What do the results from the first state to impose the Medicaid work reporting mandate reveal? Read @joanalker1.bsky.social blog to find out. ccf.georgetown.edu/2026/09/30/n...
@georgetownccf.bsky.socialReposted by @joanalker1.bsky.social
Joan Alker
@joanalker1.bsky.social
ED of Georgetown Center for Children and Families and Research Professor at Georgetown University’s McCourt School of Public Policy; post mostly about Medicaid and CHIP. Proud member of the “Best for Last” club.
@georgetownccf.bsky.socialReposted by @joanalker1.bsky.social
@davidasuper.bsky.socialReposted by @joanalker1.bsky.socialMy latest on the Administration's increasingly brazen violations of law impounding funds Congress appropriated. It must be bad if Susan Collins can get beyond "concerned".
Balkinization: More Fiscal Mismanagement share.google/uFIZ3IZJQM7q...
@joanalker1.bsky.socialThe # of kids covered by Medicaid/CHIP since Jan 2025 continues to decline As of August 2026, the ⬇️ was 2.575 million 2026 is a more rapid ⬇️ than the already large ⬇️ in 2025 This is very worrying bcuz drops in child Medicaid enrollment usually means kid uninsured rate is ⬆️
@joanalker1.bsky.social@joanalker1.bsky.socialThe state of Nebraska has released data on the 1st few months of Medicaid work reporting requirements
Over 1,000 people have lost/been denied coverage
Vast majority are losing not bcuz they aren't working but bcuz they can't get thru the red tape
My new blog: ccf.georgetown.edu/2026/09/30/n...
@joanalker1.bsky.socialTennessee letter is here:
www.medicaid.gov/medicaid/sec...
@joanalker1.bsky.socialA few observations so far: Tennessee has a parent only waiver expansion to 100% of the poverty line. The letter confirms these parents WILL be subject to new work rules. But CMS says they expect ALL parents to be exempt. But CMS says state has to do outreach on the new rules. Horribly confusing.
@joanalker1.bsky.socialFriday PM big drop from CMS on Medicaid Section 1115 waivers and compliance with OBBA. Many states received "overlay" letters which include conforming change such as cutting all lawfully residing immigrants from Medicaid benefits as of 10/1 except (LPRs, Cuban/Haitian entrants, COFA migrants, 214)
@joanalker1.bsky.socialI’m not sure I can even read this article - what more can be done by this Administration to make America unhealthier?
But thank you @apoorvanyt.bsky.social and colleagues for your work.
@edwincpark.bsky.socialReposted by @joanalker1.bsky.socialFrom @brucelesley.bsky.social a comprehensive dismantling of the Paragon Institute's attempt to explain away a well over 2 million decline in #Medicaid and CHIP enrollment among children since the start of the Trump Administration even before most of H.R. 1's massive Medicaid cuts take effect.
@joanalker1.bsky.socialA heartfelt thank you to @brucelesley.bsky.social and Jenny Rudisill for so thoroughly explaining why efforts to deny or ignore this Medicaid decline is just plain wrong.
@lizszabo.bsky.socialReposted by @joanalker1.bsky.socialVaccinating children is especially important early in life; infants have one of the highest hospitalization rates from Covid after the 65-plus age group. “Those are kids that have never been exposed to Covid,” he said, and vaccination can help prevent these severe outcomes.
@edwincpark.bsky.socialReposted by @joanalker1.bsky.socialIt’s just not credible to directly compare administrative enrollment data to unadjusted Census survey data (as Trump Admin & the Paragon Institute do to falsely claim a big share of Marketplace enrollees are ineligible). You have to adjust for differences in how income & household size are counted.
@joanalker1.bsky.social@birdy.bsky.social has scooped the 1st data I have seen on Nebraska Medicaid work reporting requirements and it is worse than I expected. Incomplete data shows that 1,000 have explicitly lost/denied coverage and almost half of new applicants are not getting thru the red tape/ineligibility.
@joanalker1.bsky.socialA second lawsuit has been filed with respect to the Trump Administration's flawed interpretation of the medically frail provision of the Medicaid work reporting requirement coming to a neighborhood near you on 1/1/27. Thank you to the plaintiffs and litigators!
@edwincpark.bsky.socialReposted by @joanalker1.bsky.socialMy Georgetown CCF colleagues @adamsearing.bsky.social & @joanalker1.bsky.social on how residents of rural communities who rely on #Medicaid are at greater risk of being disenrolled and becoming uninsured due to H.R. 1's work reporting requirements: ccf.georgetown.edu/2026/09/14/r...
@joanalker1.bsky.socialNew blog from me and Aubrianna Osorio on Census data that came out this week. We're still missing key data.
@edwincpark.bsky.socialReposted by @joanalker1.bsky.socialWhite House is expected today to tout its #Medicaid MFN drug pricing agreements under its GENEROUS model. Many key questions remain unanswered: (1) Can Rx companies pick and choose what products to offer? (2) How do MFN prices compare to existing rebates and will states actually see lower Rx costs?
@joanalker1.bsky.socialWe will be tracking the change in child uninsured rate from the Census CPS data coming tomorrow and have quick analysis. However, our usual work analyzing Census ACS data for our annual report is delayed b/c for the 1st time the ACS is not coming out this week. The Bureau has "delayed" the data 😜
@gothope.bsky.socialReposted by @joanalker1.bsky.socialUnreliable mail service and less online connectivity means more barriers for residents of rural areas to overcome to comply with the new Medicaid rules. See new report by @adamsearing.bsky.social @joanalker1.bsky.social @georgetownccf.bsky.social ccf.georgetown.edu/2026/09/14/r...