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SNA Public Policy News You Can Use – March 3, 2026

Medicaid Advocates Continue Challenging State Proposals to Cut Medicaid Services

Yesterday, KFF Health News released two articles detailing the discussions Medicaid disability and dental services advocates are facing. In Idaho, lawmakers are considering cutting $22 million from the state’s Medicaid program, with home- and community-based services (HCBS) as potential targets. Medicaid advocates note that many other states including Colorado and Missouri are considering reducing HCBS because they are optional services. Kim Musheno, Senior Director of Medicaid Policy at The Arc, commented that disability advocates predicted and warned Congress about this when the One Big Beautiful Bill Act (H.R.1) was being discussed.

Similarly, dental care advocates are concerned that H.R.1’s cuts to Medicaid will cause states to restrict optional dental benefits. KFF reported that last year, 38 states and the District of Columbia offered enhanced dental benefits for adult Medicaid beneficiaries even though fewer than 1 in 4 adults on Medicaid see a dentist at least once a year. Many beneficiaries reported that Medicaid dental networks were not sufficient or accessible, noting that transportation, childcare, and other income-related barriers to care existed.

Advocates for Medicaid coverage of routine HCBS and dental services highlighted the importance of preventative and chronic care management and expect Medicaid cuts to undermine years of progress.

Research Estimates $664 Billion Reductions in State Medicaid Budgets Over 10 Years

Last week, the Rand Corporation released a research report on the State-Level Impacts of Key Medicaid Provisions in the One Big Beautiful Bill Act (H.R.1). From 2025-2034, researchers estimate that state Medicaid budgets will be reduced by $664 billion due to $714 billion dollars in federal government savings and $87 billion in State general fund reductions. The report outlines potential impacts by H.R.1 provision, state, and both. Their research found that 34 states will experience changes in home- and community-based services (HCBS) offerings with Texas ($1.4 billion), Pennsylvania ($1.1 billion), and Florida ($820 million) experiencing the largest new investments in HCBS over the 10-year period. Additionally, the Rural Health Transformation Program (RHTP) funds are expected to provide the largest percentage-based benefits to the Medicaid programs in Wyoming, South Dakota, and North Dakota. The Rand Corporation’s calculations are similar to the Congressional Budget Office’s estimates from July 21, 2025.

CMS Announces Measures to Strengthen Medicare and Medicaid Fraud Prevention

White House officials, including Vice President J.D. Vance, Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., and Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz, announced a series of measures aimed at reducing fraud in Medicare and Medicaid. CMS is deferring $259.5 million in federal Medicaid funding to Minnesota while reviewing potentially questionable claims, imposing a six-month nationwide moratorium on certain new Medicare supplier enrollments for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS), and seeking public input on ways to strengthen fraud prevention efforts via a Request for Information (RFI). These steps are intended to prevent improper payments, hold accountable those engaged in fraudulent activity, and help safeguard taxpayer dollars. Secretary Kennedy noted “we are replacing the old ‘pay and chase’ model with a real-time ‘detect and deploy’ strategy, using advanced artificial intelligence tools to identify fraud instantly and stop improper payments before they go out the door.”

The agency stated that these efforts are part of a broader, data-driven strategy to detect fraud early and promote program integrity. Past initiatives have included suspending billions of dollars of suspected fraudulent payments, denying claims that fail coverage requirements, and revoking billing privileges for providers with a history of improper practices. CMS also plans to increase transparency, share information about providers removed from Medicare, and work with states and stakeholders to refine oversight approaches, reduce waste, and maintain access to necessary care while controlling costs for beneficiaries.

Casey Means Testifies Before Senate in Surgeon General Confirmation Hearing

Dr. Casey Means, wellness influencer, author, and entrepreneur, testified before the Senate Health, Education, Labor and Pension (HELP) Committee last Wednesday the 25th as part of the process for her to be confirmed as the next U.S. Surgeon General, the nation’s top doctor. During her testimony, Means supported a shift from reactive medical care to that which addresses the root causes of chronic disease, which she argues are heavily influenced by poor nutrition and metabolic dysfunction. She highlighted the importance of systemic solutions, saying that tackling underlying issues could reduce the country’s reliance on what she described as “whack-a-mole medicine.” Her approach aligns with Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr.’s Make America Healthy Again (MAHA) agenda which has drawn bipartisan acknowledgment that chronic disease is a growing national concern.

Means faced questions from senators on a range of issues including her past promotion of wellness products, lack of government experience, and lack of a medical license. She indicated support for informed consent when considering common vaccinations, addressed potential risks associated with hormonal contraceptives, and clarified that her recommendations on psychedelics reflected her private views rather than public health guidance.

Dr. Means’ unconventional path includes leaving her surgical residency and abandoning the opportunity to receive a medical license in order to focus on functional medicine and co-found Levels, a health-tracking app. Echoing previous Surgeon Generals’ concerns, senators questioned whether her background properly equips Means for the traditional leadership responsibilities of the Surgeon General.

President Trump’s Former Surgeon General Jerome Adams criticized Dr. Means, saying it is “incomprehensible” that the Senate is considering a candidate without an active medical license or who has not completed their medical residency. He expressed concern that confirming Means could risk the credibility of the surgeon general’s office, particularly given her cautious stance on vaccines. In the coming weeks, the Senate HELP Committee will decide whether to advance Means’ nomination for a full Senate vote or end her opportunity for confirmation.

Ahead of Midterm Elections, President Trump Centers Healthcare in Domestic Agenda

In the first State of the Union address of his second term, President Trump spoke about health care goals as part of a broader set of domestic policy priorities, with a primary emphasis on the rising cost of coverage and prescription drugs. He criticized the Affordable Care Act (ACA), arguing that the current system structure disproportionately benefits insurance companies. Relatedly, Trump outlined his proposed “Great Healthcare Plan,” which aims to expand price transparency requirements and redirect federal payments to individuals to directly purchase health insurance coverage. The President also highlighted his administration’s efforts to lower prescription drug costs through the “Most Favored Nation” policy and called on Congress to codify the program into law. Beyond healthcare financing and affordability, the president’s remarks addressed issues related to the parental rights in the context of transgender youth and national security and health care concerns tied to illicit drugs, which he linked to broader efforts to combat cartel activity and limit the flow of illegal substances into the United States.

The President’s remarks did not offer any new healthcare policies and sparsely mentioned the Make America Health Again (MAHA) initiative – which has so far been a focal point of this administration’s healthcare agenda.

What’s on Tap

Over the weekend, President Trump initiated military action in Iran after nuclear arms negotiations were reportedly derailed. This week, most of Congress’ attention will be focused on the debate and vote of a bipartisan War Powers Resolution that would end the U.S. military action in Iran; however, the bill has little chance of becoming law as President Trump will almost certainly veto any resolution that advances out of Congress.

In parallel, Republicans are placing renewed pressure on Democrats to agree to appropriations for the Department of Homeland Security (DHS) in order to fund the Transportation Security Administration (TSA). Due to the partial government shutdown, TSA agents are expected to miss their first paycheck later this week. Out of concern for the impact travel delays might have on the broader economy, Senate Majority Leader John Thune (R-SD) floated the idea of shifting border security and immigration enforcement funds from the One Big Beautiful Bill Act (H.R.1) to airport security in the interim. DHS funding lapsed on February 14th after lawmakers failed to come to an agreement on enhanced guardrails pertaining to Immigrations and Customs Enforcement (ICE) agents’ activities that led to the death of two U.S. citizens in Minneapolis earlier this year.

While Congress remains focused on foreign policy, Trump Administration officials revamped their efforts to curb fraud, waste and abuse in the healthcare industry. Following President Trump’s State of the Union Address last week, Vice President J.D. Vance, Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., and Centers for Medicare and Medicaid Services (CMS) Administrator Dr. Mehmet Oz announced a series of measures seeking to reduce fraudulent activity in Medicare and Medicaid. These measures include freezing $259.5 million in federal Medicaid funding for Minnesota while CMS reviews flagged claims, issuing a six-month nationwide moratorium on new enrollment for Durable Medical Equipment suppliers, and releasing a Request for Information (RFI) on how the federal government should address healthcare fraud broadly. The RFI provides CMS with an opportunity to address fraud in other sectors of the health care industry via rulemaking in the coming months. CMS also issued the Comprehensive Regulations to Recover Suspicious Healthcare (CRUSH) initiative which will leverage innovative artificial intelligence (AI) tools to identify fraud in real time rather than the “old pay and chase model”. Taken together, health care providers are interpreting HHS’s continued commitment to addressing fraud, waste, and abuse as a sign that the Trump Administration will expand these initiatives throughout the calendar year.

Additionally, the Department of Justice (DOJ) recently adopted AI tools to support their investigations into health care fraud, leading to twice as many fraud cases and 5.7 billion dollars in settlements in fiscal year 2025. On Friday, President Trump ordered federal agencies to cease using Anthropic’s AI large language model. This directive could complicate the DOJ’s enforcement activities – especially given that federal government struck a deal with the technology developer last year to use their AI in all branches of the government. Late last year, HHS and the Food and Drug Administration (FDA) implemented Anthropic’s product and could experience health care fraud investigation productivity losses while the Administration charts a path forward.

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