The midterm elections abruptly shifted the health-care landscape across the country, resulting in a divided Congress that could mean most changes unfold on the state level. The split between red and blue states means that statehouses will continue to pursue opposite directions in health care. Voters approved Democratic-backed ballot initiatives to expand Medicaid in three states—Idaho, Utah and Nebraska—while rejecting a similar proposal in Montana.

HHS recently announced new guidance to states looking to improve their health care and health insurance systems through state innovation waivers. The new guidance gives states significantly more flexibility to devise creative solutions to meet the health care and insurance needs of their constituents and it builds upon new community engagement waivers that made Medicaid more flexible for states earlier this year.

A new proposed rule would give states new flexibility in setting rates for their managed care plans and ensuring insurance companies have adequate provider networks. "Today's action fulfills one of my earliest commitments to reset and restore the federal-state relationship, while at the same time modernizing the program to deliver better outcomes for the people we serve," CMS Administrator Seema Verma said in a statement.

The administration is proposing a regulation that would create a new way for employers to provide health coverage for employees. This proposal would give millions of workers and their families more control over their health care. It also holds the promise of more-efficient health-care spending, expanded business growth, and higher wages.

Medicaid expansion in Kentucky made it harder for Medicaid’s core users to get the care they needed, and harder to reduce waiting lists of children with developmental disabilities who need critical therapeutic services.