Post-OBBBA Medicaid & ACA Defense

Post-OBBBA Medicaid & ACA Defense Archive

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December 3, 2025
Checking All the Boxes: A Survey of Medical Frailty Definitions in Alternative Benefit Plans and Section 1115 Work Requirements Demonstrations
Shandra Hartly Issue Brief
Individuals who are considered medically frail have traditionally been subject to different eligibility and coverage rules in the Medicaid program. Most recently, H.R. 1 exempted medically frail individuals from new work requirement imposed on Medicaid expansion populations. This survey provides information on the use of medical frailty in the…
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December 3, 2025
Recommendations for Mitigating Harms to People with Disabilities, Older Adults, and Caregivers from Medicaid Work Requirements
David Machledt and Jennifer Lav Issue Brief
*** Co-Authored with Natalie Kean, Jennifer Mathis, and Gelila Selassie The One Big Beautiful Bill Act (OBBBA) establishes unprecedented work requirements in Medicaid expansion. Prior experience has shown that people with disabilities, older adults, and caregivers who should be exempted from work requirements often lose coverage or are denied…
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December 1, 2025
Medicaid Work Requirements: Mitigating Harm through Implementation
David Machledt Issue Brief
This piece provides an overview of the structure of the new Medicaid work requirement and recommends how states can choose policies that lessen the negative effects of this new requirement. Recommendations include reducing administrative burden for states and individuals through streamlined compliance procedures, ensuring that health and functional status…
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November 20, 2025
Got Your (Work) Number: The Intersection of Medicaid Eligibility Data Sources and Work Requirements
Shandra Hartly Issue Brief
Effective data matching will be an integral part of minimizing the harm associated with OBBBA's work requirements. This resource provides a brief overview of existing ex parte verification requirements and common sources used for ex parte verification, and emphasizes that those sources should be used with care to minimize…
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November 19, 2025
OBBBA Harms People with Disabilities: Limits on State Directed Payments
Brit Vanneman, Elizabeth Zirker, and Geraldine Doetzer Fact Sheet
The One Big Beautiful Bill Act (OBBBA) includes many provisions that will harm people with disabilities. In this brief, we explain how the bill limits State Directed Payments (SDPs), discuss how these cuts will lead to slower and fewer services for disabled people, and offer potential avenues for future…
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November 18, 2025
Turning Lemons Into Lemonade: State Applications Underscore the Limitations of OBBBA’s Rural Health Transformation Program
Geraldine Doetzer Uncategorized
Earlier this month, the Centers for Medicare & Medicaid Services (CMS) announced that all 50 states have applied for funding through the Rural Health Transformation Program (RHTP) established under the so-called “One Big Beautiful Bill Act” (OBBBA). As I discussed previously, RHTP is a one-time, $50 billion grant fund…
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Post-OBBBA Medicaid & ACA Defense Archive

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Checking All the Boxes: A Survey of Medical Frailty Definitions in Alternative Benefit Plans and Section 1115 Work Requirements Demonstrations

Recommendations for Mitigating Harms to People with Disabilities, Older Adults, and Caregivers from Medicaid Work Requirements

Medicaid Work Requirements: Mitigating Harm through Implementation

Got Your (Work) Number: The Intersection of Medicaid Eligibility Data Sources and Work Requirements

OBBBA Harms People with Disabilities: Limits on State Directed Payments

Turning Lemons Into Lemonade: State Applications Underscore the Limitations of OBBBA’s Rural Health Transformation Program