Policy Trends Shaping Access to Care in 2026
Policy Trends Shaping Access to Care in 2026
December 08, 2025
Public health agencies have a role in supporting access to care open_in_new, which means assuring timely access to covered health care open_in_new services provided by a qualified workforce. However, many communities experience challenges in accessing health care services, providers, facilities, or affordable care. Gaps in access to services that prevent chronic disease, address maternal health and behavioral health challenges, and other health goals undermine public health’s ability to improve community health. Strategies to improve access open_in_new to care can include focused attention on underserved or at-risk communities or populations, including rural populations. To support access to comprehensive health care services, state legislatures continue to explore laws that strengthen clinical and community-based health workforces, support rural health care facilities, and promote access to care across the lifespan, including for women.
Access to Supportive and Community-Based Health Services
Community health workers open_in_new (CHWs) are frontline public health workers who serve as a link between health and social services and the community, and can help address the social and behavioral health drivers of health outcomes. Many jurisdictions pursued policies to support CHWs by defining the workforce, establishing training or certification programs, and pursuing financial sustainability including through Medicaid programs open_in_new. In 2025, more than a dozen states considered legislation related to CHWs, with several states enacting laws that recognize CHWs as providers and/or authorize Medicaid coverage and reimbursement. This includes Arkansas HB 1258 open_in_new, which establishes a state certification for CHWs, defines their role, and requires compensation for certified CHW services from both Medicaid and certain regulated health plans in the state. Montana (HB 850 open_in_new) and Oklahoma (SB 424 open_in_new) enacted bills to regulate CHWs but both bills were vetoed by their respective governors. In Oklahoma, the legislature overrode the veto. Rhode Island open_in_new (S 0705) considered legislation that would require regulated health plans to cover CHW services, and Virginia enacted SB 981 open_in_new which requires the health department to report on the status of the CHW workforce and future needs.
Doulas open_in_new are non-medical professionals who support individuals during pregnancy, birth, and the postpartum period. Doula care has been shown to reduce the rate open_in_new of both cesarean sections and postpartum anxiety or depression, and may be cost effective open_in_new, particularly for Medicaid programs. A majority of states open_in_new are either pursuing or already offering doula coverage in their Medicaid programs. At least fourteen jurisdictions considered legislation in 2025 to recognize or provide coverage of doula services by Medicaid programs or private insurance. At least six states enacted laws regarding Medicaid coverage of doulas, including Louisiana (HB 454 open_in_new), Montana (SB 319 open_in_new), Utah (SB 284 open_in_new), and Vermont (S 53 open_in_new). In Maine, LD 1523 open_in_new directs the health department to begin the rate development process for future coverage of doula services, establish a doula council to support that process and provide other advice to the department, and issue a report on the overall progress by February 2027. Arkansas (HB 1252 open_in_new) established a scope of practice for certified community-based doulas and requires compensation by both the Medicaid program and other health benefit plans in the state.