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One Big Beautiful Bill, One Big Rural Maternity Crisis
Before H.R. 1 passed, rural America was already facing difficulties with access to maternal health care. From hospital closures, workforce shortages, low reimbursement rates, and policy changes, rural maternal healthcare systems have faced a deep crisis that threatens patient access to medical services. 109 rural hospitals have closed since 2005. Between 2024 and early 2026…
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Fact-Checking the White House Fraud Ledger: Trusted Numbers or Legerdemain?
The White House has posted a “Fraud Ledger,” which it describes as “a public record of the fraud, waste, and corruption identified by the Trump Administration’s Task Force to Eliminate Fraud since January 2025. The Task Force, established by Executive Order in March, is chaired by Vice President Vance and includes representatives from 11 agencies…
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Census Bureau Releases Some New Data on Child Uninsured Rate, but Questions Remain
This week the U.S. Census Bureau released the Current Population Survey (CPS) Annual Social and Economic Supplement (ASEC) data, which examine poverty, income, health insurance and other trends for calendar year 2025. Normally, the Census Bureau would also release the American Community Survey (ACS) this week, which provides considerably larger sample sizes and hence much…
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CCF Comments on HHS Vaccination Request for Information
The Georgetown University Center for Children and Families submitted the following comments to the Department of Health and Human Services (HHS) regarding the Request for Information: Categories Used in Federal Vaccine Recommendations and the Role of Shared Clinical Decision-Making. Read the Comments.
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Webinar: Medicaid Connections: Substance Use Health & Justice
Download the Audio Transcript The historical arc of access to substance use services may understandably make one prone to ignore Medicaid. Often, substance use responses were housed in punitive, not healing systems. However, 21st-century legislative and system changes have begun to shift that reality, albeit unequally. Health responses for people who use drugs have become…
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New Policy Brief: Rural Communities at Greater Risk of Harmful Impacts from New Medicaid Work Reporting Requirements
As the nation nears full implementation of the Medicaid work reporting requirements Congress enacted in 2025 in H.R. 1, Joan Alker and I took an in-depth look at how these new paperwork requirements to sign-up for and keep Medicaid health coverage will affect residents of rural areas and small towns. Our previous research has shown…
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Rural Communities at Greater Risk of Harmful Impacts from New Medicaid Work Reporting Requirements
In 2025, Congress passed H.R. 1, legislation which requires work reporting requirements as a condition of Medicaid eligibility in the 41 states, including Washington, D.C., that have expanded coverage to most low-income adults under the Affordable Care Act. (These mandated reporting requirements also apply in at least two non-expansion states, Wisconsin and Georgia, that cover…
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CCF Comments on CMS Proposed Provider Tax Rule
The Georgetown University Center for Children and Families submitted the following comments to the Center for Medicare and Medicaid (CMS) regarding CMS’s proposed rule to amend the Indirect Hold Harmless Threshold of Health Care-Related Taxes. Read the Comments.
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States are Sending Initial Outreach Notices about Medicaid Work Reporting Requirements. What Do They Look Like?
With Medicaid work reporting requirements just a few months away, states are scrambling to make complex changes to their eligibility and enrollment systems and processes. States must also do targeted outreach to communicate new work reporting requirements (WRRs) to affected Medicaid expansion adults and new applicants. Many states launched websites this summer informing enrollees about…
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Proposed Head Start Rule Would Further Undermine Child and Family Health
Head Start, a federal program that supports young children in low-income families, is headlining news in the early childhood policy and health worlds. Early last month, the Trump Administration released a monumental proposal to alter the program’s framework. Head Start is an essential investment in children’s wellbeing that works alongside Medicaid in child care centers,…
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Webinar: Medicaid Financing (Part 2)
Download the Audio Transcript In June, we hosted a webinar on the basics of Medicaid financing, including how the federal-state partnership works, how federal funding is mandatory and not subject to annual appropriations, and how states finance their share of Medicaid costs. On September 10 at 1 p.m. ET, we took a closer look at H.R. 1’s restrictions on provider taxes and…
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Right Wing “Data” Arguing for Medicaid Work Reporting Requirements is Fatally Flawed
We don’t usually write a blog like this that dissects the flawed methodology of the Foundation for Government Accountability (FGA) – a right-wing group that is well known for promoting work reporting requirements at the state and federal level – as well as cuts to Medicaid and the safety net more broadly. FGA’s own annual…
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Access to Maternity Care in Rural Areas Likely to Get Worse Due to Medicaid Cuts
As part of CCF’s Rural Health Project, we continue to track the important role Medicaid plays in rural America. A recent research paper on hospitals and maternity care has some important insights, especially for parents in rural areas and small towns. KFF researchers found that 1 in 3 hospitals providing inpatient maternity care to Medicaid…
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Maternity Care Billing Changes Begin in 2027 with Potential for Better Transparency and Payments Across the Continuum of Care
As readers of Say Ahhh! know, 2027 will bring a host of unprecedented Medicaid changes, including work reporting requirements. One less prominent change ahead is adoption of new maternity care codes for insurance payers. Adopting new codes for maternity care adds to the long list of Medicaid agency to-dos, but remains critical for understanding and…
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How Are Parents Impacted By Medicaid Work Reporting Requirements?
Overview Starting January 2027, H.R. 1 requires every state that has expanded Medicaid to low-income adults – whether through the Affordable Care Act’s Medicaid expansion or a Section 1115(a)(2) waiver – to implement work reporting requirements (WRRs). New WRR mandates affect those enrolled in the Medicaid expansion category – coverage for adults with income up…
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New CDC Data Shows Increase in Vaccine Exemptions and Less Vaccine Coverage Nationally
On the heels of President Trump’s executive order directing changes to the childhood vaccine schedule, the Centers for Disease Control and Prevention (CDC) released updated data for the 2025-2026 school year showing a decrease in coverage on all vaccines for incoming kindergartners. Specifically, vaccination rates to protect against diseases such as measles, mumps, rubella, tetanus,…
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H.R. 1 Readiness Tracker Update: Strain Is Building Before the Work Reporting Requirements Clock Starts
As states prepare to implement work reporting requirements, we are closely monitoring Medicaid and CHIP performance indicators on our H.R. 1 tracker. The latest Q1 2026 data show the status of state eligibility systems and processes right before most states start notifying enrollees about the requirements. The short answer: already strained and getting worse. Renewals…
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Uninsured Infants and Toddlers Now Above 5% Nationally
What happens when children don’t have health insurance? Their families are exposed to greater financial risk if an accident or asthma attack puts their child in the emergency room. They are less likely to get regular check-ups and health services to keep them developmentally on track. For infants and toddlers, missing regular check-ups risks leaving…
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“Data Privacy” Concerns Could Mean Less Race and Ethnicity Data from the Census Bureau
A few weeks ago, I wrote that new Commerce Department restrictions on the Census Bureau’s use of a group of data privacy methods called noise infusion could lead to less of the critical data, such as from the American Community Survey (ACS), that makes health policy research and analysis possible. But while the ban on…
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Webinar: Medicaid Connections: Children and Youth with Special Health Care Needs: Health & Justice
Download the Audio Transcript One in five children under age 18 have special health care needs, representing 15 million children from birth to 21. Children with special health care needs (CSHCN) include those who have chronic physical, developmental, or behavioral health needs that require services of a type or amount beyond that required by children…
