Sarah Aker

Acting Director, State Demonstrations Group
Center for Medicaid and CHIP Services (CMCS)
Centers for Medicare & Medicaid Services

Sarah Aker is the Acting Director of the State Demonstrations Group at the Center for Medicaid and CHIP Services (CMCS) and leads the agency’s work on Medicaid demonstrations authorized under Section 1115 of the Social Security Act. In this role, Sarah leads federal efforts to support innovative state approaches that advance coverage, improve care delivery, and strengthen outcomes for Medicaid and CHIP beneficiaries.

Sarah brings over a decade of Medicaid leadership and health policy experience to CMCS from across the Dakotas, including service as the Medicaid Director in both North Dakota and South Dakota. In those roles, Sarah oversaw major program operations, policy making, and led initiatives in rural health, care management, HCBS, maternal health, and value-based purchasing. Sarah also led planning and successful implementation of Medicaid Expansion in South Dakota in 2023.  Sarah’s earlier roles include serving as the Director of Fiscal Policy for the South Dakota Association of Healthcare Organizations, advocating for South Dakota hospitals and long-term care providers. Sarah began her career in Public Service at the South Dakota Department of Social Services, holding various leadership positions in program administration and policy. Sarah holds a Bachelor of Science in Chemistry and Political Science from the University of South Dakota.