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What to Expect From This Year’s Census Data on Child Health Coverage Rates: Will it be the Big Reveal on the Impact of Medicaid Unwinding?
As we wait for the annual September release of key Census Bureau data on health insurance status, what are we at CCF expecting with respect to children? The data covers 2024, a year in which most states finished the process of Medicaid “unwinding” – a multi-year process during which everyone on Medicaid had their eligibility…
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Tracking State Readiness to Implement HR 1
This tracker will report on eight state-reported Medicaid and CHIP performance indicators. The analysis of state data is displayed in national maps for the most recent quarter broken into four quartiles with the top quartile reflecting the highest performing states. To smooth out monthly anomalies in state workload and allow for tracking these metrics over time,…
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Medicaid Work Reporting Requirements: Feds Forcing States to Spend Resources to Cover Fewer People
As discussed in our overview of H.R. 1, the budget reconciliation bill passed by Congress and signed by President Trump, the new law includes a harmful new work reporting requirement for Medicaid. The Congressional Budget Office estimates this work reporting requirement will result in a $326 billion cut in federal funding for states and lead…
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New Resource on State-by-State Impacts of Budget Reconciliation Law
On July 4, 2025, President Trump signed the Congressionally-passed budget reconciliation law, known as “One Big Beautiful Bill,” into law. As we have talked about extensively, this law will drastically cut federal funding for Medicaid and hamstring states’ ability to fund their portion of the federal-state partnership. Many of the law’s provisions target Medicaid expansion…
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Medicaid Managed Care: The Big Five in Q2 2025
Q2 2025, which ended on June 30, is not just another quarter. That’s because on July 4 the Budget Reconciliation Law (P.L. 119-21) was signed into law. That law makes major cuts to Medicaid, reducing federal payments to states by $990 billion over the next ten years and leaving 7.5 million Americans uninsured in 2034.…
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New CBO Health Coverage Estimates of Budget Reconciliation Law
On August 11, 2025, the Congressional Budget Office (CBO) issued more detailed estimates of the impact of the budget reconciliation law (H.R. 1 or P.L. 119-21) on health coverage. Consistent with final cost estimates issued in July, CBO finds that the reconciliation law will increase the number of uninsured people by 10 million in 2034, relative…
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What to Expect From States When They’re Expecting Big Changes Due to HR 1
The passage of the recently enacted tax and budget law (HR1) will have major implications for state budgets, but the impact will be disproportionate. For example, Medicaid, expansion states (plus Wisconsin and Georgia) will be required to implement work requirements, increasing administrative costs while putting up barriers to enrollment and retention. Other states will be…
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Trump Administration Blocks States from Keeping Babies and Toddlers Connected to Health Coverage
On Sunday, the Administrator of the federal Centers for Medicare and Medicaid Services (CMS), Dr. Mehmet Oz, appeared on Face the Nation. He was pressed repeatedly on Medicaid cuts by Host Margaret Brennan and responded by emphasizing the need for Medicaid to protect young children, paraphrasing the late Senator Hubert Humphrey in noting that any…
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New Federal Budget Law Spells Trouble for Patients with Insulin-Requiring Diabetes
By: Billy Dering, Amy Killelea, and Christine Monahan (Georgetown University Center on Health Insurance Reforms) The recently enacted federal budget law is set to significantly roll back critical provisions of the Affordable Care Act (ACA) that have expanded health insurance coverage to millions. The law takes aim at health care programs that primarily serve low- and moderate-…
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Webinar: Budget Reconciliation (HR1) Medicaid and Marketplace Provisions
In Partnership with Monday, July 28, 2025 the Georgetown University McCourt School of Public Policy Center for Children and Families (CCF) and Center on Health Insurance Reforms (CHIR) held a joint webinar about the Medicaid and Marketplace provisions of the new budget reconciliation law (HR1). Experts at CCF and CHIR explained the provisions of the…
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Fraud and Abuse Against Medicaid: The Truth About the Budget Reconciliation Law
After the House passed its version of what was then known as the “One Big Beautiful Bill Act,” we examined Speaker Johnson’s assertion that the House had not cut Medicaid but had instead targeted waste, fraud, and abuse in the program. We reported that just seven of the 24 Medicaid provisions in the bill truly…
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Where Interests Conflict: Medicaid Managed Care Meets Work Reporting Requirements
Q2 ended on June 30, and the earnings calls have started. The first of the “Big Five” Medicaid managed care companies out of the gate was Elevance Health. The financial analysts on last week’s call had a number of questions relating to the Medicaid provisions of the Budget Reconciliation Law (BRL) P.L. 119-21, that create…
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New CHIP Protections are In Effect Now Despite Congressional Efforts to Eliminate Them
During the legislative process, most of the talk was about Medicaid cuts, but we highlighted that the Children’s Health Insurance Program (CHIP) would not be spared if the budget reconciliation bill (HR 1) placed a moratorium on all provisions of the Eligibility and Enrollment Rule (E&E rule) finalized in April 2024. Thankfully, due to likely…
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States Pursuing Medicaid Work Requirement Waivers Must Make Changes: How the OBB Changed the Landscape for Medicaid Work Requirements
The new budget reconciliation law (aka OBBB — the One Big Beautiful Bill) makes the largest Medicaid cut in history ($990 billion over ten years). It will likely take health insurance away from about 10 million people, and another 5 million will likely lose coverage because of other Congressional Marketplace policies. It will wreak utter…
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Medicaid, CHIP, and Affordable Care Act Marketplace Cuts and Other Health Provisions in the Budget Reconciliation Law, Explained
Editor’s Note: this brief was updated on August 13, 2025 to reflect additional Congressional Budget Office coverage estimates of the reconciliation law issued on August 11, 2025 In partnership with On July 4, 2025, President Trump signed the Congressional Republican budget reconciliation bill into law (H.R. 1 or P.L. 119-21 which was previously entitled the…
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Medicaid Managed Care: Headwinds for the Big Five in the Budget Reconciliation Law
Early this week FitchRatings posted its take on the implications of the Budget Reconciliation Law (P.L. 119-21) for the “Big Five” insurers— Centene, CVSHealth/Aetna, Elevance Health, Molina Healthcare, and UnitedHealth Group—that together account for half of the Medicaid managed care market: U.S. health insurers managing coverage for state Medicaid programs will face revenue headwinds due…
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Budget Reconciliation Law Takes Aim at Medicaid and the Affordable Care Act
Just before our nation’s birthday, the House passed the Senate version of the budget reconciliation bill and it headed to the President’s desk. Congressional leaders cheered and clapped as President Trump gleefully signed the law. But what’s to cheer about a law that promises to take health insurance through Medicaid and CHIP away from 11.8…
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New FAQs from CMS on School-Based Health Services
As a follow-up to requirements under the 2022 Bipartisan Safer Communities Act that required the Centers for Medicare & Medicaid Services (CMS) to set up a technical assistance center and provide guidance to support the delivery of services to students covered by Medicaid and CHIP in school-based settings, CMS recently added 30 additional questions to…
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States’ Maternal Mental Health Efforts Show Improvement as Need for Support Grows, Especially in Rural Areas
The Policy Center for Maternal Mental Health recently released state-by-state maternal mental health report cards that provide a snapshot of state progress addressing maternal mental health. Using measures across three domains—providers and programs, screening, and coverage—these report cards pinpoint areas of opportunity for states to improve maternal mental health. Overall, the report shows modest progress…
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Truth to Power: A Republican Senator Stands Up for Medicaid and His Constituents; Then Announces Retirement
With Vice President breaking the tie, the U.S. Senate just voted 50-50 “One Big Beautiful Bill Act”, the crown jewel of President Trump’s legislative agenda. With final text not even available to assess, and presumably not even read by the 50 Senators who voted for it, three Republican Senators voted no (Paul (KY), Collins (ME),…
