If you want to see the future of the health and human service market, don’t look to Washington—watch the states. The past 11 months of changes in policies and budgets brought by the Trump administration has pushed many policy decisions and budget responsibility to the states (see Lead Like It’s 1863: Timeless Lessons For Navigating Through Uncertainty).

So what do state-level thought leaders think is coming? Their prediction is that Medicaid enrollment will remain flat in FY 2026—while Medicaid spending is expected to grow 7.9%. These were the results of a survey of state Medicaid executives published in A View Of Medicaid Today And A Look Ahead: Balancing Access, Budgets And Upcoming Changes.

These changes in…