State-by-State Policy & Advocacy Updates: Q4 2025

Please note: The following updates are current as of December 16,  2025 and are subject to change given the fluid nature of the legislative process. For any questions, please email admin@caresourcemission.com. 

As state and federal leaders finalize year-end decisions and set agendas for 2026, CareSource remains focused on advocacy that delivers real impact. 

Throughout the final months of the year, our team has been building strategic relationships and engaging in timely policy conversations to protect access to care and advance better health outcomes for the members we serve.

FEDERAL UPDATES
Our Federal Government Relations team has been closely monitoring the future of Enhanced Advance Premium Tax Credits (eAPTCs), which are set to expire after December 31, 2025.

• Originally established under the Affordable Care Act (ACA), Advance Premium Tax Credits (APTCs) were significantly expanded through the American Rescue Plan Act (ARPA) of 2021, which removed income caps and increased subsidy levels to make coverage more affordable during the COVID-19 pandemic. These enhancements were later extended by the Inflation Reduction Act (IRA) of 2022 through the end of 2025.
• Congressional debate over the future of the eAPTCs intensified this quarter as the Senate rejected competing healthcare proposals. 
• In a largely party-line vote, the Senate failed to advance a Republican-backed proposal to expand health savings accounts as an alternative to the expiring credits, as well as a Democratic proposal to extend the enhanced subsidies for three years. Both measures fell short of the 60 votes needed to clear procedural hurdles. While most votes aligned along party lines, several senators crossed party lines, underscoring the complexity and political sensitivity surrounding the issue.
• The House also passed a bill largely along party lines aimed at reducing health care costs, including funding Cost-Sharing Reduction payments rather than funding eAPTCs. 
• If eAPCTs are allowed to lapse, millions of Americans could face significant premium increases in 2026. As of this writing, the future of eAPTCs remains uncertain and continues to be a major focus of federal healthcare policy discussions.

INDIANA
In Indiana, we continue to engage with the community on mental and behavioral health awareness while navigating statewide managed care transitions and early legislative activity heading into the 2026 session.

• CareSource hosted the CareSource Invitational Indianapolis – Supporting Mental Health, recognizing LifeSpring and Regional Health with $25,000 each for their behavioral health work. 
• CareSource also presented a $10,000 donation to Arsenal Technical High School’s athletic program to expand access to mental health counseling for student-athletes.
• Following the state’s notification to MDwise that its Medicaid contracts for HIP and Hoosier Healthwise would be terminated, around 300,000 members will need to select one of the three remaining plans for 2026 (including CareSource) or be auto-assigned.
• Indiana lawmakers returned to the Statehouse in December to begin early work on the 2026 session, with a focus on redistricting. The Senate ultimately defeated HB 1032 in a 19–31 vote, ending the redistricting conversation.
• Looking ahead, Indiana is expected to have a short session in 2026, with maternal health and medical debt among the priorities. Longer-term attention will remain on implementation of the One Big Beautiful Bill Act (OBBBA) and the anticipated HIP 3.0 waiver.

MISSISSIPPI
As legislative priorities are set for 2026, our team is monitoring key developments related to access, affordability and rural health transformation. 

• Mississippi Governor Tate Reeves outlined five priorities for the upcoming legislative session beginning January 6, 2026, including strengthening the economy, preparing the workforce, improving mental health outcomes and public safety, supporting the state’s courts and educational freedom. 
• The Mississippi Insurance Study Committee (established under SB 2401, 2025) convened to review healthcare access and affordability issues, including the state’s challenges to address rising premiums and coverage gaps. 
• In November, Governor Reeves announced Mississippi’s proposed Rural Health Transformation Program, aiming to provide reliable access to high-quality healthcare for every rural resident by 2031, including in-person and telehealth services.
• CareSource and TrueCare met with Mississippi Medicaid Director Cindy Bradshaw, who commended the team’s collaborative efforts to enhance healthcare services and streamline operations within the state's Medicaid framework.

MICHIGAN
With strong budget outcomes and continued momentum for HAP CareSource, our team saw meaningful progress in Michigan this year. 

• Michigan leaders reached agreement on a Fiscal Year (FY) 2026 budget, averting a state government shutdown in early October. 
• HAP CareSource supported industry efforts to secure a $100 million supplemental appropriation for managed care plans for FY 2024 and 2025, and secured a 9% rate increase for FY 2026. The industry has been successful in holding off any conversation on a state-based exchange. 
• Looking ahead, our team is focused on implementation of the One Big Beautiful Bill Act, including responding to federal guidance on timelines for bringing the Insurance Provider Assessment (IPA) into compliance with recent changes to federal law.

NORTH CAROLINA
Amid ongoing state budget pressures and oversight activity, our team is monitoring efforts to restore provider rates alongside heightened scrutiny of cost drivers, cost-containment decisions and behavioral health funding.

• North Carolina Governor Josh Stein directed the North Carolina Department of Health and Human Services to restore Medicaid provider reimbursement rates to September 30, 2025 levels, reversing cuts of 3% to 10% that took effect on October 1.
• While the action provided short-term stability for providers, the Governor noted a $319 million Medicaid funding shortfall and urged the General Assembly to resolve the budget impasse to prevent disruptions in care for more than 3 million residents.
• The Joint Legislative Oversight Committee on Medicaid reviewed spending trends and cost drivers, including rising pharmacy costs, inflation and increased autism service utilization. 
• The committee discussions also addressed recent cost-containment actions, including provider and capitation rate reductions, ending GLP-1 coverage for weight loss and discontinuing the Integrated Care for Kids Pilot program.
• The Joint Legislative Oversight Committee on Health and Human Services reviewed progress on ARPA-funded behavioral health investments and statewide efforts to strengthen mental health and substance use services.

OHIO
As lawmakers returned from summer recess, our recent activity has focused on advancing pro-provider legislation and ongoing efforts to preserve stability and protect access to managed care. 

• The Ohio legislature resumed session, focusing largely on restructuring and revising property tax policies. While efforts to advance pro-provider legislation are ongoing, progress is expected to stay on pause until the legislature returns around February 2026.
• Scott Partika was appointed Ohio Medicaid Director and began his role in November. Prior to his appointment, he served as Governor Mike DeWine’s policy director, overseeing Health & Human Services policy. Partika previously worked with the CareSource Ohio Government Affairs team.
• Heading into 2026, our team’s top priorities are to continue to strengthen relationships with the leading 2026 gubernatorial candidates, protect the Next Generation of MyCare (FIDE) from state fiscal pressures and implementation delays and continue effective lobbying campaigns against harmful legislation.

WEST VIRGINIA

As the state prepares for the upcoming legislative session, our activity focused on workforce and economic priorities alongside efforts to strengthen rural healthcare access.

• Ahead of the upcoming session running January 14th through March 14th, the West Virginia House of Delegates Republican majority announced its “Jobs First – Opportunity Everywhere” legislative agenda, emphasizing workforce development and economic growth. 
• West Virginia officials submitted an application for the Rural Health Transformation (RHT) Fund Program, aiming to secure federal funding to enhance healthcare access in rural areas. The plan focuses on developing a data-driven network of healthcare providers and improving infrastructure to support comprehensive care delivery.
• To provide input on the RHT application, CareSource was invited to a roundtable with Governor Morrisey’s administration. The discussion focused on collaborative solutions to key issues, including the physician shortage, difficulties in recruitment due to the state's low educational rankings, public transportation barriers and inadequate broadband access that hampers telehealth services.

WISCONSIN
As the 2025–2026 Wisconsin legislative session continues, our team is closely monitoring several health care issues that would impact the members we serve. 

• Lawmakers are considering multiple proposals to restrict prior authorization, including a bill that would prohibit prior authorization for the first 12 physical, occupational, speech therapy, or chiropractic visits, as well as limit prior authorization for pain management services. A separate bill that would prohibit prior authorization for antipsychotic medications in Medicaid is also advancing. 
• Additional issues gaining attention include a proposal to increase reimbursement for emergency ambulance services and several mandate bills, including one related to advanced breast cancer screenings.
• Wisconsin is already facing a shortfall in Medicaid and other programs tied to changes required under the One Big Beautiful Bill Act, and may also have to grapple with the loss of about $1 billion annually in hospital funding if its proposed hospital assessment is not approved by the federal government.
• These pressures could trigger an extraordinary session or a budget adjustment bill in 2026. The legislature is expected to adjourn for regular session in late winter or early spring.

Stand With Us When It Matters Most
As we head into 2026, the stakes for affordability, access and quality health care continue to rise. Your support strengthens our advocacy for the members we serve. Renew your membership or become a new member and help ensure our collective voice remains strong in the year ahead.