Category: CMS News

Alternative Headline: Colorado Town Hall Sparks Tension

[MM Curator Summary]: Colorado Democrats Jason Crow and Michael Bennet faced heated questions at an Aurora town hall while addressing issues from Israel aid and Medicaid cuts to AI and climate change.

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DENVER | As congresspeople take a break from Washington, two particular lawmakers have spent a lot of time doing town halls in their districts and in Colorado. 

Democrats Rep. Jason Crow and Sen. Michael Bennet held an in-person town hall in Aurora Thursday night at Smoky Hill High School, marking their third joint town hall this year. 

The local crowd of about 500 people included some who yelled or voiced frustration that the lawmakers weren’t doing enough. Two people were asked to leave, including a protester in support of Palestine. Both officials told their constituents they were using every tool available to them. 

Both Crow and Bennet have come under fire in recent months for supporting legislation that continues to fund Israel in light of what has become frequently called “genocide” and now, a famine.

“As a representative of the 6th district and of this community, there is no job that’s more important than protecting the people of this community,” Crow said. “That is where it starts and ends with me. That is my North Star. That is my oath.”  

Federal Budget and Tax Policy

“The worst piece of legislation that we ever voted on,” Crow said about the Big Beautiful Bill. 

This year, Coloradans were supposed to get a Taxpayer Bill of Rights (TABOR) refund because the state had a surplus when the budget was balanced. Then the so-called ‘Beautiful Bill’ created a $1 billion or more state budget deficit, in part because of the way Colorado ties its taxes to the federal government. 

Bennet said that the recent legislation passed by the administration and Republican lawmakers hurts Colorado’s fiscal health. The bill cut billions from essential services while adding $3 trillion to the national debt to benefit the wealthiest Americans, he said. 

“It’s crazy,” Bennet said.

Democracy and Oversight

Crow said that preserving democracy, given the Trump administration’s actions, will require constant oversight. He said that his work monitoring federal facilities, particularly the ICE detention center in Aurora, is a top priority. 

“So what you can expect from me as your representative is that I will be all in on this,” Crow said. “I am using every tool at my disposal: legislating, budgeting, oversight.”

Oversight has become harder due to blockades from the current majority, Crow said. Citizen oversight is becoming very important, and citizens can help by acting as watchdogs, as part of an effort to help him and other politicians trying to stand up to Trump, Crow said. 

“You all have become our eyes and ears on the ground,” Crow said. ‘“All of this is going to become critical.”

Military Oversight

Crow said the president’s abuse of military authority has been “astonishing,” in response to concerns about potential misuse of the military.

Democrats have been extremely critical of Trump’s use of military personnel sent to Washington D.C. to address homelessness and crime problems.

Crow said he is working with colleagues to impose guardrails through appropriations and legislation to prevent further abuses.

Neither lawmakers directly answered questions about concerns that Trump might bring direct military force to Aurora in the near future. On Friday, Trump told reporters he’s looking next at Chicago for military enforcement.

Government Efficiency

Crow said that sensible reform was needed rather than dismantling government functions. Cutting civil servants in key roles such as aviation safety and firefighting is “incredibly dangerous” and risks severe consequences for Americans, Crow said.

Inefficient government is why the Department of Government Efficiency (DOGE) was created, he said. 

“The remedy is not to just destroy it all and burn it all down, but to actually have a sensible reform agenda,” he said.

Crow used the Inflation Reduction Act, passed in 2023, as an example of how the government was able to find more efficient ways to get work done, rather than inefficient government processes, like making residents wait eight years just to build a bridge.  

Social Security and Medicaid

Questions about Social Security’s future and what lawmakers are doing about it possibly drying up allowed Bennet to say he would want to raise income caps to sustain Social Security. 

The Trump administration is currently talking about efforts to privatize Social Security,” Crow said, and he thinks everyone should take those talks seriously. 

Both lawmakers said they were concerned about proposed Medicaid cuts, which they said would devastate rural hospitals and health centers.

“These cuts to Medicaid are going to demolish our rural hospitals and our rural health centers, and those are also going to be deeply unpopular when the American people see the result,” Bennet said. “We need to remind people where it came from, which was Donald Trump’s legislation.”

Crow said that cuts to Medicaid will cause devastating outcomes to the research being done at the Anschutz Medical Campus, which has a $13 billion economic impact and relies on $360 million annually for medical research.

“We’re fighting like hell just to maintain that funding and to keep what we already have, which is life and death for a lot of folks,” Crow said. 

Climate Change

“This is going to be a rough time environmentally in America,” Bennet said. 

The removal of environmental protection and climate legislation that was done through the Inflation Reduction Act has all been stripped away, Bennet said.

The Inflation Reduction Act was a fast-moving and sweeping U.S. federal law focused on reducing the federal deficit, lowering prescription drug costs, and promoting clean energy and climate action.

“It’s a fantasy, but he’s doing all this in service of the oil and gas industry, and we’re going to have to fight back on this,” Bennet said about Trump favoring oil and gas in the Big Beautiful Bill. He said that he hopes Colorado could one day lead the nation on climate policy.

Crow said that Bennet was being humble and let the crowd know that Bennet spearheaded preventing the Big Beautiful Bill from including the sale of public lands.

Campaign Finance and Gerrymandering

Both lawmakers said they were frustrated with the influence of Citizens United and gerrymandering on American politics. 

Citizens United is a Republican group that won a Supreme Court ruling in 2010, allowing wealthy donors, corporations and special interest groups to be considered “individuals” and have First Amendment rights and the ability to spend money on campaigns.

Crow said if he had a “magic wand” to fix one issue, it would be campaign finance reform and redistricting.

There are now fewer than 40 “truly competitive” districts in the House of Representatives, accounting for less than 10% of the House, Crow said. 

“You have deep red out of deep blue districts,” Crow said. “And what happens is there’s zero incentive to collaborate. There’s zero incentive in those districts to work together and compromise.”

Bennet said he has sponsored bills to ban gerrymandering and to prevent members of Congress from becoming lobbyists. The system has been corrupted by billionaires threatening to spend heavily against lawmakers who support reform through a corrupt “quid pro quo,” he said. 

Artificial Intelligence

AI, deepfakes and the lack of U.S. regulations have been concerning, Crow said. 

“We’re not remotely ready for it as a society,” he said.

Up to 20% of the workforce could be displaced by AI, he said, calling it the most significant disruption to the U.S. workforce since the industrial revolution. 

“I’d like to see some leadership by the United States to bring the great powers of the world together and say we all should benefit by a convention or treaty of some nature,” Crow said. 

Political Engagement and Bipartisanship

One person in the audience reminded Crow that 35% of his constituents are Republicans, and asked what both politicians do to represent all of their constituents. 

Crow said that his entire background has had diversity, from growing up in a conservative family and still having many Republican family members, to serving in the Army. 

Bennet said that he does not believe in a monopoly of wisdom and that wisdom comes through collaboration and conversation among diverse individuals. The country should avoid becoming a perpetual game of winners and losers, Bennet said. 

“There are a lot of other reasons that motivate people, and you have to understand that by spending time with them,” Crow said. 

People need to be compassionate and listen to those around them, because most people’s harshest actions come from fear.

“Compromise, being an ugly word too often, is, I think, a problem, and it’s led to a lot of this paralysis that we see,” Crow said. “Pragmatism and finding opportunities for collaboration and working together are really important, and that’s not exclusive to also fighting when you need to. You need to be good enough and smart enough as a leader to know when to fight, when to be firm and resolute, and when there’s an opportunity to build and work together.”

https://sentinelcolorado.com/metro/crow-bennet-talk-trump-taxes-medicaid-and-more-at-aurora-town-hall-meeting/

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Alternative Headline: NC Medicaid Cuts Threaten Home Care

[MM Curator Summary]: NC’s planned Medicaid reimbursement cuts could jeopardize home health care for thousands, forcing patients like Alexis Ratcliff back into costly institutions.

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FORSYTH COUNTY, N.C. (WGHP) — Nurses and CNAs are a lifeline for people getting home health care. Care teams, along with Medicaid funding, make it possible for people with complex medical issues to live independently, but one Triad woman worries her independence could be taken away.

“One of my favorite artists is Taylor Swift. I’m a huge Swiftie,” said Alexis Ratcliff.

Ratcliff is like any other 20-year-old.  She plays games on her iPad and Facetimes her friends.  What makes Ratcliff different is that she’s a quadriplegic and has a machine that breathes with her.

“I was in a car accident when I was two and a half, my spinal cord was essentially cut in half,” said Ratcliff.

Her grandfather cared for her until he wasn’t able to, and then she lived at Atrium Health Wake Forest Baptist.

“We don’t really have pediatric facilities in North Carolina that are suitable for me,” said Ratcliff.  “I stayed there from when I was 13 to 18.”

After she turned 18, there was back and forth for years about where she should and could go, until finally, the state, the hospital and BAYADA Home Health Care worked together to set Alexis up in a place of her own in Lewisville.

“I was like ‘Oh my God, we’re actually doing it.’ I thought it was beautiful, I still think it’s beautiful,” said Ratcliff.

She couldn’t be in her own home without her care team.

“They become family, you spend hours with them,” said Ratcliff.

Sometimes the nurses and CNAs that care for people in the home spend more time with their clients than with their own families.

“I’ve done something, and my person is still in their home, and they’re still with their family and they’re safe and they’re living their best life and for me, that’s a really big thing,” said Pam Hucks, a nurse caring for Ratcliff.

That idea is why Hucks, a lifelong nurse, decided to get into home care.

However, for over 19,000 people in North Carolina, that safety and security could change.  North Carolina leaders are adjusting the Medicaid budget to meet new standards under the Big Beautiful Bill.

“One thing that really concerns us is any change to Medicaid reimbursement rates will really affect our care, we pay as much as we can, we can’t pay as much as the hospitals pay, we can’t pay what facilities pay,” said Trip Smithdeal, director of the Winston-Salem office for BAYADA Home Health Care.

Reimbursements for home care services could be on the chopping block.

“Alexis is a human, she deserves to live a normal life, just like anybody else deserves to live a normal life,” said Vanessa Hernandez-Reyes, a CNA.

If CNAs and nurses go other places to find work, people like Ratcliff will end up back in institutions.

“Much more expensive, not where they want to be, she’s a young lady, 20 years old and has a whole life ahead of her,” said Smithdeal.  The director says they do what they can and keep their pay rates competitive with other employers.

Ratcliff sees herself as an advocate, speaking out to keep Medicaid funding for home health care.

“People with disabilities automatically think, oh you have a disability, nothing is going to be taken from you,” said Ratcliff.  “No, it is and we won’t be able to survive.”

Ratcliff says the nurses now and in the past are some of the many people who raised her, keeping Ratcliff on track to pursue her goal of going back to school and one day getting a law degree to push for the resources she and so many other people need.

“She wants to do something, she wants to make an impact,” said Hucks.  “She’s going to need someone to keep pushing her to go and do and stick with it, even when she says I don’t think I can do it.”

A spokesperson with the North Carolina Department of Health and Human Services says the department is looking at cuts to Medicaid reimbursement rates of about 3% due to a dip in funding.  Some areas could see as much as an 8% to 10% reduction.

Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

For the latest news, weather, sports, and streaming video, head to FOX8 WGHP.

https://www.yahoo.com/news/articles/triad-woman-raises-awareness-impact-173929911.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAIbwXfhQPTAvwlO9BQyhqo67lx41g6qq55iUSto2J_jiDvdt5lp5JXhUVi4OqxIr7AKNIipT0aso12veMBe15KsG_VFKMHaRLkbh_YjNsYfChzA7Orax7ERB3OaOzlDYbfyU3AojMO0ZX15kH9CgUaQwjjSTS0_9ibJpA0yL3web

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Alternative Headline: Medicaid cuts squeeze providers

[MM Curator Summary]: Kent County foster care providers face ongoing financial challenges as Medicaid funding cuts extend into next year.

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WYOMING, Mich. (WOOD) — Organizers of adult foster care facilities in Kent County are worrying about their bottom line after they learned Medicaid funding cuts will continue through next year.

“We have to look at how we are going to be able to balance things if cuts like this are going to continue,” said Casey Kuperus, president of David’s House Ministries. “It does appear that this will continue into the next fiscal budget that Network 180 will be voting on Monday.”

Network 180 is Kent County’s community mental health authority, which means it distributes the county’s Medicaid funding. In May, it announced a 5% cut in funding for specialized residential providers. While many, like Kuperus, were not happy about the initial cuts, they never thought the decrease would spill over into the next fiscal year.

“It seems to be we are the only ones receiving reductions in these rates with expectations to continue to provide the high-quality services,” he said.

Network 180 did not return News 8’s request for comment. Its 2026 budget shows Kent County will see a $9 million increase in Medicaid. The budget will be reviewed during a public hearing next Monday.

“It’s not about providers trying to get more money out of the budget, it’s about providers trying to get fair funding to continue the services that we are providing to this county,” Kuperus said. “And right now, it’s getting more and more difficult to do that.”

https://www.woodtv.com/news/kent-county/medicaid-cuts-worry-adult-foster-care-organizers-in-kent-county/

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Alternative Headline: Medicaid Cuts Raise Hidden Costs

[MM Curator Summary]: Medicaid budget cuts shift costs to hospitals, private insurers, and the broader economy instead of creating real savings.

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Budget reductions to Medicaid programs may appear to offer immediate financial relief for government spending. Still, evidence suggests these cuts often result in widespread cost increases that affect the entire healthcare system.

The Hidden Cost TransferEconomic Impacts Beyond HealthcareCost Shifting to Private InsurancePublic Health Considerations

When policymakers face budget constraints, Medicaid frequently becomes a target for spending reductions. As one of the largest items in many state budgets, the program presents an attractive option for officials looking to address fiscal challenges. However, financial experts and healthcare analysts warn that such cuts can create a ripple effect throughout the healthcare ecosystem.

Reducing Medicaid coverage doesn’t eliminate healthcare needs – it simply shifts where and how those needs are addressed. When individuals lose Medicaid coverage, they don’t stop getting sick or requiring medical attention. Instead, they often delay care until conditions worsen and require emergency intervention.

Hospitals and emergency departments become the default providers for uninsured patients, delivering care that is both more expensive and less effective than preventive services. These facilities are legally required to treat patients regardless of insurance status, resulting in uncompensated care costs that must be absorbed somewhere in the system.

Cutting Medicaid can seem like an easy way to slash the budget. But, the costs can spread to all of us.

Economic Impacts Beyond Healthcare

The financial consequences extend beyond direct healthcare costs. When people lack access to regular medical care, workforce productivity suffers as preventable illnesses lead to increased absenteeism and disability. Families facing medical bankruptcies experience financial instability that affects local economies.

State economies also feel the impact through reduced federal matching funds. For every dollar a state cuts from Medicaid, it loses multiple dollars in federal funding that would otherwise circulate through the local healthcare economy, supporting jobs and services.

Cost Shifting to Private Insurance

Healthcare providers typically respond to Medicaid reimbursement reductions by shifting costs to private insurers. This practice, known as cost-shifting, results in higher premiums for those with private insurance coverage. Research indicates that hospitals and medical practices often increase charges to privately insured patients to compensate for losses from public programs.

The resulting premium increases affect employers and employees alike, with businesses facing higher costs for providing health benefits and workers experiencing reduced wages as employers allocate more resources to healthcare.

Public Health Considerations

Medicaid reductions can also compromise public health initiatives. The program funds critical preventive services including:

• Vaccination programs
• Maternal and child health services
• Chronic disease management
• Substance abuse treatment

When these services become less accessible, communities may experience increased rates of preventable diseases and complications, creating additional healthcare demands and costs.

Public health officials note that Medicaid plays a crucial role in addressing health disparities and providing care to vulnerable populations. Reductions in coverage can exacerbate existing inequalities and create long-term social costs.

As budget discussions continue at state and federal levels, policymakers face difficult choices about program funding. However, the evidence suggests that Medicaid cuts rarely produce the straightforward savings they promise. Instead, they often result in cost transfers that ultimately affect taxpayers, businesses, and individuals throughout the economy.

Healthcare economists recommend that budget planners consider these broader implications when evaluating potential changes to Medicaid funding, recognizing that short-term budget reductions may lead to larger long-term costs across multiple sectors of society.

https://www.considerable.com/medicaid-cuts-shift-healthcare-costs-to-broader-public/

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Alternative Headline: Medicaid Cuts Threaten Elder Care

[MM Curator Summary]: Medicaid cuts under Trump’s bill will reduce access to long-term care, hitting seniors and home services hardest.

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The One Big Beautiful Bill Act (OBBBA) is projected to cut Medicaid benefits by over $1 trillion. How will these cuts affect long-term care? The law will likely result in worsening quality of care and access to nursing homes and home-based care, said LDI’s Executive Director Rachel M. Werner, speaking on the Make Me Smart podcast with Marketplace’s Kimberly Adams.     

Werner said there will also be large differences state-by-state, and the benefits you get may depend on where you live in. So, it’s crucial to plan ahead for long-term care.   

Here are eight points from Dr. Werner’s interview on July 16, 2025.

1. OBBBA Cuts “Provider Taxes”—a Key Funding Source for Medicaid

States use taxes on health care providers and insurers to boost their share of Medicaid funding and draw matching federal funds. The new bill limits both existing and new provider taxes, cutting off a major funding pipeline.

Rachel M. Werner, MD, PhD

2. The Loss of Coverage Will be Widespread and Hit Some Seniors

Roughly 11.8 million Americans, including 1.3 million older adults on both Medicare and Medicaid, could lose access to Medicaid due to these funding cuts, according to the Congressional Budget Office.

3. Long-Term Care Will Suffer

Medicaid is the primary payer for long-term services for older adults and people with disabilities, including nursing home and in-home care. With less funding, quality and access will decline.

4. Home Care May Be Hit Hardest

Medicaid is required to pay for nursing home care, but home and community-based services are optional. So states are likely to cut these benefits first, reducing options for people who want to live independently at home.

5. Family Caregivers Will Shoulder More Burden

As formal care options shrink, unpaid family caregivers will likely have to fill in the gaps, taking on more emotional, physical, and financial burdens.

6. Where You Live Will Matter More

Medicaid programs are state-run, and the generosity of care varies across states. With reduced federal funding, wealthier states might fill the funding gap; poorer ones may reduce services—deepening geographic inequality.

7. Workforce Crisis Will Get Worse

Medicaid cuts may drive down pay for already underpaid care workers. Combined with immigration restrictions and delayed nursing home minimum staffing mandates, we could see even more severe shortages in both nursing homes and home care.

8. Plan for Long-Term Care Before You Need it

Medicare does not cover long-term care, so know your state’s Medicaid rules and start saving early.Medicaid eligibility also varies across states and requires planning. If you don’t qualify for Medicaid, you’ll need personal savings or unpaid family help. Start preparing now to avoid tough choices later.

https://ldi.upenn.edu/our-work/research-updates/how-medicaid-cuts-will-affect-quality-and-access-in-long-term-care/

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Alternative Headline: Counties May Shoulder Medicaid Burden

[MM Curator Summary]: Medicaid changes under Trump’s bill could overwhelm local governments with new workloads and financial penalties.

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WATERTOWN, New York (WWNY) – President Trump’s Big Beautiful Bill aims to save money at the federal level. However, there’s reason to believe that as you save in Washington, you will end up paying more at the local level.

When it comes to Medicaid, President Trump’s bill requires able-bodied workers to check in and prove they are eligible for Medicaid.

There are currently 32,000 people in Jefferson County on Medicaid. At last check, around 6,000 are considered “able-bodied workers.”

Under Donald Trump’s recent Big Beautiful Bill, those people would need to essentially prove they are working or looking for work every six months.

“Early indications are that the work requirements and the recertification are going to be somewhat burdensome on counties,” said Jefferson County Administrator Ryan Piche. “If there’s 6,000 people that need to come through DSS now twice a year, and then go through The WorkPlace twice a year and seek employment opportunities and prove they’re seeking employment opportunities, that’s potentially 24,000 touch points the county government has to account for.”

That means a much bigger workload and a need to hire more people.

Cheryl Mayforth, Executive Director of The WorkPlace, says she is already looking to hire at least one person now to do the recertification.

“It could affect up to 950 families or households in Jefferson County alone, so it’s going to be a challenge,” said Mayforth.

For people who have to check in to keep their Medicaid, they’ll have to check a few boxes.

“They’re going to have to work at least 20 hours a week, 80 hours a month, and they’re going to have to report to us job searches, any volunteer work that they’re doing,” said Mayforth.

Mayforth says those on Medicaid will be exempt from re-certifying if they are 65 or older, disabled, or have a child under 14.

The Big Beautiful Bill also makes changes to who qualifies for SNAP, or the Supplemental Nutrition Assistance Program. It’ll use some of the same recertification as Medicaid.

Piche says in New York State, counties are responsible for administering SNAP, and currently, the state does not meet the new standards the federal government is trying to implement.

What does that mean? Piche says, hypothetically speaking, $5 million in penalties on Jefferson County taxpayers.

“The question is, are those penalties going to be paid by the state or are they going to be paid at the local level? If they’re paid at the local level, that means local taxpayers, on your property tax bills, are going to have to cover those penalties,” said Piche.

It’s important to note that there are still a lot of unknowns.

The changes go into effect in 2027, and Piche says the county will be working with other county governments and the state over the next year to learn more about how to best implement the changes.

Copyright 2025 WWNY. All rights reserved.

https://www.wwnytv.com/2025/07/22/could-big-beautiful-bills-medicaid-cuts-shift-work-expenses-county-level/

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Alternative Headline: CMS Tightens Medicaid Immigration Checks

[MM Curator Summary]: CMS is requiring states to verify immigration status more rigorously for Medicaid and CHIP enrollees through new monthly reports.

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The Centers for Medicare & Medicaid Services today announced a nationwide initiative aimed at reinforcing eligibility standards for Medicaid and the Children’s Health Insurance Program. This effort focuses on verifying enrollees’ immigration status.

Starting today, CMS will begin issuing monthly enrollment reports to states, flagging individuals whose immigration status could not be confirmed in federal databases. States are expected to promptly review the cases, request additional documentation if necessary and take appropriate actions to ensure compliance with federal eligibility rules. Individuals who do not meet immigration requirements may only receive limited services under specific circumstances.

https://www.aha.org/news/headline/2025-08-19-cms-launches-oversight-medicaid-chip-enrollees-ensure-immigration-status

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Alternative Headline: Rural Health Faces Medicaid Shifts

[MM Curator Summary]: Under federal law H.R. 1, the Rural Health Transformation Program, $50 billion is designated for rural healthcare—$25 billion allocated equally among states and $25 billion available competitively.

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Eastern Shore Rural Health System, Inc. is reviewing recent federal and state actions related to Medicaid eligibility and rural health funding.

CEO Jeannette Edwards stated that the organization is tracking developments following Governor Glenn Youngkin’s Executive Directive Twelve, signed August 13, 2025, and the Centers for Medicare & Medicaid Services’ nationwide initiative to remove ineligible Medicaid enrollees announced this week.

Under federal law H.R. 1, also referred to as the Rural Health Transformation Program, $50 billion has been designated to support rural health care. Half of the funding will be distributed among all 50 states, while the remaining $25 billion will be available to states through competitive applications. Executive Directive Twelve requires Federally Qualified Health Centers to participate in creating Virginia’s Rural Health Transformation Plan in order to compete for these additional funds. Eastern Shore Rural Health qualifies as a Federally Qualified Health Center and is preparing to provide input.

The directive also notes upcoming changes to Medicaid. Federal guidance on work and community engagement requirements for Medicaid recipients is due by December 31, 2025. Until that information is issued, Virginia has not provided details to Community Health Centers, including Eastern Shore Rural Health, on how the requirements will be implemented.

In addition, changes connected to the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) could alter Medicaid eligibility for certain non-U.S. citizens. The Trump administration has expanded the definition of “federal public benefit” and revised eligibility standards for immigrants holding various visas. Eastern Shore Rural Health noted that the implications of this reinterpretation will not be clear until further federal direction is issued.

Edwards said the organization will continue monitoring policy developments from both Washington, D.C., and Richmond, and will provide updates to the community as more details become available.

https://shoredailynews.com/headlines/eastern-shore-rural-health-monitoring-federal-and-state-medicaid-rural-health-policy-changes/

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Alternative Headline: Medicaid Work Rules Add Hurdles

[MM Curator Summary]: New Medicaid work rules risk millions losing coverage, while Code for America pushes states to adopt simpler, human-centered systems to reduce reporting burdens.

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Terry Gerton I want to start by having you give us a little bit of background on Code for America, what you are and what you do.

Danny Mintz Sure, Code for America is a 501c3 non-profit civic technology organization. We work shoulder to shoulder with government to help government meet people’s needs more effectively in the digital age. In practice, what this means is that we try to make government programs more hassle-free to access and government agencies more efficient and effective at meeting their goals.

Terry Gerton Well, that hassle-free part is the next piece I want to talk to you about, because in the reconciliation bill that passed this summer, there was a tremendous addition of requirements for Medicaid and SNAP recipients to document their work, to add new work requirements. And I know Code for America has been working on that very kind of issue with a number of states. So can you tell us first what these additional work requirements mean for the recipients of these benefit programs, and how Code for America helps make that process easier?

Danny Mintz So the new community engagement requirements, as they were called in the bill that were introduced for Medicaid, impose very significant new policy and new operational hurdles up front for folks who are trying to access Medicaid to get their health coverage. In practice, what it says in the legislation is that folks need to be working at least 80 hours a [month] or meeting that requirement through volunteering, through participation in a work program. Or through being in school at least half time or more, or they need to earn at least $580 a month in income. While that sounds pretty cut and dry on paper, in practice what we’ve seen in our work in a wide variety of public benefit programs is that communicating that you are meeting these requirements or that you meet an exemption from these requirements can be very significant challenges for people who are trying to get or maintain their health coverage.

Terry Gerton So for an individual, what kinds of information do they have to provide, and how complicated is that process?

Danny Mintz You know, it can range from pretty easy and straightforward if they have a job situation where all their income is reported on a W-2 from a single source at the end of the year, to what is much more common among people who are participating in the low-wage labor market, which is conveying a wide variety of information about work that they’ve done as an Uber driver, as a driver for DoorDash, babysitting that they may be using to pay their bills, other sources of income for a three-month period that goes back before they applied for Medicaid. One huge change in this version of work reporting requirements from what we’ve seen in the past is that the approach that the bill took to Medicaid was to look back before the date of application. So for somebody who’s trying to get access to medical care, states have an option of looking back either one month or up to three months. That means if you lose your job, you better apply for Medicaid right away, because if you have lost health coverage because it’s no longer provided by your employer and then try to apply after two months or so, when you need to get a prescription refilled or need to go see the doctor for a checkup or some urgent issue, it’s going to be quite likely that folks will no longer qualify because of the very reason that they’ve lost their health coverage. CBO estimated that about 5.2 million people are likely to lose health coverage as a result of the new requirements in the law.

Terry Gerton I know that Code for America has worked with many states — California, Minnesota, Louisiana — to try to simplify the benefits application process. What sort of lessons have you learned from that work that could be especially applicable to this new requirement?

Danny Mintz It’s a great question, Terry. We’ve learned two key lessons. One is that there are a lot of improvements that can be made through automating data exchanges at the state level as much as possible and simplifying the mechanisms that people use to submit information to government agencies. We’ve also learned that there are real limits to what technology improvement can do. So we have a great deal of experience in trying to make government technology more human-centered. Easier for people to understand, less jargony, and easy for folks to use on a mobile phone with a limited-bandwidth connection from their homes in rural areas that have unreliable internet access. Not all government technology is set up to meet those needs as it is now, but even when government technology is set up for those needs, there are still very significant practical hurdles that people can encounter simply in understanding what the requirements are, gathering information to meet those requirements, and conveying that information effectively to the government. We saw in Arkansas in 2018 and 2019, when Medicaid work requirements were briefly implemented there, that a huge number of Medicaid participants lost coverage, despite the fact that they were likely already meeting the requirements in practice, because they didn’t know that they needed to separately report their income on a monthly basis and their participation on a monthly basis. We would anticipate that even with really significant and well thought-out efforts to inform the public about what these new requirements are and what they mean, that there are still going to be the same kind of challenges that people not covered by government programs may find when trying to interact with private insurance and understand all of the rules and regulations that cover their ability to access care.

Terry Gerton I’m speaking with Danny Mintz. He’s the associate director of safety net policy at Code for America. So Danny, let’s go back to that human-centered design for a minute. We’re going to assume that everybody who’s in state government that’s responsible for implementing these programs really wants to do it and do it well, so that people who are eligible for these benefits can receive them. What are the key points in terms of designing this kind of new reporting requirement so that it can be successful?

Danny Mintz It’s very important that governments, as they’re designing new systems, are testing those systems with the people who are going to be using them. And this is true both for members of the public who are going to be using systems to get and maintain their coverage, and for the workers who are using the information that’s submitted through these systems to process cases and ensure that medical coverage is still accessible to people who still qualify to receive it. We are strong advocates of working incrementally to put things into the field, test them, and improve on them. We know that government technology doesn’t always follow that pattern. We also know that states are facing very significant budgetary pressures in the near future and that there’ll be a strong impetus to get technology in the field as quickly as possible. We would advise states to try as much as possible to take the burden off of members of the public to report information that states might already be able to access from backend data sources. And this means not just using the sources that they have, that they’re very familiar with, but also looking into new opportunities to gather data from increasingly common forms of low wage and variable hour income, like gig work and other ones.

Terry Gerton So there’s a period before these new rules go into effect, presumably that’s to allow the federal agencies to write their regulations, but also to allow states to prepare to implement this. What should states be doing now to make sure that they’re ready when the timeframe begins?

Danny Mintz  States should be looking closely at what capabilities they have in their systems and what the gaps are likely to be in terms of getting information, particularly about folks who might be exempt from these requirements. You know, SNAP has a long history of similar work requirements that have slightly different parameters, but what SNAP and Medicaid doesn’t is an interview. So in the SNAP program, states and county agencies have a chance to talk with people who are applying and really assess their situation. In Medicaid, states don’t have that option. And so states should be thinking really carefully about how their applications are structured, how they’re asking about information that’s going to be critical for people to supply in order to demonstrate either that they’re meeting these requirements or that they are exempt from them. And states should thinking about how they’re going to adjust their processes on the worker side to make it easier to flag potential areas for follow-up, to make sure that folks keep their health coverage, don’t start going into medical debt or overwhelming emergency rooms.

Terry Gerton I know as you’ve been working with states, you’ve probably been seeing a growing uptake of this concept of human-centered design and simplifying benefits. Do you think that these new rules around Medicaid and SNAP might be sort of the tipping point in terms of moving states sort of collectively towards a more empathetic and effective benefits application process?

Danny Mintz Well, I would hope so. I think in practice, some of the new policies in the reconciliation bill that passed this past year are going to make it a little bit harder for states to implement technology flexibly, because states will have fewer resources to do so. I think we do see a big shift in this new budget environment towards states trying to find efficiencies, do more with less, and human-centered design is a huge part of that. I think what remains to be seen is how states are going to be able to execute on those goals. It’s definitely the case that states are more aware of the need to provide services in ways that are empathetic and human-centered from the first interaction that a person has with government through to their whole case lifecycle. I think there are still structural challenges in place for how states can actually put that into practice.

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https://federalnewsnetwork.com/technology-main/2025/08/human-centered-design-could-help-medicaid-recipients-meet-new-work-rules-without-losing-coverage/

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Alternative Headline: Trump Orders Monthly Medicaid Checks

[MM Curator Summary]: The Trump administration mandated monthly Medicaid and CHIP eligibility checks, sparking legal and advocacy challenges over their impact on immigrants and vulnerable groups.

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The Trump administration will require monthly eligibility checks for Medicaid and CHIP to curb improper payments, sparking concerns over effects on vulnerable groups.

The Centers for Medicare and Medicaid Services (CMS) have launched a nationwide oversight initiative to ensure that those enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) are U.S. citizens, nationals, or have a satisfactory immigration status. This initiative aims to remove ineligible beneficiaries and uphold citizenship requirements, thereby maintaining program integrity and safeguarding taxpayer funds.

Monthly verification mechanism

CMS now provides states with monthly enrollment reports identifying individuals whose citizenship or immigration status could not be confirmed through federal databases, including the Department of Homeland Security’s SAVE program. States must review these cases, verify status, request additional documentation if necessary, and take appropriate actions, such as adjusting coverage or applying eligibility rules for non-citizens. CMS will monitor progress monthly.

Official justifications and key statements

U.S. Secretary of Health and Human Services, Robert F. Kennedy Jr., emphasized the importance of protecting Medicaid from abuse, stating,

"Medicaid is a lifeline for vulnerable Americans, and I will protect it from abuse."

CMS Administrator Dr. Mehmet Oz highlighted the commitment to program integrity, noting,

“Every dollar wasted is a dollar taken from an eligible and vulnerable individual who needs Medicaid and CHIP.”

Impact on immigrants

Individuals without satisfactory immigration status will only receive limited services under certain circumstances. Medicaid eligibility rules for immigrants will change, and starting October 1, 2026, only U.S. citizens, nationals, or a smaller group of legally present immigrants will qualify. This could affect groups previously eligible without being permanent residents, such as refugees or asylum seekers. 

Context of broader legislation

These changes are part of the "Big Beautiful Bill," signed by President Trump on July 4, 2025, which includes approximately $1 trillion in Medicaid cuts. Other significant changes include new work requirements for adults, more frequent eligibility reviews, increased out-of-pocket costs, shorter retroactive coverage periods, and reduced funding for reproductive health clinics.

Controversy and legal opposition

New York Attorney General Letitia James and 20 other attorneys general have sued the Trump administration over directives that prevent health, education, and social services programs from serving all residents, regardless of immigration status. James criticized these measures for "uprooting" support systems and endangering vital services like cancer screenings and primary care.

Patient advocates warn that the loss of continuous eligibility waivers could lead to vulnerable populations losing coverage. The changes could also strain state resources as they implement more frequent eligibility checks and adjust to new federal requirements.

The Trump administration’s changes to Medicaid and CHIP rules represent a significant shift in policy, with the potential to impact millions of Americans. While the goal is to protect taxpayer dollars and ensure program integrity, the implications for vulnerable populations, particularly immigrants, remain a point of contention and concern.

https://www.mibolsillo.co/news/Medicaid-and-CHIP-rules-change-Trump-orders-monthly-eligibility-checks-20250820-0002.html

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