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No discernible difference exists between the ACA mandate penalty that was overturned by the US Supreme Court and the mandate penalty in the 2025 OBBBA. More

Despite a mountain of evidence showing its deleterious effects, a Medicaid work requirement is now law. The mandate, considered by its supporters to be a centerpiece of the One Big Beautiful Bill Act (OBBBA), is the product of a desperate search to find ways to help offset over $3 trillion in tax losses, coupled with the enduring desire among Affordable Care Act (ACA) opponents to repeal the Medicaid expansion for working-age adults. To accomplish their goal, Medicaid advocates coupled a claim that removing millions of people from Medicaid somehow makes the program more efficient with grossly misleading “research” characterizing Medicaid beneficiaries as healthy adults living off their benefits, with free time on their hands. More

The One Big Beautiful Bill Act (OBBBA)’s cuts to Medicaid will heighten the nation’s behavioral health crisis. Nationally, each year an estimated… More

Joseph, a 45-year-old man with Down syndrome is brought to the emergency department (ED) after he and his mother fell down the stairs. In a phone… More

The GOP Plan to End Obamacare involves fiscally starving it to death rather than an explicit repeal. Trump’s recent signing of the “Big Beautiful Bill” brings us closer to that harsh reality. More

Health insurance coverage increases access to recommended pregnancy care, but undocumented immigrants are not eligible for pregnancy Medicaid coverage without state uptake of alternative policy options. Twenty-four states and the District of Columbia (DC) offer public insurance to undocumented immigrants who are income eligible for pregnancy Medicaid through the Children’s Health Insurance Program From-Conception-to-End-of-Pregnancy option or state funds. More

The American Hospital Association determined that in 2022 nonprofit hospitals spent $129 billion on community benefits. This is more than the entire budget for the US public health service. Different organizations estimate different amounts of community benefit spending depending on their definition of community benefit. More

For more than 2 years, I have started my speaking engagements with a simple message: “Health equity benefits all communities.” Although the message may be straightforward, health equity–focused scientists and advocates like me have done an inadequate and ineffective job making that point clear and believable through stories, data, and messaging. More

From 2004 to 2024, Medicare Advantage (MA) went from being a “policy disappointment,” covering 12% of all Medicare beneficiaries, to predominance, covering more than one-half (52%), with more growth predicted in the future. Drawing on an extensive review and synthesis of the literature, Medicare Payment Advisory Commission (MedPAC) reports, congressional committee hearings, and Centers for Medicare and Medicaid Services (CMS) data, this paper analyzes the evolution of Medicare and managed care in three parts More