Blog
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Child Uninsurance Rate Hits Highest Level in Almost a Decade. Check What Is Happening in Your State
The latest data from the U.S. Census Bureau’s American Community Survey (ACS) bring troubling news for children’s health coverage. After years of progress, the child uninsured rate rose again in 2024, reaching its highest level since 2014. As Joan Alker explains in her blog, these numbers signal that the progress made over the past years…
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Fact Checking Claims about Medicaid and Marketplace Health Coverage for Immigrants – Government Shutdown Edition
We are getting a lot of questions about the U.S. government shutdown that began on October 1, 2025, after a bipartisan failure to reach a deal to fund the government. The main point reporters are trying to fact-check is whether or not extending Advanced Premium Tax Credits (APTC) and reversing health care cuts in H.R.…
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New Immigrant Eligibility Restrictions Coming to Federally-Funded Health Coverage
This time next year, an estimated 1.4 million lawfully present immigrants are expected to lose health coverage due to the Budget Reconciliation Law. The law restricts eligibility for federally funded health coverage to only a very narrow group of immigrants – lawful permanent residents (LPR, or green card holders), Cuban and Haitian entrants, and people…
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States Should Use Rural Transformation Fund to Focus on Children and Families
At this moment, states are seeking input and putting ideas on paper to develop priorities for their state applications for a piece of the $50 billion Rural Health Transformation Fund included in H.R. 1 (with applications due to the federal government by November 5th). Our colleague Adam Searing reminded readers that these funds will by…
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Preventive Services at Risk: Federal Instability and State Responses
In late June, the Supreme Court upheld the Affordable Care Act’s (ACA) preventive services provision, preserving—for now—zero cost sharing access to screenings, vaccines, and other preventive care for more than 150 million people. The decision in Kennedy v. Braidwood Management Inc. foreclosed a constitutional challenge to coverage of preventive care while underscoring new risks to consumers’ access to…
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Unpacking the Rural Health Transformation Fund Created by Congress to Soften Impact of Medicaid Cuts on Rural Hospitals
I grew up in North Carolina and often split my time between the urban center of the state and some of its most beautiful and rural areas on the back sounds “Down East.” This part of NC is so rural and was isolated for so long, generations of residents still speak with a distinctive Elizabethan…
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Medicaid Cuts Kick in Quickly and Quietly in Idaho
Amber and Darrell Daniels with three of their four children. They live in Caldwell, Idaho. Darrell works for a pest control company while Amber enjoys being a stay-at-home mom to care for their children
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Progress for Children is Eroding as Child Uninsured Rate Spikes to Highest Level since 2014
Every year we examine data provided by the U.S. Census Bureau’s American Community Survey (ACS) which provides the most comprehensive look nationally and by state at important trends impacting America’s families – including health insurance. Today we are sharing our analysis of data that came out just yesterday for calendar year 2024. Our analysis is…
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Who Cares for Our Nation’s Children? Federal Medicaid Cuts Will Magnify Challenges for Child Care Workforce and the Young Families They Support
Last spring we walked through Medicaid’s role in supporting early childhood educators and subsequently the risks of proposed federal Medicaid cuts to the child care system. Fast forward to July 4th: the HR 1 “Megabill” was rushed through reconciliation and signed into law, leading to the biggest cut in Medicaid’s 60-year history. These cuts– and…
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What does the CDC’s Vaccine Panel have to do with Medicaid?
Vaccine safety and changes happening at the Department of Health and Human Services (HHS) have been an ongoing topic of conversation throughout the past few months. As we have previously discussed here on Say Ahhh!, HHS has announced upcoming studies and potential changes to how vaccines are approved and recommended for different populations. Most notably,…
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US Uninsured Rate Stays Level in 2024 for Adults and Kids: Storm Clouds Lie Ahead
Today the U.S. Census Bureau released the Current Population Survey (CPS) for 2024 which examines income, health insurance and other trends. Overall, the uninsured rate was unchanged at 8%; the child uninsured rate was 6.1%. – a slight increase that was not statistically significant. Later this week we will get state by state data from…
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What is the Current Status of Vaccines in the US?
As fall respiratory virus season ramps up, major changes to the vaccine policy landscape in the U.S. are coming. Some states, such as Florida, have announced an effort to end all vaccine requirements for children to attend school. Federally, changes promulgated by the Secretary of Health and Human Services (HHS), Robert F. Kennedy Jr., have…
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Federal Threats to Maternal and Infant Health Highlighted in Health Affairs
A recent article in Health Affairs Forefront argues that threats to policies, programs, and data systems will substantially set back progress made over the past few years in addressing the maternal and infant mortality. As a group of experts who previously served as federally-appointed members of the US Department of Health and Human Services (HHS)…
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How Will We Know if States are Ready to Implement HR 1 and Work Reporting Requirements? Follow the State Performance Metrics Here.
States are just emerging from the unwinding of the pandemic-related Medicaid continuous enrollment provision when HR 1 presents a host of state budget impacts and new administrative hurdles for states. If states are already having trouble keeping up with their eligibility and enrollment administrative workload, adding work reporting requirements, six-month renewals, and mandatory cost sharing…
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Untangling the Current Debate Around Federal Medicaid Cuts, the “Rural Health Transformation Program” and State Medicaid Budgets
The Congressional Budget Office estimates that the budget reconciliation law signed into law by President Trump (HR1) will result in a gross reduction of $990 billion in federal Medicaid/CHIP spending over 10 years and an increase in the number of uninsured Americans by 10 million. This is the largest cut to Medicaid in the history…
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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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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…
