico due to existing state law and regulations. CVS indicated that they cannot vaccinate anyone in these three states outside of the eligible population regardless of whether they have a prescription or not. There are an additional sixteen states where CVS believes it is limited to administering a COVID-19 vaccination to an individual outside of the federal eligibility criteria depending on whether they have a prescriber’s prescription and dependent on their age.
Western States Form Alliance to Develop Vaccine Guidance. The Governors of Washington, Oregon and California announced this past week their intent to establish an alliance between the three states that would develop clinical guidance for vaccine administration in their respective states. Hawaii joined the alliance the following day. Driven largely in response recently revised guidance from the Food and Drug Administration on COVID-19 administration and other recent federal changes with the Centers for Disease Control, the three states will establish their own recommendations as to who should receive certain vaccinations that their state health departments and regulated private entities will be required to comply with. The joint statement iterates that such recommendations and immunization plans will be based on science-based evidence from respected national medical organizations.
Texas and Florida Request to Join Legal Effort to Ban Mifepristone. Recently, Florida and Texas asked a federal judge to allow them to join a lawsuit as plaintiffs which seeks to challenge the Food and Drug Administration’s approval of mifepristone. Notably, both states note that the availability of the drug across states make it impossible for them to enforce their abortion bans. Missouri, Kansas and Idaho had originally brought the case before a federal court in Texas and the Trump Administration had originally requested a dismissal arguing that no plaintiff was located in Texas. If Texas is approved to join the lawsuit, that dismissal request may be a moot point and its possible it could provide some enhanced focus and activity on the lawsuit.
Florida
Surgeon General Intends to End All State Vaccine Mandates. This past week, Florida Surgeon General Dr. Joseph Ladapo announced that the state will work to move to ending all vaccine mandates currently in place in the state. If done, this would make Florida the first state in the country to end a longstanding practice of requiring certain vaccination requirements for attendance at schools by minors. Dr. Ladapo announced that all non-statutory mandates will be pulled back in the immediate future. Governor Ron DeSantis (R) stated that Republican leaders in the Legislature will put forth a legislative package to repeal any statutory mandates that may exist. Following the announcement, Centers for Medicare & Medicaid Services (CMS) Administrator Dr. Mehmet Oz iterated his support for the decision saying that such a choice to vaccine is between the physician and the patient.
Governor Announces State MAHA Commission. At the same event to announce the end of all vaccine mandates in Florida, Governor Ron DeSantis (R) also announced the establishment of a Make America Healthy Again (MAHA) Commission. Mirroring the federal-level initiative, First Lady Casey DeSantis and Lt. Governor Jay Collins (R) will chair the Commission. During the press conference, Gov. DeSantis iterated that the Commission will follow certain principles, inclusive of informed consent and parental rights of healthcare decision-making and promoting clean, nutritious and healthy food. More information is expected to be announced in the coming weeks on the makeup of the commission and its guiding principles.
Ohio
State is Required to Recalculate Medicaid Payments to Nursing Homes. The Supreme Court of Ohio issued a ruling this past week that requires the Ohio Department of Medicaid to recalculate how much it pays nursing homes for care. The Court is requiring such recalculation due to the Department having provided less funding for incentives to high-quality providers than originally required by state statute. State law provides a funding formula for how nursing homes are to be reimbursed in the state, inclusive of a quality incentive payment rate that has its own dedicated funding pool. Nursing homes had argued that existing state law required that for each point a nursing home received due to quality, its quality bonus pool became larger. However, the Department had maintained that such an increase in the incentive pool has to be included in calculating the rebase of the reimbursement for direct care costs. The Department will adhere to the Court’s decision and is expected to begin the administrative implementation in the coming weeks.
Tennessee
TennCare to Cover Obesity Management Medications. Recently, TennCare announced that they will begin covering obesity management medications for both children and adults as of this past August 1, 2025. Specifically, phentermine, orlistat and phentermine/topiramate will be preferred without prior authorization requirements while Wegovy and Zepbound will be preferred drugs with prior authorization requirements applied. The list of non-preferred drugs include Evekeo, Imcivree, and Saxenda. Quantity limits apply to the coverage as described in the provider notice.
Texas
Bill Enrolled to Ban Abortion Pills from Being Mailed In State. This past week, the Texas Legislature concluded a second special session of the year by enrolling HB 7. The bill provides a right to private citizens to sue healthcare providers for mailing, prescribing or providing abortion medication to patients in Texas. Penalties for healthcare providers violating this requirement would run at least $100,000 per offense and the bill would also authorize lawsuits against drug manufacturers should they make drugs used by state residents for abortion. The bill had originally been proposed in March during the regular session but a final version of it failed in the final days of session when the House of Representatives opted against prioritizing its passage.
