William Schpero

Emergency Medicaid at Risk — Preserving State Authority and Access to Care | NEJM States that use federal dollars to provide health care to unauthorized immigrants, beyond narrowly defined emergency services, will now face enforcement actions and potential recoupment of funds.

For decades, the narrowly defined Emergency Medicaid (EM) program has reimbursed hospitals for emergency care provided to uninsured, low-income immigrants.

In @nejm.org, we write in defense of state flexibilities in EM, which seem at risk: www.nejm.org/doi/full/10....

cc @chpc-cornell.bsky.social

➡️ Please spread the word:

The Medicaid Data Learning Network (MDLN) is launching a survey to gain insights into researchers’ use of federal Medicaid claims data (TAF).

The survey will help the MDLN advocate for improvements to data access / quality.

weillcornell.az1.qualtrics.com/jfe/form/SV_...

Check out our article in Health Affairs Forefront:
www.healthaffairs.org/content/fore...

Dig through individual responses (with comments) on the CHPC website:
healthpolicycenter.cornell.edu/chpc/surveys...

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Every 5-6 weeks, the Cornell Health Policy Center (@chpc-cornell.bsky.social) will survey 64 leading health policy researchers on the most pressing health policy topics of the day.

To start: effects of Medicaid work requirements under the One Big Beautiful Bill Act.

2/N

For many years, the Clark Center at Chicago Booth has regularly surveyed leading economists to assess consensus on timely economic policy issues.

We are excited today to launch the Cornell Health Policy Insight Panel, where we extend that model to health policy.

1/N ⬇️

📣 It’s not too late to join us THIS THURSDAY for our September CHPC Journalism Series webinar: “Supporting Data-Driven Journalism on Medicaid Policy!”

🗓️ Thursday, September 25th | 2:00-3:00 PM ET

Register: buff.ly/PqOT9rD

Not great apples-to-apples estimates out there, but roughly my sense is rx is comparable, ED in Medicaid is higher, outpatient care in Medicaid is lower.

Diagnosed health conditions and health care use among Medicaid expansion enrollees, 2019 and 2022 As of 2025, 40 states and the District of Columbia have implemented expansions of Medicaid eligibility under the Affordable Care Act (ACA).1 A large body o

Link to Paper:

academic.oup.com/healthaffair...

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cc @chpc-cornell.bsky.social

2. The OBBBA includes work requirement exemptions for certain groups, including folks who are "medically frail" or in treatment for SUD.

Our paper is an early proof-of-concept that states could use claims to automate exemptions (if allowed to do so in final regs).

5/N

➡️ We see two important implications:

1. Most expansion enrollees are actively receiving care. The coverage losses predicted under the OBBBA's work requirement will thus likely introduce discontinuities in care.

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➡️ Key Finding 2: There was meaningful variation in health care use across states.

Rx use exhibited the largest variation across states, followed by outpatient visits, ED visits, and inpatient visits.

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➡️ Key Finding 1: In 2022, over one-third of adult expansion enrollees had at least 1 diagnosed health condition.

One-quarter had an ED visit, while over 60% had outpatient visits and prescription drug fills.

2/N

During debate on the OBBBA, I realized we know very little about health care needs and use in the adult Medicaid expansion population.

We have a short paper out in Health Affairs Scholar this week that uses national Medicaid claims data in an attempt to fill that gap:

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Calling all health policy journalists:

Come to our session next week on data resources for reporting on Medicaid!

Postdoc, Postgrad, and Research Intern Vacancies Browse Postoc and Research Intern vacancies at UW–Madison.

Dan Sacks and I are looking for a postdoc to work on Medicaid evaluation projects at UW-IRP. See posting: hr.wisc.edu/postdoc-and-... . Email your resume and cover letter to Tim Connor at tim.connor@wisc.edu.
For any questions regarding the position, please contact Dan Sacks at dan.sacks@wisc.edu

Welcome! You are invited to join a webinar: CHPC Journalism Series: Supporting Data-Driven Journalism on Medicaid Policy. After registering, you will receive a confirmation email about joining the webinar. In this session, two Cornell experts will identify key data resources for reporting on timely Medicaid policy topics, including: - Impact of emerging federal and state policy developments - Coverage trends...

📢 Calling all journalists 📢

Join our third session of the Cornell Health Policy Center Journalism Series “Supporting Data-Driven Journalism on Medicaid Policy!”

🗓️ Thursday, September 25th | 2:00 PM–3:00 PM ET on Zoom

Register now:

🚨 Want to learn more about key public data resources for reporting on Medicaid policy issues?

Join our third session of the Cornell Health Policy Center Journalism Series
“Supporting Data-Driven Journalism on Medicaid Policy!”

🔗 Register: buff.ly/WsGMU4H

Please spread the word -- our next @chpc-cornell.bsky.social event for journalists is focused on data resources for reporting on Medicaid policy.

Details below:

Insurance Churn and the COVID-19 Pandemic This study estimates whether the Families First Coronavirus Response Act decreased insurance churn.

My co-authors Sarah Shubeck (UCM) & Emily Crawford (Booth PhD student) & I have a new paper in JAMA Health Forum studying the effects of the Families First Coronavirus Response Act (FFCRA) on insurance churn (defined as losing health insurance over the next 12 months) jamanetwork.com/journals/jam...

Please spread the word!

Happening tomorrow.

Very clear article discussing our @beckerfriedman.bsky.social / @nber.org working paper and other aspects of healthcare job growth.

The full paper together with @nealemahoney.bsky.social @siepr.bsky.social @kevinrinz.bsky.social @victoriaudalova.bsky.social is here: gottlieb.ca/papers/Healt...

This portends another addition to the Cape Cod house that is subsidies for the safety net: Medicare DSH, Medicaid DSH, the Critical Access Hospital program, 340B, etc.

All have overlapping purposes and are subject to gaming and mis-targeting.

Early School Medicaid Expansions and Health Services for Children With Parental Opioid Use Disorder This cohort study estimates the early effects of state school Medicaid expansions on the receipt of Medicaid-funded school-based health services among children who have experienced parental opioid use...

What happens when states expand school Medicaid? Our new study @jamahealthforum.bsky.social finds that the receipt of school-based health services rises significantly among children affected by parental opioid use disorder, following early state expansions. jamanetwork.com/journals/jam...

Today at 3pm! Join @povertyscholar.bsky.social (Cornell), Andrea Campbell (MIT), David Adler (RWJF) and me for a webinar on Medicaid's past, present and future at a critical moment in the program's trajectory. Event reg below. 1/2 @rwjf.bsky.social @watsoninstitute.bsky.social @jhppl.bsky.social

JAMA Health Forum @jamahealthforum.bsky.social - the health policy journal of the JAMA Network - is now on BlueSky!! #MedSky #ARM25

Very timely -> happening now!

~ 3 hours after the CBO score on the reconciliation bill...

Ok folks, we know work requirements reduce benefits without increasing work (cc: @chloeneast.bsky.social)

But who loses benefits and what happens if work requirements are reversed?

New evidence from linked SNAP-Medicaid data and a natural experiment in CT tell a concerning story...

Thread below 👇

Of course, not to be confused with "Pickle" hospitals!

www.hrsa.gov/about/faqs/w...

Very excited to moderate a conversation next Wed with Anne Dwyer from the Georgetown Center for Children and Families.

The goal: make sense of all that's happening re: Medicaid on the Hill.

Register for the next Medicaid Insights Colloquium below:

us06web.zoom.us/webinar/regi...

Loss of Subsidized Drug Coverage and Mortality among Medicare Beneficiaries | NEJM A total of 14 million Medicare beneficiaries receive the Low-Income Subsidy (LIS), which reduces cost sharing in Medicare Part D. Losing the LIS may impede medication access and affect mortality. U...

Eric Roberts and @joefigs.bsky.social led a groundbreaking new study on Medicaid and Medicare, out today in NEJM. I’m lucky to have been a part of it.

Medicare saves lives. But is it enough to save lives of the most vulnerable Americans? The study suggests no; Medicaid still matters. (1/11)