Blog
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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 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),…
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Supreme Court Reduces Rights to Women’s Health Care Because Congress Didn’t Use the Magic Words that Congress Didn’t Know About
Here we go again. Earlier this week, on June 26, 2025, the Supreme Court issued yet another dubious decision involving two of its favorite topics for judicial malpractice: women’s rights and access to the courts. In the case, known as Medina, the court ruled to allow South Carolina to exclude Planned Parenthood providers from the…
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Worth Repeating: Pregnant Women, Infants, Young Children are NOT Protected in Proposed Medicaid Cuts
Last month, the U.S. House passed the One, Big Beautiful Bill Act with an array of cuts to Medicaid and other critical supports for mothers, infants, and young children. Somehow, as Joan Alker described last week, the Senate version of the bill only made the prospects worse. Research shows that Medicaid coverage of pregnant mothers…
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Medicaid: A Lifeline for Women’s Health Across the Lifespan
Medicaid is a critical source of health care for millions of US women, supporting them through every stage of life. Nearly 1 in 5 women aged 19-64 rely on Medicaid or CHIP. The Affordable Care Act Medicaid expansions allowed states to cover all adults up to 138% FPL, covering millions more low-income women regardless of…
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Congressional Budget Office Confirms Senate Republican Reconciliation Bill’s Medicaid Cuts Are More Draconian than the House-Passed Bill
In the late evening of Saturday, June 28th, the Congressional Budget Office (CBO) issued preliminary estimates of the current version of the Senate Republican budget reconciliation bill now being debated on the Senate floor. The CBO estimates confirm that the Senate Republican reconciliation bill as it now stands would cut Medicaid to an even harsher…
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One Big Beautiful Bill Act: Winners and Losers in the Medicaid Provisions
Federal legislation almost always creates winners and losers. The One Big Beautiful Bill Act, now before the Senate, is no exception. Overall, the OBBBA as passed by the House will redistribute resources from the poorest children and families (the losers) to the wealthiest (the winners). That’s according to an analysis by the nonpartisan Congressional Budget…
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Senate OBBB Continues House Overreach on Immigrant Health Coverage by Imposing Restrictions on How States Can Spend Their Own Funds
As we have already written, the House-passed reconciliation bill section 44111 would penalize expansion states for providing coverage with state-only funds to noncitizens otherwise ineligible for Medicaid, including some lawfully present immigrants, as well as for adopting the state plan option to cover lawfully residing children and pregnant women without a 5-year waiting period in…
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Things Just Got Worse for Children and Families in the Senate Version of OBBB
The Wallstreet Journal and other news outlets previously reported that some Republican moderates in the House who expressed concerns about the deep Medicaid cuts in the budget reconciliation bill were reassured by House Republican leaders: “Don’t worry about the Senate. They’ll fix it.” In other words, the Senate would mitigate the draconian Medicaid cuts in…
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Senate Finance Committee Reconciliation Bill Would More Harshly Restrict State Use of Provider Taxes by Targeting Expansion State Financing
On June 16, the Senate Finance Committee unveiled preliminary bill language for its section of the Senate Republican budget reconciliation bill. Senate Republican leaders could have chosen to moderate the draconian cuts to Medicaid and the Children’s Health Insurance Program (CHIP) included in the House-passed budget reconciliation bill (H.R. 1 or the “One Big Beautiful…
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Medicaid Managed Care: Work Reporting Requirements in the One Big Beautiful Bill Act
Centene Corporation is the nation’s largest Medicaid managed care company, with nearly 13 million Medicaid enrollees in Q1 2025. At the company’s April 25 earnings call, a financial analyst asked Centene’s CEO about the implications of work reporting requirements for the company’s Medicaid business: AJ Rice (UBS): “…You also mentioned the work rules which does…
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Here’s What’s Really at Stake in the Fight for Medicaid Funding
The raging battle over Medicaid funding is really a fight about the soul of Medicaid and our progress as a society. The broader objective of the House legislation is clear – to reverse decades of progress and take us back to 1965, when health care was welfare, and many people simply were considered undeserving of…
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Factchecking The White House “Mythbuster” on Medicaid Cuts and Immigrants
On June 2, 2025, The White House posted a “Mythbuster” fact sheet in defense of the House-passed reconciliation bill. However, the sheet is full of inaccuracies and advances more myths than facts—too many to cover in just one blog. This blog will focus on one prominent false claim, namely that 1.4 million undocumented immigrants will…
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The One Big, Beautiful Bill Act will Mean Big Budget Hits for Families
Last month, Congress rushed through the night to pass the One Big, Beautiful Bill Act with last minute changes that would further increase cuts to many federal programs. In the health care sections, the bill primarily targets adults – including many parents and caregivers – who gained health coverage from the Affordable Care Act (ACA)…
