May 29, 2025
How Non-disabled Medicaid Recipients Without Children Spend Their Time
The reconciliation bill passed by the United States House of Representatives imposes community engagement requirements for childless non-disabled Medicaid recipients age 19–64, starting in 2027. The requirement can be met by spending 80 hours in at least some months either working, going to school, participating in a work program, or doing community service. In a…
May 20, 2025
The share of Medicaid recipients in compliance with the House bill’s community engagement requirement
Last week, the House Committee on Energy and Commerce approved several changes to Medicaid as part of the reconciliation bill. One major change is the imposition of community engagement requirements for non-disabled working age adults without dependent children. This change would take effect in January 2029, although some House members have argued for moving up…
May 19, 2025
The Case for Shifting More Welfare Costs to States
As part of Congressional Republicans’ drive to craft “one big beautiful bill” reflecting Donald Trump’s tax and spending agenda, the House Agriculture committee on May 14 approved several proposals that would reduce federal spending by shifting some current federal welfare costs to states. At the same time, dissatisfied conservative members have called for more federal…
May 18, 2025
Saved by Medicaid: New Evidence on Health Insurance and Mortality from the Universe of Low-Income Adults
Abstract We examine the causal effect of health insurance on mortality using the universe of low-income adults, a dataset of 37 million individuals identified by linking the 2010 Census to administrative tax data. Our methodology leverages state-level variation in the timing and adoption of Medicaid expansions under the Affordable Care Act (ACA) and earlier waivers…
April 8, 2025
Public Support of Health Insurance Enrollment
Health insurance subsidies, especially as provided by Medicaid, are under scrutiny as Republicans scout for savings to make way for their tax agenda. However, instead of selective cuts, Congress should simplify the enrollment rules, treat individuals with similar incomes more equally regardless of where they get their coverage, and implement reforms which will lower costs…
March 24, 2025
Keeping Medicaid Sustainable While Prioritizing the Vulnerable
The unsustainability of future federal budget deficits necessitates reduced entitlement spending. Finding savings from Medicaid will likely be a central part of this year’s budget debate. What are the costs and benefits of various reform proposals affecting children, working-age adults, and the elderly? How can policymakers best prioritize vulnerable populations as they debate ways to…
February 28, 2025
Less Than Half of Medicaid Recipients Work Enough to Comply With a Work Requirement
Congress is considering implementing work requirements for Medicaid. This reform could help Congress achieve its goal of reducing federal expenditures and simultaneously strengthen the incentive for Medicaid recipients to work. At the same time, individuals who do not comply with the work requirement may lose health insurance coverage. Underlying the policy debate is the extent…