National
CDC Seeks Nominations for Advisory Committee on Immunization Practices. Recently, the Centers for Disease Control and Prevention (CDC) published a Federal Register notice seeking nominations for membership on the Advisory Committee on Immunization Practices (ACIP) 2027 membership cycle. In June 2025, U.S. Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. appointed 13 members to the ACIP, which subsequently took votes to change the childhood immunization schedule. These changes and the appointments have been subject to ongoing litigation; last March, the District Court of Massachusetts stayed the appointments and changes. HHS filed an appeal, which the First Circuit Court of Appeals is now reviewing. The CDC will review candidates before Secretary Kennedy ultimately appoints the new members, who may serve terms of up to four years. Nominations are due by December 31, 2026, creating the possibility for HHS to appoint new members and hold meetings in early 2027. In 2026, state legislatures took action to establish vaccine authority independent of federal recommendations and pursued diverging approaches on vaccine exemptions, access, parental rights, and informed consent. It’s likely that vaccine policy variation among states will continue to expand into 2027 as federal litigation continues.
Office of Rural Health Transformation Delays 2nd-Year RHTP Funding Amounts. Recently, states completed awarding their first year of Rural Health Transformation Program (RHTP) funding and were expecting to hear back on how the 2nd year of funding would be allocated. A day before 2027 funding amounts were scheduled to be announced, Office of Rural Health Transformation Director Alex Czekai notified states that federal officials had discovered an “additional administrative process requirement,” leading to further delays. States received between $147 million and $281 million in 2026; while funding is redetermined each year through a scoring process, they have generally assumed they would receive the same amount for the next four years of the program. Czekai did not specify when the office would announce the funding amounts but noted that states were required to submit their budget revisions accounting for the 2027 funding by November 30.
Voters Decide on Several Health Policy Ballot Measures. Last Tuesday, voters nationwide decided whether to approve several ballot measures concerning healthcare funding, Medicaid, abortion, and gender affirming care. As of the morning of November 9, the following projections have been made on health policy ballot measures.
California Proposition 40: One-Time Wealth Tax for State-Funded Healthcare, Education, and Food Assistance Programs Initiative - Pending
California Proposition 44: Spending Requirements for Federally Qualified Health Centers Initiative - Failed
Colorado Proposition 135: Prohibit Surgeries for Treatment in Response to Minors’ Perception of Sex or Gender Measure - Passed
Idaho Proposition 1: Reproductive Freedom and Privacy Act Initiative - Failed
Missouri Amendment 3: Prohibit Abortion and Gender Transition Procedures for Minors Amendment - Failed
Nevada Question 6: Right to Abortion Initiative - Passed
South Dakota Constitutional Amendment I: Medicaid Expansion Conditioned on 90% Federal Funding Amendment - Failed
Virginia Question 1: Right to Reproductive Freedom - Passed
Virginia voters passed a measure to guarantee the right to reproductive freedom, including abortion care, contraception, and fertility care. This measure was challenged over claims of misleading language; with its approval, the Tazewell Circuit Court will now hold a hearing on November 13. In a similar manner, Nevada voters also opted to create a right to abortion before fetal viability, and Missouri voters rejected a measure to repeal a previous abortion rights amendment approved in 2024. Contrastingly, Idaho voters rejected a measure to establish a right to reproductive freedom and privacy over decisions about abortion and other fertility care. The state now joins Florida, Nebraska, and South Dakota, where voters have rejected an abortion rights ballot measure since the Dobbs decision, meaning Idaho will continue to enforce one of the most restrictive abortion laws in the country.
Arkansas
Department of Human Services Receives 6-Month Extension for ARHOME. Last Thursday, the Centers for Medicare & Medicaid Services (CMS) approved a six-month extension for ARHOME, the state’s Section 1115 waiver program that covers its Medicaid expansion program. After CMS verbally rejected the Arkansas Department of Human Services’ (DHS) request for a five-year extension, the state began working to retain coverage for the more than 215,000 enrollees as they prepare to transition members to either a managed care or fee-for-service model. DHS then requested a subsequent two-year extension in August, though the program is now set to remain in effect until June 30, 2027. ARHOME’s future is expected to be a key topic of discussion during next year’s legislative session. Republicans still lead the legislature, though no longer hold a supermajority in the Arkansas House, which could give Democrats increased leverage when discussing the future of Medicaid expansion in the state.
Colorado
Governor Polis Proposes $600 Million in Medicaid Cuts in SFY 2028 Budget. Last Monday, Governor Jared Polis (D) released his budget proposal for state fiscal year 2028, which includes $600 million in Medicaid cuts. About $300 million of the cuts will eliminate adult and senior dental coverage, in-home physical therapy, some pediatric hospital funding, and children’s coverage through Cover All Coloradans, which extends Medicaid coverage to undocumented immigrant children and pregnant women. Additionally, the proposal would reduce payments to teaching hospitals and reinstate prior authorization requirements for behavioral healthcare services. Governor Polis noted that the remaining $300 million in cuts are unspecified and would be identified later. This is Polis’ last budget proposal as he leaves office in January and is largely considered a placeholder until Governor-elect Phil Weiser (D) comes into office to identify his priorities for the budget and the Joint Budget Committee begins its own work.
Connecticut
Department of Social Services Receives Approval to Renew SUD Section 1115 Demonstration. This past Friday, the Centers for Medicare & Medicaid Services approved the Connecticut Department of Social Services’ (DSS) request for a five-year renewal of the state’s Substance Use Disorder (SUD) Section 1115 Demonstration. Through the renewal, the state can continue to provide SUD treatment services to Medicaid beneficiaries who reside in institutions for mental diseases (IMDs). Children’s Health Insurance Program (CHIP) beneficiaries diagnosed with SUD will be able to access SUD services in IMDs as well. The renewal also authorizes DSS to provide reentry Medicaid benefits to eligible incarcerated individuals 60 days before release from jails and prisons, or 90 days before release from youth correctional facilities. Children under 21 and former foster youth under 26 will not be subject to health-related eligibility criteria, while other adults 21 or older must meet a specified diagnosis or population requirement to receive the benefits. The waiver is now effective through March 31, 2032.
Florida
Administrative Judge Sets Hearing on Changes to School Vaccine Requirements. Recently, Florida Division of Administrative Hearings Judge David Watkins agreed to set an expedited hearing on challenges to proposed revisions to eliminate four immunization requirements for children attending school and day care. In particular, children would no longer need to be vaccinated against hepatitis B, varicella (chickenpox), Haemophilus influenzae type b (Hib), and pneumococcal conjugate to attend. The hearing scheduled for December 14 through December 18 consolidates two challenges against the Florida Department of Health (FDOH) for failing to follow proper rulemaking and overstepping its legislative authority. The first challenge comes from the Florida Academy of Family Physicians, a physician, and three other individuals, while the second challenge comes from two families and their children. Governor Ron DeSantis (R) has long pushed to eliminate the requirements. If the challenge fails, FDOH could repeal the requirements without legislative approval because they only exist in agency rules.
Eleventh Circuit Court Upholds Ruling over Unconstitutional Medicaid Termination Notices. Last Wednesday, a 11th U.S. Circuit Court of Appeals panel of three judges unanimously upheld a district court ruling that found Florida’s Medicaid termination notices were not constitutionally adequate. The panel sided with District Judge Marcia Morales Howard’s findings that the notices were vague and confusing, and with her injunction requiring the state to notify enrollees of the figures it uses before terminating Medicaid coverage on the basis of income during redetermination. Now, notices must include the enrollee’s household size and countable income, the enrollee’s eligibility category and reason for change, and sufficient information for enrollees to identify which income limits applied to the evaluated categories. The state has not yet signaled whether it will file an appeal to the Supreme Court.
Idaho
Ninth Circuit Court Pauses Ruling Allowing Health Protection Exemptions to Abortion Ban. Last Friday, a 3-judge panel from the 9th U.S. Circuit Court of Appeals issued a stay on a district court ruling that allowed a Boise doctor to perform abortions to protect a mother’s health or address a risk of self-harm. Idaho currently has a strict felony abortion ban with exemptions to save the life of the pregnant person or during the first trimester when there is a reported case of rape or incest. In a 2-1 decision, the circuit court panel found that Dr. Stacy Seyb was unlikely to succeed with his claims that abortions to protect the mother’s health were valid under Idaho’s constitution. Originally, the district court had ruled to allow any doctor in Idaho to perform abortions to protect a mother’s health; however, after pushback from Attorney General Raúl Labrador (R), Judge Barry Lynn Winmill narrowed the ruling to just Dr. Seyb. While Dr. Seyb no longer holds this exemption, he has not indicated whether he will file an appeal with the Supreme Court.
Michigan
Governor Whitmer Issues Executive Directive to Limit Reproductive Health Data Sharing. Last Friday, Governor Gretchen Whitmer (D) issued an executive directive (ED 2026-4) aimed at limiting the sharing of Michiganders' reproductive health data with federal and commercial entities. The directive requires executive departments and agencies to conduct a comprehensive review of all policies and practices governing the collection, storage, and retention of individual reproductive health data, including precise geolocation information and existing data-sharing agreements. Then, the departments and agencies must revise all policies and practices to restrict sharing reproductive health data with federal and commercial entities, consistent with current Michigan constitutional rights and reporting obligations. The directive also requires departments with relevant data to report to Governor Whitmer’s office on any findings, policy recommendations, and legislative or technical needs. Former Secretary of State and Governor-elect Jocelyn Benson (D) will succeed Governor Whitmer in January, ahead of a new legislative session with a recently gained Democratic trifecta.
Medicaid Managed Care Adult Dental Benefits to Transition to Healthy Kids Dental Contract. Recently, the Michigan Department of Health and Human Services (MDHHS) announced that Medicaid adult dental benefits will transition from managed care organizations (MCOs) to the new Healthy Kids Dental contract administrator, Delta Dental of Michigan, effective January 1, 2027. MDHHS specified that existing prior authorizations are required to remain effective for 90 days following the switch and gave beneficiaries the option to request up to six months of continuity of care for ongoing treatment if disruption could cause serious harm. Dental providers may enroll in the new payor’s network, and patients of nonparticipating providers will be reassigned to in-network providers on January 1. Before the transition is finalized, MDHHS will issue additional policy guidance and notify affected beneficiaries.
Oregon
Health Authority Launches State-based Health Insurance Marketplace. Last Monday, the Oregon Health Authority announced the launch of Explore Health, Oregon’s new state-based health insurance marketplace replacing the federally facilitated HealthCare.gov platform for the 2027 plan year. The marketplace allows consumers to compare health and dental plans, estimate financial assistance eligibility, and enroll in coverage. Existing enrollees with HealthCare.gov coverage will be transferred to Explore Health and will need to activate their accounts, review their information, and select coverage for 2027. Through the transition, Oregon gains greater control over enrollment technology and services, access to data, consumer assistance, the ability to react to federal and state policy changes, and coordination with state health programs. Open enrollment runs through January 15, 2027, with an enrollment deadline of December 31 for coverage beginning January 1.