State Health Policy Leadership

Introduction Housing instability and unaffordability are contributing to adverse outcomes across a wide range of health domains. In a Milbank Quarterly Perspective from the 2026 special issue, Disease Burden, Mortality, and Life Expectancy in the United States: What Can State Policymakers Do to Meet the Challenges?, Andrew Fenelon of the University of Minnesota School of […] More

Emergency medical services (EMS) are basic lifesaving infrastructure for any community. More

North Carolina’s Healthy Opportunities Pilots (HOP) program, which was paused in July 2025 due to state funding constraints, tested whether providing evidence-based services to address upstream drivers of health for eligible Medicaid members could improve health outcomes, reduce costs, and address disparities in three predominantly rural regions of the state. More

As states brace for federal funding cuts and potentially large disenrollments in Medicaid, this report assesses the extent to which Medicaid managed care delivers value across its core functions: reducing financial risk for states; utilization management; network formation; care management; quality improvement; and paying for claims. More

Physician workforce shortages are limiting access to health care in nearly every state, with underserved and rural areas facing the greatest shortfalls. More

My second job at CDC was running policy for the chronic disease center. More

This Spotlight Brief demonstrates the health and economic impacts of heat emergencies, using a summer heat wave as a case study. More

In this interview about managing executive branch transitions in state government, Debra Farrington, Deputy Secretary for Health in the North Carolina Department of Health and Human Services, emphasized identifying priorities, engaging with legislators, and documenting relationships with community partners, so that important initiatives are understood as shared commitments. More

In this edited Q&A and video with Milbank’s Morgan McDonald, MD, Jeff Lunardi—then interim Medicaid director at Virginia’s Department of Medical Assistance Services (Cardinal Care)—shares practical lessons on prioritization, nonpartisan leadership, and agency stability during a gubernatorial handoff. More

One year ago in April, I walked off CDC’s campus for the last time, after spending over 20 years in the agency. More