Post-OBBBA Medicaid & ACA Defense Archive

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September 9, 2026
A Proper Scare: How OBBBA Changes Improper Payment Rules to Expose States to Significant Financial Liability
Shandra Hartly Uncategorized
The issues described in this blog post are explored more fully in a new NHeLP resource, OBBBA Changes to Improper Payment Penalties Pose Risks to State Medicaid Programs. In that paper, we provide a history of the PERM program, analyze how OBBBA changes it, discuss how the changes may…
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September 9, 2026
OBBBA Changes to Improper Payment Penalties Pose Risks to State Medicaid Programs
Shandra Hartly Issue Brief
Beginning October 1, 2029, OBBBA makes significant changes to Medicaid's Payment Error Rate Measurement (PERM) program: The law eliminates the "good faith waiver," making penalties for error rates over 3 percent mandatory, and it changes definitions to expand the universe of payments subject to penalties. The risk to state…
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August 12, 2026
State Law Alternatives for Medicaid Enforcement: Issue Brief 3 – State Constitutional Claims
Steven Schmidt Issue Brief
This issue brief examines State Constitutional Claims and how they may be used to enforce and improve access to health care for low-income and underserved individuals. The brief provides examples of numerous health-related state constitutional claims, and gives advocates ideas for claims to explore in their state. The brief…
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August 3, 2026
NHeLP Comments | Work Requirement IFR
National Health Law Program (NHeLP) Comments
Medicaid work requirements do not increase employment. Instead, they result in substantial coverage loss which, in turn, leads to health and financial harm. In comments on CMS's interim final rule implementing work requirements, NHeLP urges the agency to follow the evidence and craft a final rule that minimizes coverage…
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August 3, 2026
Statement for the Record for the Senate Budget Committee Hearing entitled “Medicaid: The Reality”
Steven Schmidt Testimony
On August 4, 2026, the United States Senate Budget Committee held a hearing titled: “Medicaid: The Reality." NHeLP submitted a statement for the record emphasizing the importance of Medicaid and Home and Community-Based Services (HCBS). NHeLP's statement made clear that increased spending on HCBS is not evidence of fraud,…
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July 21, 2026
NHeLP Comments on Medicaid Managed Care State Directed Payments and Fee-for-Service Targeted Payments Proposed Rule
Geraldine Doetzer, Jennifer Lav, and Christina Piecora Comments
NHeLP submitted comments opposing this proposed rule, which would substantially restrict access to care for Medicaid beneficiaries by reducing payment limits on state directed payments (SDPs) in Medicaid managed care and certain fee-for-service supplemental payments. The comment focus on how these proposals go far beyond statutory requirements and would…
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Post-OBBBA Medicaid & ACA Defense Archive

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A Proper Scare: How OBBBA Changes Improper Payment Rules to Expose States to Significant Financial Liability

OBBBA Changes to Improper Payment Penalties Pose Risks to State Medicaid Programs

State Law Alternatives for Medicaid Enforcement: Issue Brief 3 – State Constitutional Claims

NHeLP Comments | Work Requirement IFR

Statement for the Record for the Senate Budget Committee Hearing entitled “Medicaid: The Reality”

NHeLP Comments on Medicaid Managed Care State Directed Payments and Fee-for-Service Targeted Payments Proposed Rule