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The 2026 State Healthcare Policy Review examines US state efforts to regulate private equity in healthcare, focusing on transparency, approval authority, targeted prohibitions, and the corporate practice of medicine. While several states enacted new disclosure and reporting laws, few expanded the power to block transactions, and many stringent proposals were narrowed or failed. Key developments include Maine's new administrative approval process and Connecticut's ban on hospital sale-leasebacks.

The document is a formal statement by a coalition of state attorneys general and local officials opposing federal legislation that would shield fossil fuel companies from state-level lawsuits regarding climate deception and consumer protection violations.

June 2026 was the second-warmest June on record globally, with the Arctic experiencing its warmest June ever. In the U.S., 66% of the contiguous region faced abnormally dry or drought conditions by July 7, 2026, and the West and Southwest regions saw their warmest January-June period on record. A very strong El Niño is forecast to develop between October and December 2026, with an 81% probability, likely pushing global temperatures to or above 1.5C by October. Climate Central's analysis indicates human-caused climate change is a key driver of summertime warming in 91% of analyzed U.S. cities.

Climate Central analyzed data from 476 weather stations to track fire weather trends in the contiguous U.S. between 1973 and 2025. The analysis reveals a significant increase in fire weather days, particularly in the western U.S., where conditions are intensifying in spring and summer. While the eastern U.S. has seen smaller increases, some areas in the Southeast and Northeast are experiencing more frequent fire weather. The report highlights that climate change is driving these trends through warming temperatures and decreasing relative humidity, which prime landscapes for wildfires to ignite and spread.

The report argues that substituting tax-exempt public debt for investor-owned utility (IOU) equity and taxable debt can significantly lower transmission costs for ratepayers in New England. It identifies two primary paths: strengthening existing quasi-public entities or creating a new purpose-built transmission authority. The author emphasizes that any such vehicle must have a clear statutory mandate for FERC-jurisdictional transmission, non-recourse revenue-bond authority, the ability to form public-private partnerships, and governance structures that ensure state accountability and risk control.

The report argues that New England's transmission costs are the highest in the U.S., driven by a lack of cohesive planning and a reliance on expensive private capital. It proposes replacing private equity and debt with low-cost, tax-exempt public financing, which could save ratepayers up to $8.3 billion on new transmission and $1.1 billion on asset condition projects. The authors suggest several implementation pathways, including integrating public financing into ISO New England's Longer-Term Transmission Planning (LTTP) process or creating new state transmission authorities.

The report details how private equity firms have acquired Medicaid contractors to capitalize on government-backed revenue, often leading to operational failures. It highlights systemic payment errors and wage theft allegations at Public Partnerships, LLC; massive debt-driven cost-cutting and fraud allegations at Gainwell Technologies; and delays in care authorizations and the use of offshore labor at Acentra Health. The document also warns of the risks associated with AI-driven analytics and the offshoring of sensitive patient health information to India.

An analysis of the winter 2024–2025 season indicates that offshore wind projects could significantly lower the risk of power outages in New England by offsetting high electricity demand during cold spells. A 1,500 MW fleet would have reduced the risk of energy shortfalls by 55%, while a 3,500 MW fleet would have reduced it by 79%. Such a transition to local renewable resources would decrease reliance on volatile imported LNG and lower wholesale electricity prices, potentially saving consumers $400 million.

The brief contends that the Wind Directive lacks a reasoned basis and ignores the public health, climate, and economic benefits of wind power. It argues that existing permitting frameworks already sufficiently protect wildlife and that the sudden ban on wind permits contradicts the administration's own goals of increasing domestic energy production and its simultaneous efforts to expedite fossil-fuel projects.

The policy brief argues that while performance incentive mechanisms (PIMs) can drive regulatory outcomes and affordability, they require intentional evaluation to ensure benefits outweigh costs. RMI recommends that PUCs implement recurring and transparent evaluations via web-based dashboards, assess PIMs as a holistic portfolio rather than in silos, create informal stakeholder dialogue spaces to reduce administrative burdens, and utilize existing design guidelines to standardize retrospective evaluations.

The document examines how climate change is creating a home insurance crisis in the U.S., characterized by skyrocketing premiums and widespread policy non-renewals. It asserts that 'Big Oil' companies, who knew about the risks of fossil fuels as early as 1954, are responsible for these conditions. The report highlights specific state-level crises in Florida, California, and Hawaiʻi, and advocates for policy solutions—such as subrogation and legislative surcharges—to shift the financial burden from policyholders to the fossil fuel industry.

The brief argues that the 'Wind Directive'—which suspends all federal wind permitting—violates the Administrative Procedure Act (APA) by deviating from established review processes without a reasoned explanation. Amici assert that wind power is a cost-effective, critical energy source with significant public health and climate benefits. They further argue that the directive's claims regarding wind energy's impact on whales and birds are scientifically unsupported, citing findings from NOAA and the GAO. Finally, the brief highlights a contradiction in federal policy, where the administration fast-tracks fossil fuel projects while blocking wind energy, despite the latter's superior economic and environmental profile.

The analysis reveals a significant increase in fire weather days across much of the contiguous U.S., with the western U.S. experiencing far more frequent fire weather than the east. While the western U.S. has seen strong increases, particularly in the Southwest during spring and summer, parts of the eastern U.S. have also seen impactful increases, especially in the Southeast and Northeast. The study emphasizes that while human activity causes 87% of wildfires, fire weather primes the landscape for these fires to ignite and spread.

The U.S. public EV charging network grew more than six-fold between 2016 and 2025, reaching nearly 196,000 ports. While California leads in total numbers and northeastern states lead in density, significant coverage gaps remain in the southern, central, and plains regions. To support a projected 33 million EVs by 2030, the U.S. may need 1 million additional public chargers, including 170,000 DC fast chargers.

The Private Equity Stakeholder Project (PESP) argues that private equity's business model in the US healthcare sector—characterized by high leverage, sale-leasebacks, and dividend recapitalizations—prioritizes short-term investor returns over patient care. The document details how these strategies lead to increased healthcare costs, reduced staffing, and hospital bankruptcies, citing case studies of Prospect Medical Holdings, Steward Health Care, and Apollo Global Management's Lifepoint and ScionHealth. PESP advocates for state-level policy solutions including robust merger reviews, financial transparency requirements, and bans on debt-funded dividends to protect healthcare infrastructure.

The Private Equity Stakeholder Project (PESP) urges the Connecticut General Assembly to pass HB 6873, arguing that private equity's business model—characterized by high debt and profit extraction—threatens healthcare stability. PESP cites the 2025 bankruptcy of Prospect Medical Holdings, which owns three Connecticut hospitals, as a primary example of how private equity ownership can lead to financial distress and diminished care quality. The testimony highlights that in 2024, 21% of healthcare bankruptcies involved private equity-owned companies. PESP supports HB 6873 because it would expand the 'notice of material change' statute to include joint ventures and sale-leaseback transactions, preventing firms from evading antitrust scrutiny or stripping assets through real estate deals.

The document argues that repealing federal technology-neutral electricity tax credits (§45Y and §48E) would significantly increase household energy bills across the United States. Drawing on analyses from multiple research groups, it estimates that national annual household energy bills would rise by $40–$60 in 2030, $56–$150 in 2035, and $140–$220 by 2040. The report highlights that these credits lower costs by reducing investment expenses for wind, solar, battery, nuclear, and geothermal projects, savings which utilities are regulated to pass on to consumers. Repeal would likely lead to substantial price hikes in specific states, with some households facing increases over $500 annually.

The Block Island Wind Farm, the first operational offshore wind farm in the U.S., utilized a community benefits agreement (CBA) to secure local support by addressing the island's critical need for mainland electricity and internet connectivity. Key successes included the hiring of a local community liaison and funding for third-party technical consultants for the town. The project resulted in a 40% reduction in electricity rates, the elimination of diesel generators, and the installation of broadband fiber optic cables. While early engagement was perceived as limited, the project's alignment with the island's infrastructure needs and the state's Special Area Management Plan facilitated its approval.

The document reports that 2024 is on track to be the hottest year on record, with global temperatures exceeding 1.5°C above pre-industrial levels for the first time. In the U.S., 24 billion-dollar disasters occurred through November 2024, resulting in at least 418 deaths and $61 billion in damages, excluding the costs of Hurricanes Helene and Milton. The analysis highlights a shrinking interval between such disasters, falling to an average of 12 days in 2024 compared to 82 days in the early 1980s.

The article examines the impact of private equity ownership on US hospitals, specifically detailing how leveraged buyouts, dividend recapitalizations, and sale-leaseback transactions with real estate investment trusts (REITs) drain resources from healthcare operations. Using Steward Health Care and Prospect Medical Holdings as primary examples, the author illustrates how these financial tactics lead to understaffing, reduced quality of care, and bankruptcy. The document calls for increased state and federal regulation, including joint liability for private equity firms and restrictions on debt-funded dividends, alongside healthcare worker organizing.