Blog
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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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Fact Checking 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)…
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Fraud and Abuse Against Medicaid: Rhetoric and Reality in the One Big Beautiful Bill Act
We have not cut Medicaid, and we have not cut SNAP. What we’re doing…is working on fraud, waste, and abuse. And everyone in Louisiana and around the country understands that that’s a responsibility of Congress….[Medicaid] is intended for vulnerable populations, for young single pregnant women and the elderly and the disabled and people who desperately…
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More Fact Checking on Medicaid Spending for Immigrants
Last week, a member of the Trump administration repeated a claim that the Administration was “kicking illegal immigrants off Medicaid to protect Medicaid for AMERICANS!” This is consistent with misleading talking points that the House-passed reconciliation bill, now under consideration by the Senate, targets cuts on Medicaid spending to undocumented immigrants. But is any of…
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What Does the One Big Beautiful Bill Act Do to CHIP?
The Children’s Health Insurance Program (CHIP) has a long history of bipartisan support. But CHIP is not spared by the One Big Beautiful Bill Act (HB 1). It’s quite possible bipartisan CHIP supporters were not aware of the impact the bill rammed through the House in the wee hours of night would have on children…
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House Bill Takes Health Care Away From Immigrants, Including Lawfully Present Children and Pregnant Women
Misinformation and confusion (even among lawmakers, more on that below) about immigrant eligibility and enrollment in Medicaid and CHIP (Children’s Health Insurance Program) continues to dominate the dialogue about the proposed changes in the House-passed reconciliation bill (see bill text as considered by the Rules Committee, alongside the manager’s amendment that was adopted before final…
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Medicaid Cuts in the House-Passed Reconciliation Bill: Questions for Senators
Last week the House of Representatives, by the narrowest of margins (215-214), passed the One Big Beautiful Bill Act, H.R. 1. The bill includes unprecedented changes to Medicaid summarized here by my colleague Edwin Park. Over the next ten years, these changes will terminate Medicaid coverage for millions of Americans and reduce federal Medicaid payments…
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State Momentum for Maternal Health Legislation Continues: Congressional Cuts Would Turn Back the Clock
The U.S. has the highest maternal mortality rate of high-income countries and over 80% of maternal deaths are preventable. To improve maternal health outcomes, the Black Maternal Health Momnibus Act was introduced in the 117th and 118th by Representative Alma Adams and Representative Lauren Underwood, and Senator Cory Booker. The Momnibus Act is a set…
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The Truth About Medicaid Coverage for Immigrants – and the Looming Threats
There has been a lot of information and misinformation about Medicaid coverage for immigrants circulating in the news, including wildly inaccurate reporting that undocumented immigrants are driving up Medicaid spending—when the truth is that they are NOT even eligible for traditional Medicaid. At the same time, while some Republicans in Congress have said they are…
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Medicaid Cuts Grow Harsher as GOP Attempts to Ram Trump Agenda Through House Before Memorial Day
The full court press is on to pass the “One Big Beautiful Bill” with President Trump visiting the House Republican Caucus this morning to pressure competing factions to just say “yes” and pass the bill this week — before the Memorial Day recess and before anyone has time to untangle what is in the bill.…
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Medicaid Work Requirements Could Threaten Parents’ and Children’s Coverage and Well-Being
By Jennifer M. Haley, Genevieve M. Kenney, Eva H. Allen, and Michael Karpman Work requirements in Medicaid are on the agenda at the federal level and in multiple states, despite evidence that they increase uninsurance without boosting employment. Medicaid provisions approved by the House Energy and Commerce Committee as part of budget reconciliation include a…
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House Budget Bill Would Impose Administrative Barriers for Kids, Families, Seniors, and People with Disabilities in Medicaid
With the House Energy and Commerce Committee reporting out its budget reconciliation bill with at least $625 billion in cuts to Medicaid, I find it ironic that a section of the bill entitled “Improving Enrollment Processes” puts a halt to implementation of a Biden-era rule intended to streamline enrollment and improve retention, especially for children,…
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House Energy and Commerce Committee Reconciliation Bill Would Restrict State Use of Provider Taxes and Undermine State Financing of Medicaid
The House Energy and Commerce Committee is completing its markup of its section of the House Republican budget reconciliation bill. The bill includes draconian Medicaid cuts, as well as cuts affecting the Affordable Care Act’s marketplaces, which would cut Medicaid enrollment by 10.3 million people and increase the number of uninsured by 7.6 million people…
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Cuts to Medicaid Expansion in the Proposed Budget Reconciliation Bill being Considered by Congress
FMAP Cuts Tied to State Decisions to Expand Comprehensive Health Coverage with State-Only Funds to Children Regardless of Immigration Status Section 44111 of the proposed budget reconciliation bill being marked up by the House Energy and Commerce Committee today targets the Affordable Care Act’s Medicaid expansion for cuts with an apparent aim to advance a…
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How Do We Know Congress’s Work Requirements in Medicaid Will Fail? They Already Have.
As expected, the House’s rushed attempt to finance the Trump Administration’s immigration and tax agenda by cutting Medicaid includes a “work requirement.” Proponents claim that it is intended to support employment but it does no such thing. In fact, it’s a policy that takes health insurance away from millions of people, including workers. This policy…
