Medicaid is one of the largest and most important programs overseen by state governments, providing health coverage to millions of Americans while accounting for a significant share of state spending. Recent federal policy changes have increased the responsibility states bear for administering and financing Medicaid, making effective legislative oversight more important than ever.
In our new explainer, Preventive Care: State Legislative Oversight of Medicaid, the Levin Center’s State Oversight Academy examines how state legislatures can use audits, investigations, and hearings to monitor Medicaid programs, identify problems early, and improve outcomes for the people who depend on them.
The explainer highlights examples from Minnesota, Kansas, Utah, and Maine, showing how legislative oversight has helped uncover fraud risks, strengthen program administration, improve accountability, and inform policy decisions. It also outlines practical steps legislatures can take to enhance their oversight capacity and build a stronger factual foundation for policymaking.
As Medicaid continues to evolve, effective oversight will play a critical role in helping state legislatures ensure program integrity, accountability, and performance.