Applications to the State Medicaid Policy and Strategy Learning Collaborative are due by 8 p.m. ET, April 6, 2026. To apply, complete the application form and submit it to Sara Federman (sfederman@nashp.org). Interested states can register for an informational webinar about the Learning Collaborative and the application process to learn more.
With support from Arnold Ventures, NASHP will select up to five states to participate in NASHP’s 18-month State Medicaid Policy and Strategy Learning Collaborative.
The collaborative will focus on supporting states with key policy decisions, cross-sector programming, and investment approaches related to the implementation of the One Big Beautiful Bill Act (OBBBA) within broader state health priorities.
OBBBA ushered in sweeping changes to Medicaid and other health and human services programs, and many states face tightening financial constraints and difficult budgeting decisions due to shifts in revenue and the impacts of the law. Therefore, a particular focus of the collaborative will be to support states with considering and implementing strategies to reduce costs and achieve efficiencies within state Medicaid programs while balancing quality, access, and accountability.
Selected state teams will be part of a unique opportunity to receive timely, targeted technical assistance from national experts. They will also engage with a cohort of states strategizing about the implications of OBBBA on their health ecosystems over the next several years and exploring promising practices. Technical assistance will focus on supporting state teams with the following (among other topics):
- Decision-making related to the Medicaid and overall state budgets,
- Identifying program efficiencies and approaches to address cost drivers while maintaining program goals,
- Fostering strategic partnerships and alignment across health and human services programs impacted by OBBBA, and
- Communication approaches with key partners (such as legislative leads, providers and consumers).
State Medicaid Policy & Strategy Learning Collaborative Timeline
Application and Selection Process
- Each state team must complete an application form and submit it to Sara Federman (sfederman@nashp.org) by April 6, 2026, at 8 p.m. ET/ 5pm PT.
- NASHP will review states’ application forms and select states to participate in the learning collaborative. All states that applied will receive notifications the week of April 13, 2026.
Any questions about the application process should be directed to Sara Federman (sfederman@nashp.org).
What Will States Gain during the Learning Collaborative?
Learning collaborative participants will have access to a unique opportunity for individual state support, multi-state peer learning opportunities, and technical assistance from state and national experts. NASHP will also provide a clearinghouse of tools and resources from NASHP and other expert state-facing organizations to support policy and strategy development and execution.
Learning collaborative activities will include:
Individual Technical Assistance
Each state team will identify core team members with decision-making authority to participate. Guided by a state-specific strategic plan, each state team will participate in monthly technical assistance virtual calls with NASHP staff and expert consultants to facilitate development of and execution of the plan. States will have the opportunity during these calls to identify and address emerging technical assistance needs. States will have ongoing access to NASHP staff and expert consultants, who will provide a timely and actionable response to inquiries, including connections to external experts when necessary to support initiative planning, development, and implementation. Technical assistance, along with the clearinghouse of tools and resources, will be informed by two NASHP advisory groups comprised of current state officials and external experts with deep experience in Medicaid, health financing, and policy.
Possible technical assistance topics include but are not limited to:
- Budget: Support with evaluating decisions relating to the Medicaid and overall state budget across the next several years. This may include strategic discussions around interpreting modeling and impacts on programs; considering and prioritizing options for generating savings and/or revenue; and communicating with key stakeholders (e.g., Governors, the legislature, Secretaries, external stakeholders).
- Cost Drivers: Support to identify underlying cost drivers in a state’s Medicaid program and as related to the broader state health care market. This will include working with state leaders to share strategies to slow the growth of health care costs and generate more efficiencies across the Medicaid program in areas such as drug pricing, health system costs, value-based payment, oversight of managed care plans, and other areas.
- Cross-Program Alignment: Support to develop an overarching strategy for implementing OBBBA provisions across health and human services programs. This will include facilitating strategic partnerships and aligned policy development across Medicaid, broader health and human services programs (including SNAP), marketplaces, workforce programs, and other state-level partners implicated in key cost drivers (such as long-term services and supports, prescription drugs, behavioral health, etc.) to ensure statewide planning, coordination, and sequencing of activities.
- Changes in Coverage: Support to understand coverage changes, movement across markets, and impact on providers. This will include strategies for individuals who may become newly uninsured across programs as well as identifying options for providers who may have higher numbers of uninsured patients.
In-Person Meetings
In addition to virtual technical assistance, state teams will participate in two NASHP-supported and facilitated in-person meetings.
- Learning Collaborative Convening: A convening of all participating state teams will take place in July of 2026 in Northern Virginia (exact time and location to be determined). The convening will include Learning Collaborative states as well as select state and national experts to inform peer-learning and discussion around emerging strategies to identify efficiencies, navigate cost drivers, drive cross-program policy and financial alignment, manage coverage changes, and other key issues identified by participating states. Up to four core team members are expected to attend in person, and funding will be available to cover associated travel and meeting expenses.
- In-state Convening. Participating state teams will individually work with NASHP to design and host an in-person convening that will provide state decision-makers with a dedicated time for strategic plan refinement and concrete steps for implementation. The meeting time and location will be selected with individual state teams.
State-to-State Learning Calls
State-to-state learning calls will be held approximately quarterly and include virtual learning opportunities to allow states to hear about work going on in other states, identify areas of shared need, discuss emerging challenges, and receive expert technical assistance. Topics for each group learning opportunity will be developed collaboratively to meet priority technical assistance needs identified by participating states. There is also the opportunity for affinity group breakouts for cross-state exchange to supplement state-specific calls.
Expectations of Participation
By committing to this initiative, each state team will be expected to:
- Maintain a core team of state officials with decision-making authority for overarching state strategy, including Health and Human Services agency leadership, Medicaid leadership, and a relevant member of the governor’s team. States are welcome to have additional team members (see below).
- Develop a project plan and work toward accomplishing goals and actionable steps to achieve these goals.
- Participate in monthly individual team technical assistance calls with NASHP staff to further implementation, share opportunities and barriers, and identify any emerging technical assistance needs.
- Participate in multi-state convenings (in-person and virtual).
- Participate in, and support the planning of, an in-state convening.
State Teams
State teams must consist of individuals with significant decision-making authority relating to strategy, policy, and budget for OBBBA implementation.
Team members should include:
- Senior member(s) of the Health and Human Services Agency (Secretaries and Commissioners; Senior Advisors that coordinate across multiple workstreams)
- Governor’s health policy advisor or another senior member of the Governor’s team
- Senior Medicaid lead (Medicaid Director, Deputy Director, Senior Advisor on Medicaid, etc.)
- Senior member(s) of the Budget Office
- Senior members from other related agencies, as applicable
