Weekly StateVitals Update: Volume 55 (February 9, 2026)
*Due to Presidents’ Day on Monday, February 16, the next edition of the Weekly StateVitals Update will be published and distributed on Tuesday, February 17.
National
NASHP Announces Increasing Access to Primary Care in Rural Communities Learning Network. This past week, the National Academy of State Health Policy (NASHP) announced a new initiative, the Increasing Access to Primary Care in Rural Communities Learning Network. The purpose of the network is to promote learning and discussion on strengthening primary care systems in rural and underserved areas, particularly as states navigate implementation of the One Big Beautiful Bill Act and the Rural Health Transformation Program. In the announcement, NASHP highlighted rural primary care workforce, infrastructure, funding, reimbursement, and technology as key strategies and topics for discussion. The network is open to all state officials interested in primary care and rural health, and will be supported by the National Organization of State Offices of Rural Health (NOSORH) and the Milbank Memorial Fund.
Settlement Reached on Antitrust Drug Manufacturer Case. Last Monday, Connecticut Attorney General William Tong announced that two settlements totaling $17.85 million had been reached to resolve two antitrust cases alleging that two drug manufacturers engaged in widespread, long-running conspiracies to manipulate drug prices for generic prescription drugs. As part of the settlement agreements, both companies agreed to cooperate in further multistate litigation against other corporations and to implement internal reforms to guarantee antitrust law compliance and fair competition.
In his press release, AG Tong also announced that 42 states and territories would be filing a new lawsuit against other drug manufacturers for conspiring to price fix, allocate markets, and rig bids for generic drugs. This comes as the latest development of nearly a decade of antitrust litigation against drug manufacturers led by multiple of Connecticut’s Attorney Generals.
Florida
State Submits Application for 1115 IMD Demonstration. This past week, Florida submitted an application for a new five-year Institutions for Mental Disease (IMD) 1115 Demonstration. The proposed demonstration would establish spending authority to cover services for Medicaid enrollees who reside in IMDs and are diagnosed with serious mental illness, serious emotional disorder, or substance use disorder. The intent is to drive enhanced care coordination and placement opportunities for Medicaid enrollees in the state’s Medicaid managed care program. The public comment period is open, and CMS intends to accept public comments through March of this year.
State Committees Advance Healthcare Omnibus and 340B Study. This past week, the Senate Health Policy Committee voted 8 to 3 to move SB 1758 out of committee favorably. The bill, in its current state, among other provisions, would require the Agency for Health Care Administration (AHCA) to contract with a vendor to perform a detailed fiscal impact study evaluating the 340B program and require managed care plans, PBMs, and Medicaid providers to submit all data necessary for the completion of the study. At the same time, the House Health Care Facilities & Systems Subcommittee approved HB 693 for consideration by the full Health and Human Services Committee. The measure would repeal the state’s certificate of need (CON) program most substantially. However, it would also enact interstate licensure compacts for emergency medical services personnel and physician assistants, revise eligibility requirements for Medicaid for noncitizens, prohibit the AHCA from making a payment to a prohibited entity that provides abortions, and implement a number of scope of practice changes for certain providers. It’s expected that committee work on the bill will continue in the week ahead.
Illinois
Governor Opts to Have Illinois Join WHO’s Global Disease Network. This past week, Illinois joined California in becoming the second state to join the World Health Organization’s (WHO) Global Outbreak Alert and Response Network. The participation in the Network is intended to provide the state with direct access to timely global alerts, expert public health networks, and international response capabilities to emerging disease threats. The decision to join the Network comes after the White House opted to drop its membership from the WHO after nearly 80 years. It’s likely that other states will follow the trend set by Illinois and California, most likely starting with those that had originally formed the Governor’s Public Health Alliance.
Indiana
FSSA to Release RFP for All Medicaid Managed Care Programs. Recently, the Indiana Family and Social Services Administration (FSSA) announced its intent to release a request for proposals (RFP) this upcoming August for the state’s four Medicaid managed care programs. Notably, the RFP for the Healthy Indiana plan, Hoosier Healthwise, Hoosier Care Connect, and Pathways for Aging is expected to provide coverage to an additional 1.4 million enrollees and have an estimated procurement value of $68 billion. The announcement came as part of a quarterly financial review for FSSA. As part of the review, FSSA highlighted some deficiencies in the existing Medicaid managed care programs they intend to address in the new procurement, including a more significant focus on mental health and addiction, an enhanced focus on quality and outcome metrics, and cost drivers of high hospital prices and substandard health outcomes. More information is expected in the coming months.
Kentucky
Bill Passes House to Make Water Fluoridation Optional. This past week, and for the second year in a row, the Kentucky House of Representatives has passed a measure that would make water fluoridation optional for local utility providers. The House voted 67 to 29 to advance HB 103 which would eliminate the state’s mandate on water fluoridation. Notably, opponents of the measure argued throughout the hearing process that if authorized, the measure stands to increase Medicaid costs given an expected increase in dental issues for enrollees without access to fluoridated water. Despite existing support in the House, the Senate opted not to pass the bill last year and it is likely to face headwinds should the bill get to the Governor’s desk. If the bill were to be ultimately enacted it would make Kentucky the third state following Florida and Utah to remove such a state mandate.
Mississippi
Governor Reeves Signs New Certificate of Need Law. On Wednesday, Governor Tate Reeves (R) signed into law HB 3, a Certificate of Need (CON) reform bill that is nearly identical to the previous session’s version. Unlike its last iteration, HB 3 no longer grants a CON application to build a behavioral health hospital in Jackson. As enacted, the bill increases capital expenditure thresholds required for a CON requirement and narrows CON exemptions for the University of Mississippi Medical Center, requiring the university to get state approval before opening educational facilities outside a designated area within Jackson. As the legislative session progresses, Mississippi legislators are considering several other bills that loosen CON requirements within the state. This Wednesday, members of the House passed HB 1622, which exempts rural hospitals from CON requirements. Moreover, SB 2474, which aims to accomplish similar measures by requiring the Department of Health to issue CON licenses for several health facilities connected to rural hospitals passed the Senate Public Health and Welfare Committee on Monday.
Michigan
DHHS Cancels Efforts to Overhaul Medicaid Mental Health Administration. Recently, the Michigan Department of Health and Human Services (DHHS) cancelled its request for proposal (RFP) to bid out the administration of $4.9 billion in Medicaid mental health funds. This comes after a months-long dispute between the state and regional health agencies, who disagreed on the choice to introduce consumer choice reforms to the Medicaid-supported system. Several Prepaid Inpatient Health Plans (PIHPs) had filed lawsuits against the state in August 2025, after DHHS announced it would be implementing changes to how PIHPs were contracted to provide behavioral health services. In its RFP, DHHS planned to eliminate 7 of 10 regional agencies and bring in public-private partnerships with local governments into the system. In January 2026, a Court of Claims judge ruled that the RFP violated state law by undercutting funding for Community Mental Health Service Programs and that the state would need to amend its RFP to continue. Looking ahead, the original change was scheduled for October 2026, and DHHS could still consider introducing another RFP.
New Mexico
House Approves Interstate Medical Licensure Compact. This past week, the New Mexico House of Representatives opted to unanimously adopt SB 1. The measure authorizes New Mexico to join the Interstate Medical Licensure Compact and had previously been passed by the Senate unanimously. The Governor has already reiterated her intent to sign the bill into law. This enrollment comes as the Legislature continues its deliberation and consideration of compacts related to physician assistants, dental hygienists, and social workers, among other professions.
North Carolina
Governor Signs EO Related to Behavioral Health Care. This past week, Governor Josh Stein (D) signed an Executive Order (EO) that intends to address ongoing gaps in the state’s behavioral health delivery system. Notably, the EO directs additional support to agencies assigned responsibility to increase recruitment and retention of behavioral health workers in the state, assess and increase state behavioral health care salaries to meet market norms, directs the North Carolina Payers Council to develop processes to increase coverage of crisis services by private insurers, and expand models to embed mental health providers into 911 centers and protocols. Additionally, the EO convenes a working group to recommend reforms to the state’s involuntary commitment process in North Carolina, among other similar elements. The provisions within the EO are effective immediately and seek to address gaps that the Governor’s office feel are inadequately being addressed by the Legislature given existing budget negotiations.
Oklahoma
Governor Calls for Medicaid Expansion Adjustments. During his State of the State address last Monday, Governor Stitt (R) highlighted Medicaid spending increases and called on the legislature to send a question to voters to allow adjustments to Medicaid expansion. Lawmakers are currently limited in making changes to the program since voters approved Medicaid expansion through a constitutional amendment in 2020. During the address, Gov. Stitt emphasized that Medicaid is projected to take up 37% of the annual budget in 10 years, and urged lawmakers to protect the program for those who need it.
Texas
Texas Resident Utilizes Recently Effective Legislation to Open Up California Abortion Pill Lawsuit. On Sunday, a resident from Galveston County, Texas, submitted an amended lawsuit against a California doctor, challenging the state’s shield laws. In the original lawsuit, the plaintiff argued that the California doctor provided abortion medication to his girlfriend in September 2024 and January 2025. In September 2025, Governor Greg Abbott (R) signed HB 7, which, starting December 2025, authorized residents to file lawsuits against out-of-state abortion providers. The plaintiff has now used this legal authority as supporting evidence within his suit, demanding that the California doctor pay an additional $75,000 in fines. This lawsuit joins several other Texas lawsuits challenging state shield laws, including two filed by Attorney General Ken Paxton (R) against providers in New York and Delaware.
Virginia
PDAB Bill Passed by Senate. This past week, SB 271 passed the Senate on a 31 to 8 vote. Similar to previous years, the bill establishes the Prescription Drug Affordability Board (PDAB) to conduct affordability reviews of prescription drugs and establishes an upper payment limit (UPL) setting authority on drugs found to pose affordability challenges. Notably, the UPL is tied to the federal maximum fair price established through Medicare price negotiation. The bill also provides the PDAB with the ability to conduct affordability reviews. At the same time, a companion bill (HB 483) is moving its way through the House having just been voted out by a House appropriations subcommittee last week.
West Virginia
Senate Committee Advances Abortion Medication Legislation. On Wednesday, the Senate Health and Human Resources Committee reported SB 173, which establishes prohibitions related to the mailing and prescribing of abortifacients in the state. The bill establishes felony criminal penalties for non-medical professionals, provides for licensure revocation for medical professionals, and authorizes civil action for violations. The bill originally included language to require medical professionals to complete continuing education on abortion medication, but such language was replaced with a requirement for abortion medication providers to sign an attestation that they understand the abortion laws of the state. The bill is now in the Senate Judiciary Committee for consideration.
For additional information and updates on state activity this past week relative to state COVID-19 vaccine guidance, StateVitals Subscribers can check out our guidance tracker.
