Comprehensive, capitated managed care is the dominant Medicaid delivery system, accounting for about 78% of beneficiaries (over 66 million individuals as of July 2024) and 50% of total Medicaid spending (over $458 billion in FY 2024). States were contracting with over 280 individual Medicaid managed care organizations (MCOs) (as of July 2022), which represent a mix of private for-profit, private non-profit, and government plans. Medicaid managed care contracts are among the largest and most complex state contracts, frequently exceeding billions of dollars a year. While the majority of states contract with managed care plans, states decide which populations and services to include in managed care arrangements, leading to considerable variation across states.

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In the final days of 2025, governors around the country trumpeted the hundreds of millions of federal dollars they won from a new, $50 billion rural health fund.

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COLUSA, Calif. — Early on, Jean Franklin got some career advice she followed religiously: “Pay yourself first.” So she did, socking away hundreds of thousands of dollars in retirement savings by the time she became a stay-at-home mom at age 41.

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For people with Medicare, the Medicare Part D outpatient prescription drug benefit is provided by private plans, either Medicare Advantage plans that offer Part D drug coverage (MA-PDs) or, for those in traditional Medicare, stand-alone prescription drug plans (PDPs). While most beneficiaries are enrolled in Medicare private plans on an individual basis, some have coverage through a group plan sponsored by an employer or union providing retiree health benefits, either group MA plans that cover Medicare Part A and B benefits, which can also include Part D coverage, or group PDPs that cover prescription drugs only.

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In a major victory long sought after by abortion opponents, the federal government now has codified a ban on Medicaid funds that support care provided at Planned Parenthood clinics and other locations. Section 71113 of the 2025 Federal Budget Reconciliation Law, prevents Medicaid payments to certain reproductive health care entities that provide abortion care for one year from the date of enactment.

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ASHEVILLE, N.C. — At around 2 a.m., 7-year-old twin brothers arrived at Mission Hospital in Asheville. Both had a fever, a cough, a rash, pink eye, and cold symptoms.

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Subsidies. Love ’em or hate them, they dominated the news during the Affordable Care Act’s sign-up season, and their reduction is now hitting many enrollees in the pocketbook.

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Lawmakers in at least eight states this year are aiming to reel in wage garnishment for unpaid medical bills.

The legislation introduced in Colorado, Florida, Hawaii, Indiana, Maine, Michigan, Ohio, and Washington builds on efforts made in other states in past years. This latest push for patient protections comes as the Trump administration has backed away from federal debt protections, health care has become more costly, and more people are expected to go without medical coverage or choose cheaper but riskier high-deductible insurance plans that could lead them into debt.

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More than 10,000 people have enrolled in Nevada’s new public option health plans, which debuted last fall with the expectation that they would bring lower prices to the health insurance market.

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Wyoming officials say they have a plan to make five years of upcoming grants from a new $50 billion federal rural health program last “forever.” The state could tackle rural health issues long into the future by investing its awards from the Rural Health Transformation Program, the director of Wyoming’s health department, Stefan Johansson, told state lawmakers.

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