Update: What We’re Watching, Nov. 11, 2026
Hill to the Heartland: Federal Health Policy Briefing
The Centers for Medicare & Medicaid Services (CMS) announced $10 billion in second-year Rural Health Transformation Program awards to all 50 states, including $225.9 million for Kansas. CMS also proposed new marketplace income and eligibility verification requirements and announced a $275 million initiative to recruit and retain nurses in nursing homes. The Health Resources and Services Administration (HRSA) awarded more than $525 million for maternal and early childhood home visiting services. The Department of Justice announced plans to classify 7-OH and three related opioid substances found in enhanced or concentrated kratom products as Schedule I controlled substances. Health and Human Services (HHS) launched research and reporting initiatives on health problems following vaccination.
Here is some of the health-related news we are watching that could have an impact on Kansas.
The views expressed in the following news stories, news releases or documents are not necessarily those of the Kansas Health Institute (KHI). They are being shared with the intent of keeping Kansans informed of the latest developments related to federal health policy.
U.S. Health and Human Services Updates
1. Second Year Rural Health Transformation Program Awards Announced
On Nov. 9, CMS announced $10 billion in awards to all 50 states through the second year of the Rural Health Transformation Program (RHTP). Each state received $100 million for baseline funding, with the remaining funding allocated based on characteristics of the state, initiatives proposed in the RHTP plan, state policy actions and progress implementing the state’s approved plan. Kansas received $225.9 million for the second year of the program, $4 million more than the first-year award of $221.9 million.
🔗 Read the press release from HHS: Trump Administration Announces $10 Billion in Second Year of Rural Health Transformation Awards to All 50 States
🔗 Read the fact sheet: Rural Health Transformation Program: Year 2 Awards
🔗 Read more from KSNT: $226 million to support rural healthcare in Kansas
2. CMS Proposes New Marketplace Eligibility Verification Requirements Beginning in 2028
On Oct. 23, CMS proposed new verification requirements for consumers enrolling in the health insurance marketplace and seeking advance premium tax credits (APTC) and cost-sharing reduction (CSR) subsidies. The proposal would implement marketplace eligibility verification requirements enacted in H.R. 1. CMS refers to the law in the proposed rule as the Working Family Tax Cuts (WFTC) legislation. The proposal revisits some of the verification policies in the 2025 Marketplace Integrity and Affordability Final Rule that were later vacated by a federal district court. Beginning in 2028, marketplaces would be required to verify household income and family size, citizenship or eligible immigration status, access to other qualifying coverage, and place of residence. Consumers whose information cannot be verified could enroll in marketplace coverage without financial assistance while documentation is pending. The proposed rule would also require current enrollees receiving APTC and CSR to actively confirm certain eligibility information and have it verified. Those not completing the process could be enrolled automatically without financial assistance. Public comments on the proposed regulation must be submitted by Nov. 27, 2026.
For the upcoming 2027 open enrollment period, if an exchange cannot verify an enrollee’s information electronically, the enrollee enters an inconsistency period. Consumers who appear eligible continue to receive APTC and CSR during this period. If they do not submit documentation by the deadline, those benefits are typically reduced or terminated. The proposed changes would not take effect until the open enrollment period of plan year 2028.
During the most recent open enrollment period, 192,811 Kansans enrolled in marketplace coverage. Of those, 26,335 were new to the marketplace, 92,554 returned to the marketplace and actively selected their plan, and 73,922 were automatically reenrolled without returning to the marketplace.
🔗 Read the press release from CMS: Exchange Pre-Eligibility Verification Proposed Rule (CMS 9873-P)
🔗 Read the press release from CMS: CMS Proposes New Verification Requirement to Implement Law that Combats Exchange Fraud and Protects Taxpayer Dollars
🔗 Read more from Strategic Health Care: CMS Proposed Rule: ACA Exchange Pre-Eligibility Verification
🔗 Read more from the American Hospital Association: CMS proposes changes to Marketplace pre-enrollment verification process
3. Initiative to Recruit and Retain Nurses in Nursing Homes
On Oct. 23, CMS announced the Nurses for Nursing Homes initiative, a nationwide effort to increase staffing at the nation’s nursing homes, particularly in rural and higher labor shortage areas. Nursing students and licensed nurses interested in working in a nursing home may qualify for up to $40,000 in student loan repayment and/or a $10,000 stipend in exchange for a three-year commitment to working 30 hours per week at a qualifying nursing home in a rural or higher labor-shortage area. CMS estimates the initiative will support 4,000 nurses and nursing students nationwide.
🔗 Read the press release from CMS: CMS and States Launch $275 Million Initiative to Recruit and Retain Nurses in Nursing Homes
🔗 Read more from CMS: Nurses for Nursing Homes Frequently Asked Questions
🔗 Read more from The Hill: Trump announces $250M-plus initiative to recruit, retain nursing home nurses
4. DOJ Announces Emergency Scheduling of 7-OH and Related Opioid Substances in Enhanced Kratom Products
On Oct. 9, the U.S. Department of Justice (DOJ) announced emergency scheduling actions related to 7-hydroxymitragynine (7-OH) and three potent opioid substances related to 7-OH ─ mitragynine pseudoindoxyl (MGPI), MGM-15 and MGM-16. These related substances had already been temporarily placed in Schedule I of the Controlled Substances Act on Aug. 26, and those controls remain in effect. These compounds are associated with products marketed as kratom. The DOJ stated it was taking this action based on new recommendations provided by HHS. While 7-OH occurs naturally in botanical kratom products at relatively low levels, HHS recommended this approach to distinguish products containing enhanced or concentrated amounts of 7-OH and the other opioid substances from products more consistent with botanical kratom. The Schedule I category indicates there is no accepted medical use and a high potential for abuse. Substances that naturally occur in trace amounts in botanical kratom would not meet concentration thresholds. Synthetically concentrated kratom extracts, sometimes referred to as “gas station heroin,” would be impacted by the regulation.
Kansas law prohibits kratom products. House Bill 2365, signed Apr. 10, 2026, amended the Uniform Controlled Substances Act to add 7-OH and related kratom substances to Schedule I. Senate Bill 430, signed Apr. 27, 2026, added mitragynine to Schedule I.
🔗 Read the press release from DOJ: Department of Justice Announces Updates to Emergency Scheduling Actions for 7-OH and Related Opioid Substances
🔗 Read more from HHS: HHS Recommends Science-Based Thresholds to Target Dangerous Enhanced Kratom Products
🔗 Read more from The Hill: HHS endorses DEA move to schedule synthetic kratom extracts
🔗 Read more from Becker’s Behavioral Health: Kratom, 7-OH and related compounds: 10 developments to know
🔗 Read the news release: Governor Kelly Signs Bipartisan Bill Banning Kratom Products
5. HHS Takes Actions to Strengthen Vaccine Injury Research, Reporting and Patient Care
On Oct. 8, HHS announced a series of actions related to how the federal government “identifies, documents, investigates and responds” to health problems reported following vaccination. The National Institutes of Health (NIH) opened a clinic to evaluate and study patients with health problems following vaccination, including investigating whether those conditions may be related to vaccination. CMS is proposing reimbursing physicians for reporting suspected vaccine-related injuries. Electronic health records will be required to capture vaccine-related adverse events so that the information follows the patient across the health care system. The CDC is modernizing the vaccine adverse events reporting system (VAERS) to make reporting simpler and improve the tools available for researchers and medical professionals.
🔗 Read the press release from HHS: HHS Launches Agency-Wide Actions to Strengthen Vaccine Injury Research, Reporting and Patient Care
🔗 Read more from HHS: Secretary Kennedy Hosts NIH Roundtable on Vaccine Injury Research and Reporting
🔗 Read more from Fierce Healthcare: HHS launches 4 new vaccine injury research, reporting initiatives
6. HRSA Awards $525 Million for Maternal and Early Childhood Home Visiting
On Oct. 5, the Health Resources and Services Administration (HRSA) announced more than $525 million in fiscal year 2026 awards through the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program to 56 states and jurisdictions. The MIECHV Program supports communities to provide voluntary, evidence-based home visiting services to women during pregnancy and to parents with young children up to kindergarten entry. The Kansas Department of Health and Environment received $7.1 million, including about $5.2 million in base funding and $1.9 million in federal matching funds.
🔗 Read more from HRSA: HRSA Awards More Than $525 Million to Strengthen and Expand Evidence-Based Home Visiting Services Nationwide
🔗 Read more from HRSA: FY26 Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program Awards
News From the Kansas Delegation
Members of the Kansas congressional delegation were active in September and October on a range of health care and related policy matters.
- On Oct. 5, U.S. Rep. Sharice Davids (D-KS) introduced a package of seven health care bills addressing Affordable Care Act and Medicaid coverage, rural hospital and maternity care, Medicare Supplement coverage and Medicare eligibility for people with early-onset Alzheimer’s disease.
🔗 Read more from Rep. Davids’ office: Davids Fights Washington Healthcare Cuts with Plan to Lower Costs, Protect Kansas Hospitals
🔗 Read more from the Kansas Reflector: US Rep. Sharice Davids introduces healthcare reform package in response to federal cuts
🔗 Read the bill language: Healthy Communities Act of 2026
🔗 Read the bill language: Rural Surgery Sustainability Act of 2026
🔗 Read the bill language: Guaranteeing Access to supplemental Plans Act (GAP Act)
🔗 Read the bill language: Long-Term Rural Health Investment Act of 2026
🔗 Read the bill language: Access to Community Care Act of 2026
🔗 Read the bill language: Maternity Care for Rural Communities Act of 2026
🔗 Read the bill language: Early-Onset Alzheimer’s Coverage Act of 2026
- On Sept. 15, U.S. Rep. Derek Schmidt (R-KS) announced that he was co-sponsoring the SKIM Act aimed at electronic benefit transfer (EBT) card and identity fraud. The bill would strengthen coordination among federal, state and local law enforcement, increase penalties for using fraudulent cards and establish best practices to identify and prevent EBT fraud.
🔗 Read more from Rep. Schmidt’s office: Rep. Derek Schmidt Joins Effort to Crack Down on EBT Fraud
🔗 Read the bill language: Stopping Klepto-card and Identity Misuse Act (SKIM Act)
Stay tuned for further updates on policy shifts that may affect health programs and services in Kansas. For related work on how federal policies could impact Kansans, please check out Hill to the Heartland.
About Kansas Health Institute
The Kansas Health Institute supports effective policymaking through nonpartisan research, education and engagement. KHI believes evidence-based information, objective analysis and civil dialogue enable policy leaders to be champions for a healthier Kansas. Established in 1995 with a multiyear grant from the Kansas Health Foundation, KHI is a nonprofit, nonpartisan educational organization based in Topeka.