The Role of State and Territory Legislators in Medicaid

The executive and legislative branches share responsibility for ensuring Medicaid is administered effectively and efficiently. This episode of the Medicaid Leadership Exchange podcast explores how Medicaid directors and state legislators can build productive working relationships grounded in trust, clear communication, and shared goals. The discussion highlights how these partnerships can help states navigate Medicaid’s complexity while balancing policy priorities, program oversight, and budget realities. The conversation features perspectives from current and former state leaders with experience across Medicaid administration and state legislatures: Todd Richardson, former Missouri Medicaid director, and former speaker of the house, Missouri House of Representatives Christine Osterlund, Kansas Medicaid director Pat Pettey, Kansas state senator The episode is hosted by Mark Larson, senior vice president, Center for Health Care Strategies (CHCS), and former Vermont Medicaid director, and Kate McEvoy, executive director, National Association of Medicaid Directors (NAMD) and former Connecticut Medicaid director. The Medicaid Leadership Exchange podcast, an initiative of CHCS’ National Medicaid Leadership Center, explores priority topics for Medicaid leaders. It is jointly developed by NAMD and CHCS. The 2026 season is funded by the Robert Wood Johnson Foundation. Allow up to 20 seconds for audio playback to begin. Featured in this episode: Mark Larson, senior vice president, Leadership and Capacity Building, CHCS, and former Vermont Medicaid director Kate McEvoy, executive director, NAMD, and former Connecticut Medicaid directorTodd Richardson, former Missouri Medicaid director, and former speaker of the house, Missouri House of Representatives<img loading="lazy" decoding="async" width="150" height="150" class="wp-image-25363" style="width: 150px;" src="https://www.chcs.org/media/Christine-Osterlund_Headshot.png" alt="" srcset="https://www.chcs.org/media/Christine-Osterlund_Headshot.png 232w, https://www.chcs.org/media/Christine-Osterlund_Headshot-60x60.png 60w, https://www.chcs.org/media/Christine-Osterlund_Headshot-80x80.png 80w, https://www.chcs.org/media/Christine-Osterlund_Headshot-100x100.png 100w, https://www.chcs.org/media/Christine-Osterlund_Headshot-120x120.png 120w, https://www.chcs.org/media/Christine-Osterlund_Headshot-140x140.png 140w, https://www.chcs.org/media/Christine-Osterlund_Headshot-200x200.png 200w, https://www.chcs.org/media/Christine-Osterlund_Headshot-125x125.png 125w" sizes="auto