States Ranked by Potential Coverage Losses under Medicaid Work Requirements

Posted on by lad3

From Becker’s Hospital Review

California is projected to experience the largest potential losses in Medicaid coverage if federal work requirements are enacted, according to an analysis released by the Urban Institute on April 14.

Approximately five million adults across the country could lose Medicaid coverage next year under a possible federal mandate requiring adults aged 19 to 55 in Medicaid expansion states to work. At least 10,000 adults in nearly every expansion state could lose coverage, with the largest losses occurring in the most populous states.

These coverage reductions are likely to stem from a lack of awareness or confusion about the new policy, rather than from enrollees failing to work. The extent of the losses could also vary depending on the final policy and how each state implements the work requirements.

The study examined a proposal that would withhold federal funds for adult Medicaid enrollees in expansion states who do not report working at least 80 hours per month, or who do not meet exemption criteria such as being a student, caregiver, or having a disability. Similar legislation has been proposed in several states this year.

States ranked by potential coverage losses under Medicaid work requirements:

  • California: 1 to 1.2 million
  • New York: 743,000 to 846,000
  • Illinois: 193,000 to 220,000
  • Pennsylvania: 174,000 to 198,000
  • North Carolina: 171,000 to 195,000
  • Arizona: 166,000 to 189,000
  • Ohio: 158,000 to 180,000
  • Michigan: 145,000 to 165,000
  • Washington: 121,000 to 138,000
  • Kentucky: 120,000 to 136,000
  • Louisiana: 116,000 to 132,000
  • New Jersey: 115,000 to 131,000
  • Indiana: 102,000 to 116,000
  • Virginia: 98,000 to 111,000
  • Maryland: 95,000 to 109,000
  • Colorado: 95,000 to 108,000
  • Massachusetts: 86,000 to 98,000
  • Oregon: 83,000 to 95,000
  • New Mexico: 75,000 to 86,000
  • Connecticut: 74,000 to 85,000
  • Missouri: 69,000 to 78,000
  • Minnesota: 67,000 to 76,000
  • Arkansas: 62,000 to 70,000
  • Nevada: 59,000 to 67,000
  • Oklahoma: 47,000 to 53,000
  • West Virginia: 38,000 to 44,000
  • Iowa: 34,000 to 39,000
  • District of Columbia: 26,000 to 30,000
  • Rhode Island: 25,000 to 29,000
  • Hawaii: 24,000 to 27,000
  • Montana: 23,000 to 27,000
  • Utah: 20,000 to 23,000
  • Idaho: 17,000 to 20,000
  • Delaware: 17,000 to 20,000
  • New Hampshire: 17,000 to 19,000
  • Nebraska: 13,000 to 15,000
  • Maine: 11,000 to 13,000
  • Alaska: 10,000 to 11,000
  • South Dakota: 8,000 to 9,000
  • Vermont: 7,000 to 8,000
  • North Dakota: 5,000 to 6,000

Share of US Adults Who Are “Unable to Afford or Access Quality Health Care” Reaches Record High

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According to a recent Gallup poll, the number of U.S. adults unable to afford or access quality health care has risen by 3 percentage points since 2021, reaching a record high of 11%, or about 29 million people. The steepest increases were seen among low-income and minority groups: Hispanic adults rose 8 points to 18%, Black adults rose 5 points to 14%, and those earning under $24,000 annually rose 11 points to 25%. Over the same period, the share of adults considered “cost secure” dropped significantly, especially among Hispanic adults (down 17 points to 34%) and Black adults (down 13 points to 41%). These shifts underscore the widening gap in health care access and affordability since 2021 – and the important role of CHCs.

Need Data on Medicaid and SNAP?

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The Pennsylvania Department of Human Services publishes data on Medicaid and SNAP enrollees by county and congressional district. As of February 2025, PA had 3,009,860 individuals accessing Medicaid which is 23.17% of the population. In 2015, Pennsylvania implemented Medicaid Expansion, part of the Affordable Care Act that allows low-income people to obtain health care coverage. The SNAP data includes an interactive map by county and age group. The United States Department of Agriculture’s Economic Research Center found that for every $1 issued in federal SNAP benefits, it helps grow our economy by $1.54 Click here to access the PA Department of Human Services Dashboard.

Provider Groups Calling for Congress to Bolster Visa Waivers

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More than three dozen healthcare associations and organizations wrote a letter calling on House and Senate leaders for action on a bill bolstering foreign-born physician recruitment to underserved areas. The letters speak to the Conrad 30 Waiver program and support a pair of bills introduced last month that would increase the number of waivers allotted per state, among other “common sense changes.” Read more.

Providing Oral Health Care in Rural Areas

Posted on by vfl5083

This distance from places like dental offices and grocery stores makes it challenging for patients in rural areas to have good oral health. Dr. Jessica Robertson, DMD, shares patients are only coming to town once a month to get their groceries. So, their perishables will be done and over within the first two weeks. And then the next two weeks are just ultra-processed foods, which are high in sugar and salt. Read more about Dr. Robertson’s efforts to improve oral health in rural areas Voices from the Field.

Final Recommendation Statement: Primary Care Behavioral Counseling Interventions to Support Breastfeeding

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The U.S. Preventive Services Task Force released a final recommendation statement on primary care behavioral counseling interventions to support breastfeeding in JAMA. Clinicians can help improve the health of babies by providing interventions that support breastfeeding. Visit the April 8 online issue of JAMA to view the recommendation, the evidence on which it is based, and a summary for clinicians.

HHS’ Transformation to Make America Healthy Again

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On March 27, the U.S. Department of Health and Human Services (HHS) announced a dramatic restructuring in accordance with President Trump’s Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.” Reductions in Force (RIFs) started last Friday March 28. Here is some information that has been gleaned from media reports and interactions with current and former HHS staff:

·       Total RIFs at large agencies: HHS did announce that it planned to reduce:

o  2,400 full-time jobs at the CDC,

o  3,500 jobs at the FDA,

o  1,200 at the NIH, and

o  300 at the CMS. This included the entire staff of the Office of Equal Opportunity and Civil Rights.

No details were announced about what functions would be impacted by these RIFs. Also, these figures suggest that roughly 2,600 FTEs were let go at smaller agencies such as HRSA, SAMHSA, and AHRQ.

·       Reports suggest that up to one third of HRSA staff were let go. According to Politico, as many as 500 to 600 people from HRSA were let go. Trade publication Government Executive also reported that about a third of HRSA staff got RIF notices. In 2024, HRSA reported having 2,749 FTEs.

·       Two offices within BPHC were eliminated entirely. All staff from the following BPHC offices were let go:

o      The Office of Strategic Business Operations (OSBO), which supports BPHC operations around internal/external communications, including the BPHC Contact Form, the HRSA GeoCareNavigator, IT, strategic planning, professional development, EHB, BPHC website, etc.

o      The Office of Health Center Investment Oversight (OHCIO), which oversees all “supplemental” CHC funding.

·       Five HHS Regional Offices were eliminated in their entirety. All staff at the Boston, New York, Chicago, San Francisco, and Seattle offices received RIF notices this week. While the regional offices in Philadelphia, Atlanta, Dallas, Kansas City, and Denver will remain open, it is not yet clear what states they will each work with.

We will continue to update members about the changes at HHS, HRSA, and BPHC as we become aware of them. If you have questions or learn information, contact Eric Kiehl, PACHC Director of Policy and Partnership.

Congress Passes Budget Resolution, Teeing up Huge Healthcare Cuts

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Congress paved the way for deep cuts in healthcare spending as part of an effort to extend expiring tax cuts on Thursday. The House voted 216-214 to adopt the final version of the fiscal 2026 budget resolution, with GOP Reps. Thomas Massie (Ky.) and Victoria Spartz (Ind.) joining the Democratic minority in opposition. This followed a Senate vote to approve the budget on Monday and a House vote in February on the lower chamber’s first draft of the measure.