Part 3 of series on IN #Medicaid now out: “We know that this is going to be confusing. We know this is going to be scary,” she said. “Anytime there is a new system or a new program put into place, there are always going to be hiccups.” publichealthwatch.org/2026/08/05/i... #healthpolicy #HR1 #OBBBA

More Potential Upheaval Awaits Indiana Medicaid - Public Health Watch

New work requirements, more frequent eligibility reviews and other policy changes will reshape Medicaid for many Hoosiers beginning in 2027.

publichealthwatch.org

ICYMI: Nebraska started implementing #Medicaid work requirements for people currently enrolled in the expansion group on 8/1. [Phase 1 (launched 5/1) only applied to new applicants.] nebraskapublicmedia.org/en/news/news... #healthpolicy

Nebraska becomes first state to disenroll Medicaid recipients under new work requirements

The first work requirement-related disenrollments begin in Nebraska on Saturday. While the state Medicaid director estimates this will impact 200 Nebraskans, advocates are concerned that the number wi...

nebraskapublicmedia.org

“It’s like you’re in fight mode...The stress is high. The anxiety is high. And then all of a sudden, ‘Oh, it’s magically better.’ But then you’re trying to come down off of it … and you’re like, ‘Well, what’s going to happen the next time?’” indianacapitalchronicle.com/2026/08/04/p... #Medicaid

'Powerless': Indiana families describe the toll of losing Medicaid access • Indiana Capital Chronicle

Indiana families describe delayed care, confusion and financial strain as Medicaid coverage lapses ripple across the state's health system.

indianacapitalchronicle.com

New @georgetownccf.bsky.social blog from me on CMS's new proposed rule implementing H.R. 1's restrictions on state use of provider taxes financing #Medicaid. It explains how the rule again goes beyond H.R. 1 requirements to make cost-shifts to states even larger: ccf.georgetown.edu/2026/07/27/c...

CMS Issues New Rule Again Going Beyond H.R. 1 Requirements to Further Restrict State Use of Medicaid Provider Taxes

On July 21, 2026, the Centers for Medicare & Medicaid Services (CMS) issued a new proposed rule that would implement two of H.R. 1’s restrictions on states’ use of provider taxes to finance their shar...

ccf.georgetown.edu

ICYMI: Great overview of the Medicaid HCBS landscape, specifically 1915(c) waivers and strategies to protect them www.commonwealthfund.org/blog/2026/st... #Medicaid #LTSS #healthpolicy

State Strategies Help Older Adults Live Independently

By adopting proven strategies, states can ensure older adults and those with disabilities have the support they need to live independently in their communities.

commonwealthfund.org

New white paper from myself + colleagues: Implementation of Medicaid Work Requirements: Key Design Considerations and Strategies to Minimize Avoidable Coverage Loss hsph.me/Medicaid-Wor... We synthesize evidence in the peer-reviewed and gray literature to identify key lessons + recommendations

Many coverage restrictions in HR1 don't apply to seniors, children, or people who are disabled. Nonetheless, the law's demands on state agencies & the computer systems they oversee will disrupt #Medicaid benefits, advocates & other healthcare experts said in interviews. www.npr.org/2026/07/20/n...

Deloitte-run systems denied Medicaid to disabled people. New laws could make it worse

Complex computer systems that decide whether people get Medicaid benefits have a history of errors. Now, changes to comply with Trump's tax and domestic policy law are inundating those systems.

npr.org

Deciding if a patient is too sick to work is a subjective, high-stakes decision, said Chen, who practices as a hospitalist. “We’re trained to take care of people...We’re not trained to make these kinds of work determinations.” www.washingtonpost.com/health/2026/... #Medicaid #WorkRequirement #HR1

Doctors fear Medicaid changes will force them to decide who’s too sick to work

Physicians say new Medicaid rules starting Jan. 1 regarding employment will undermine their relationships with patients.

washingtonpost.com

Worked with @bobjherman.bsky.social on the data for this piece. Here’s the chart I think is the showstopper: Over the last 40 years, the amount of money spent on employer-sponsored insurance premiums skyrocketed by nearly 1000%, well above baseline inflation.

STAT@statnews.com · 4w ago

America's employer-based health insurance system is crumbling. STAT investigates why, in our new series, “Out of Pocket, Out of Reach.” www.statnews.com/2026/07/07/s...

New study in @jamahealthforum.com finds that Medicaid expansion was associated with a 14% lower monthly odds of death post-release. Meaning Medicaid expansion helps prevent deaths among people leaving prisons and jails. jamanetwork.com/journals/jam... #Medicaid #Reentry #healthpolicy

Medicaid Expansion and Mortality Among Formerly Incarcerated Individuals

This cross-sectional study reports on the association of mortality in formerly incarcerated individuals after the Affordable Care Act allowed states to expand Medicaid coverage.

jamanetwork.com

The question is: how long will it take Montana and Nebraska to come into compliance with the IFR? New and renewing applicants there were already going to have a hard time navigating the changes and now things will shift again. #Medicaid #WorkRequirement #healthpolicy

Joan Alker@joanalker1.bsky.social · last mo.

Today Montana becomes the second state after Nebraska to implement Medicaid work reporting requirements. Given the rule was finalized just one month ago and had many changes there is no way the system there is ready.

Not surprised to see more than 1/2 of states subject to the #Medicaid work requirement have filed a lawsuit to pause implementation based on the interim final rule released 6/1 apnews.com/article/medi... #WorkRequirement #healthpolicy

Democrats in half of states sue Trump administration over Medicaid work rules

Democrats in 25 states and the District of Columbia are suing the Trump administration over its interpretation of new Medicaid work requirements.

apnews.com

As states prepare to implement Medicaid work requirements, managed care plans can play an important role in helping eligible people keep their coverage. https://healthlaw.org/timely-tips-to-safeguard-medicaid/

Kate Morton at Albuquerque Health Care for the Homeless, where most patients have #Medicaid, worries the new burden will fall on her & her patients. The extra paperwork will leave less time to focus on patients’ complex health needs, including high rates of SUD. www.kunm.org/medicaid-cut...

In a state where addiction exacts a steep toll, Medicaid work rules could endanger lives

Thousands of New Mexicans rely on Medicaid to get treatment for life-threatening substance use disorders. Keeping that coverage is about to get harder.

kunm.org

Vital reporting from @rosebroderick.bsky.social at @statnews.com about the impact of Medicaid “fraud” crackdowns on disabled people. www.statnews.com/2026/06/15/m...

As states follow Trump's Medicaid fraud playbook, people with disabilities struggle to find care

Medicaid cuts and fraud crackdown trickle down to states, threatening people with disabilities.

statnews.com

New in Health Affairs: "As written, the medical frailty rule not only departs from the law on which it is based but seriously endangers the health of low-income working-age adults." www.healthaffairs.org/content/fore... #Medicaid #WorkRequirement #healthpolicy

"States are going to be asked to make a determination using information that doesn’t exist in their systems." Still lots of confusion over whether/how states can automate frailty determinations for Medicaid work requirements. And states don't have the luxury of time for CMS to figure this out.

Too sick to work, but can they prove it? New Medicaid rule worries patients

Blood cancer survivor DeAnna Brandon worries about new Medicaid work requirements affecting her health coverage

abcnews.com

"California, Texas, Indiana, Florida, Georgia, Illinois, Ohio, Arizona, Virginia and Kentucky accounted for 67% of enrollment losses. The geographic and political diversity of these states underscores that this is a widespread problem." #Medicaid #CHIP #healthpolicy

Joan Alker@joanalker1.bsky.social · 2mo ago

My latest blog explores the 2 million decline in child Medicaid enrollment and which states are seeing the largest declines. ccf.georgetown.edu/2026/06/10/w...

Even with a new $50 billion investment in rural health, every state is projected to experience net economic and employment losses by 2029 under H.R. 1, according to a new analysis by Leighton Ku and colleagues at GWU www.commonwealthfund.org/publications... #OBBBA #healthpolicy #HR1 #RHTF

H.R. 1 Funding Cuts Will Overshadow Gains from the New Rural Health Transformation Program

It is predicted that the Rural Health Transformation Program’s modest economic gains will be overshadowed by losses from H.R. 1’s budgetary cutbacks.

commonwealthfund.org

States have some ways to tell whether someone has a diagnosis & we've heard states are working on code lists & claims data they can use to try to identify people automatically who would have this exemption...But adding an element of ‘unable to work’ — nobody knows where that data will come from.

Alice Miranda Ollstein@alicemiranda.bsky.social · 2mo ago

New Medicaid rules may force doctors to do something they were never trained to do: determine which patients with HIV, cancer and other conditions are too sick to work. Doctors told me this will be especially hard bc the energy/mobility of the chronically ill fluctuates day-to-day.

I know a lot of #Medicaid folks are focused on digesting the work requirement rule. Don't forget the SDP rule that recently came out will also have a major impact across all states. This thread offers a good summary. #healthpolicy

Edwin Park@edwincpark.bsky.social · 2mo ago

My colleague Leo Cuello on a recently released CMS proposed rule that goes well beyond just implementing the requirements of H.R. 1 in further restricting state-directed payments to hospitals and other providers (1/x): ccf.georgetown.edu/2026/05/28/c...

Great story from over the weekend on how states — red and blue — are struggling with the costs of rushing to stand up work requirements. These concerns could get worse if the IFR (expected this afternoon) includes "surprises" that contradict implementation choices states have already made

States balk at the high price of Medicaid work requirements amid budget crunch

States dealing with budget shortfalls are facing tens of millions of dollars in new costs ahead of the federal Jan. 1 deadline.

politico.com

Great thread highlighting some of the same questions I have about what will be in the guidance for #Medicaid work requirements. I'd also add: how much will states have to change systems & implementation plans in response to the regs?

Adrianna McIntyre@adrianna.bsky.social · 2mo ago

Congress set a June 1 deadline for CMS to issue detailed regulations on how states must operationalize Medicaid work requirements, leaving states with just 7 months to finalize implementation with guidance in hand. The rule could drop Monday. Or today. There are still a lot of known unknowns.

When people forgo regular care & seek treatment only in an emergency, it burdens the health care system & increases costs. “It leads to more wait times for other people trying to get emergency care, it leads to understaffed clinics...and it leads to cuts in services” www.kvpr.org/health/2026-...

When new California laws kicked in, thousands of immigrants dropped or lost Medicaid coverage

Driving the decline, experts say, are several state and federal policy changes that block or discourage immigrants from getting coverage.

kvpr.org

Cheaper plans may mean less comprehensive coverage: Now in remission, Ramsey urges those considering cheaper insurance to do careful research. “Make sure it’s covering what you need to be covered,” she said. “It could be too good to be true.”

KFF Health News@kffhealthnews.org · 2mo ago

“I don’t gamble. But I may as well,” said a retired teacher in Michigan who looked outside the Affordable Care Act marketplace for health insurance this year because her premium payment was set to nearly triple. “This is gambling.”

Despite promises to protect Medicaid for the most vulnerable during the reconciliation debates (OBBBA/HR1), services these individuals depend on are at risk. This piece highlights the situation in AZ www.kjzz.org/the-show/202... #Medicaid #healthpolicy #HCBS #LTSS

Arizonans with disabilities depend on at-home services. Medicaid cuts could erode the program

Arizona’s Home and Community-Based Services for people with disabilities could be on the chopping block this year because of federally driven Medicaid cuts. One reason is that Medicaid isn’t required ...

kjzz.org

I hope health researchers, @academyhealth.bsky.social, and others share their experience through the transition and any challenges that emerge. #healthpolicy #Medicare #Medicaid

Aaron Schwartz@aschwartz.bsky.social · 3mo ago

Supposedly they are shutting down ResDAC in 5 weeks, and, I’m told, replacing them with a totally novice firm with no experience/expertise in Medicare data.

A Look at the High Unemployment Hardship Exception to Medicaid Work Requirements Based on Unemployment Data from February 2025 to January 2026 www.kff.org/medicaid/a-l...

A Look at the High Unemployment Hardship Exception to Medicaid Work Requirements Based on Unemployment Data from February 2025 to January 2026 | KFF

In the 39 states that are adopting or may adopt the high unemployment hardship exception, about 1.4 million or 7.5% of Medicaid expansion enrollees live in one of the 133 counties that currently meet ...

kff.org

A very informative blog from my colleagues Adriana Kohler and Jade Little about state outreach materials so far on Medicaid work reporting requirements for consumers. Nebraska and Montana the two early adopters do not inspire confidence. ccf.georgetown.edu/2026/05/07/w...

What Do We Know So Far About State Materials & Consumer Outreach on Medicaid Work Reporting Requirements?

States need to do effective, consumer-friendly outreach and education to communicate new work reporting requirements to affected Medicaid expansion adults and new applicants. Mandatory work reporting ...

ccf.georgetown.edu

Across the U.S., hospitals and patient advocates are looking to state lawmakers and local officials to help shore up shaky finances. California lawmakers are mulling another $300 million in interest-free loans for troubled hospitals. Pennsylvania and Illinois are weighing similar programs.

States Eye Aid To Prop Up Distressed Hospitals Amid Federal Medicaid Cuts - KFF Health News

Hundreds of hospitals nationwide are bracing for Medicaid cuts as a result of the One Big Beautiful Bill Act. Some state lawmakers are eyeing loans and other forms of financial aid to distressed hospi...

kffhealthnews.org