Center for Advancing Health Services Policy & Economics Research

A Missouri pilot program reimagines rural hospitals as the central hub for more than health care The Missouri pilot program taps a federal waiver to allow rural hospitals to use funding for things like home repairs, utility costs or food assistance in hopes of improving rural Missourians’ health ...

Missouri Medicaid pilot reimagines the role of a rural hospital for patients

"The ToRCH program is the brainchild of Kirk Mathews, MOHealthNET's chief transformation officer and Abigail Barker, a health economist at WashU" and @cahsperiph.bsky.social
thebeaconnews.org/stories/2026...

Why is Missouri Medicaid losing children on its rolls?

Since January 2025, enrollment of children on Medicaid in Missouri has dropped 28,845, about 5%, despite no change in eligibility criteria
[Update, Feb 2026 data]
siftingandwinnowing.substack.com/p/why-is-mis...

CAHSPER is hosting its 3rd Data Bootcamp on Chronic Disease Research and Policy
Keynote Elbert Huang from U of Chicago

Why heart disease and stroke are projected to rise significantly in women, even younger ones Obesity, diabetes and high blood pressure are fueling increases in cardiovascular disease, even among much younger women, the American Heart Association said.

Heart disease and stroke projected to rise significantly in women in the next 25 years
New study by @cahsperiph.bsky.social Co-Director Karen Joynt Maddox
www.nbcnews.com/health/heart...

Updated:
MISSOURI Medicaid DASHBOARD
with Jan 2026 data on enrollment, applications, managed care

Final report showing impact after open enrollment; applications up but below 2024 levels.
Enrollment steady at about 1.3 million;
@cahsperiph.bsky.social analysis

cahsper.wustl.edu/impact/medic...

Missouri Medicaid Update, Jan 2026:
Enrollment steady but enrollment of children falling

Number of children on Medicaid has dropped almost 24,000 in last year despite no changes in eligibility criteria

Latest from @cahsperiph.bsky.social
siftingandwinnowing.substack.com/p/missouri-m...

Missouri and Kansas families pay nearly 10% of their income on employer-provided health insurance A new report found that nearly 10% of median household income in Missouri and Kansas goes toward deductibles and premiums. At that level, economists say those households are underinsured.

Employer health insurance costs in Missouri and Kansas near 10% of household income

from MO Beacon
[with comments by @cahsperiph.bsky.social Co-Director @mcbridetd.bsky.social
thebeaconnews.org/stories/2026...

Health Affairs Journal

The FDA and Its Changing Relationship to Industry

Join Health Affairs Feb 17 for an event exploring recent changes at FDA and what it means for industry&consumers. Join an expert panel moderated by our briliant colleague @rachelsachs.bsky.social from WashU
www.healthaffairs.org/do/10.1377/h...

Why is Missouri’s Medicaid losing children on its rolls?
open.substack.com/pub/siftinga...

Health Affairs Journal

Analyzing The Drugs Selected For The 2028 Medicare Drug Price Negotiation Cycle
by @cahsperiph.bsky.social affiliated scholar @rachelsachs.bsky.social
| Health Affairs www.healthaffairs.org/content/fore...

ACA Marketplace (Obamacare) signups drop 1.2 million (-4.9%) in 2026, as consumers face increase in premiums

ACA marketplace enrollment down -12% in Missouri, over 51,000 in 2026
siftingandwinnowing.substack.com/p/aca-signup...

Missouri Medicaid Update:
Applications down 11% in 2025 during open enrollment period; but approvals up 26%

Latest report may reflect improved processing times and drop in pending applications
siftingandwinnowing.substack.com/p/missouri-m...

The Economics of Healthcare: Myths, Policy, and Reform with Dr. Timothy McBride Alternative title: Everything you wanted to know about healthcare - from the ACA to Medicaid - bu...

The Economics of Healthcare: Myths, Policy, and Reform with Dr. Timothy McBride
(co-Director of @cahsperiph.bsky.social) thecatalyst2.substack.com/p/the-econom...

Missouri Medicaid Financing Update: Medicaid expansion completely funded by federal funds to date

Medicaid expansion completely funded by federal funds: matching funds and over $1 billion MO received and put into a reserve. But reserves will be exhausted in 2026 open.substack.com/pub/siftinga...

CMS reports that over 833,810 fewer people have signed up for ACA marketplace (“Obamacare”) plans.
In 11 states (including Missouri) signups for plans dropped by more than 10%. In MO, signups dropped 11.3% (-46,054), from 407,782 in 2025 to 361,728 in 2026. See
open.substack.com/pub/siftinga...

Missouri Medicaid Financing Update Medicaid expansion completely funded by federal funds to date; Missoureceived over $1 billion from feds and put this into reserve, using this to fund expansion, but likely will be exhausted in 2026

Missouri Medicaid Financing Update

Medicaid expansion completely funded by federal funds to date; Missouri received over $1 billion from federal government and put this into reserve, using this to fund expansion. But likely these funds will be exhausted in 2026 open.substack.com/pub/siftinga...

Federal government awards $50 billion to states for rural healthcare. How much does Florida get? Donald Trump's administration awarded $50 billion in federal funding to support rural healthcare. But it comes after deep cuts to Medicaid could force some rural hospitals to close.

Federal government awards $50 billion to states for rural healthcare. How much does Florida get?
The Centers for Medicare and Medicaid Services awarded money through it's Rural Health Transformation Program.
[with comments from @cahsperiph.bsky.social Co-Director]
www.fox4now.com/arcadia/fede...

Missouri Medicaid 2025 Update: Annual Summary

Medicaid enrollment stable (up 0.2%), but stability hides significant underlying changes in categories of recipients

Open enrollment in progress, applications up 29% in Nov but pending applications down
siftingandwinnowing.substack.com/p/missouri-m...

Updated:
MISSOURI Medicaid DASHBOARD
with NOV 2025 data on enrollment, applications, managed care

First report after open enrollment started; applications up but below 2024 levels. Enrollment steady at about 1.3 million;
@cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...

"Missouri has released their first report on Medicaid applications" since open enrollment for the ACA. "applications to Medicaid rose 29% in Nov 2025; however, that level of applications is 13% below the number of applications received in November 2024...too early to tell what this drop indicates"

"Medicaid enrollment dropped slightly in Nov 2025 but has been roughly steady for months" but this does not "capture important changes in categories...enrollment dropped for custodial adults, people with disabilities & children, while enrollment grew for AEG, pregnant women, and the elderly."

Missouri Medicaid November 2025 Update:
First Report on Open Enrollment

Enrollment is steady, but the number of applications to Medicaid rose 29% from Oct to Nov 2025; however that level of applications is 13% below number of applications received in Nov 2024
open.substack.com/pub/timothym...

Missouri Medicaid November 2025 Update:
First Report on Open Enrollment

Enrollment is steady, but the number of applications to Medicaid rose 29% from Oct to Nov 2025; however that level of applications is 13% below number of applications received in Nov 2024
open.substack.com/pub/timothym...

First ACA Marketplace Snapshot Report for 2026:
Mixed and confusing results?

New consumers down -3.9%; existing selections up 9.9%.

In Missouri, existing selections down 6.6%
timothymcbride.substack.com/p/first-mark...

October 2025 Update:
Missouri Medicaid enrollment steady; pending applications drop considerably
Update from @cahsperiph.bsky.social
open.substack.com/pub/timothym...

October 2025 MO Medicaid update: pending applications drop considerably

"significant drop in number of pending applications...70% drop in pending applications from July to October 2025...average days to complete application dropped from 40 to 21 days"
timothymcbride.substack.com/p/october-20...

Total enrollment MO Medicaid program rose slightly in Oct but there are shifts in enrollment

Falling:
custodial adults (-20%)
disabled (-13%)
children (-7%),

Rising:
expansion group (+9%)
pregnant women (+31%)
elderly (+5%)

since unwinding
timothymcbride.substack.com/p/october-20...

October 2025 Update: Missouri Medicaid enrollment steady; pending applications drop considerably Enrollment in Missouri Medicaid up slightly, pending applications down 51%; shifts in enrollment categories underway.

October 2025 Update:
Missouri Medicaid enrollment steady; pending applications drop considerably
Update from @cahsperiph.bsky.social open.substack.com/pub/timothym...

October 2025 Update: Missouri Medicaid enrollment steady; pending applications drop considerably Enrollment in Missouri Medicaid up slightly, pending applications down 51%; shifts in enrollment categories underway.

October 2025 Update:
Missouri Medicaid enrollment steady; pending applications drop considerably
Update from @cahsperiph.bsky.social open.substack.com/pub/timothym...

Updated:
MISSOURI Medicaid DASHBOARD
with OCTOBER 2025 data on enrollment, applications, managed care & geographic distribution

Enrollment steady at about 1.27 million; @cahsperiph.bsky.social analysis
cahsper.wustl.edu/impact/medic...