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Today’s Medicaid programs are operating in a rapidly changing environment — shaped by significant budget pressures, high turnover among state program leadership, the operational demands of implementing new eligibility and work requirement policies, and a heightened focus on curbing fraud, waste, and abuse, all while positioning programs for long-term success. At the same time, states continue to advance major priorities such as behavioral health system improvements, maternal health initiatives, payment and delivery system modernization, and rural health transformation efforts.

Against this unprecedented mix of pressures, this panel convened current and former Medicaid directors from across the country, including leaders from the District of Columbia and Georgia, a former director who led Medicaid in both Arizona and Texas, and a former director from Vermont. Panelists offered a candid look at how states are navigating the moment, including:

• How directors are setting priorities amid shifting federal guidance and resource constraints;
• What challenges are most pressing — and where they see opportunities and innovation emerging;
• How agencies are strengthening staff capacity to promote organizational resilience; and
• What states need from partners — including plans, providers, community organizations, and vendors — to advance shared goals.

Designed for a broad Medicaid stakeholder audience, this 60-minute panel highlighted how states are adapting in real time and what it will take to sustain strong, resilient programs moving forward. This conversation is part of CHCS’ newly launched National Medicaid Leadership Center, which aims to strengthen and support Medicaid leadership nationwide.

Agenda

I. Opening Remarks  

Speaker: Allison Hamblin, President and CEO, CHCS  

A. Hamblin welcomed participants, introduced the National Medicaid Leadership Center, and set the stage for the panel.

II. Panel Discussion  

Moderator: Allison Hamblin  

A. Hamblin led a discussion with four panelists — all current or former Medicaid directors — who explored how states are navigating changes in the current environment and what is needed to maintain effective, adaptable, and resilient programs over time.

Panelists:

• Melisa Byrd, Senior Deputy Director and Medicaid Director, Department of Health Care Finance, District of Columbia, former NAMD Board President
• Mark Larson, Senior Vice President, Leadership and Capacity Building, Center for Health Care Strategies, former Vermont Medicaid Director
• Stuart Portman, Executive Director, Division of Medical Assistance Plans, Georgia Department of Community Health; NAMD Board President
• Jami Snyder, President and CEO, JSN Strategies, former Arizona and Texas Medicaid Director, former NAMD Board President

III. Moderated Q&A

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