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Joan Alker

@joanalker1.bsky.social

ED of Georgetown Center for Children and Families and Research Professor at Georgetown University’s McCourt School of Public Policy; post mostly about Medicaid, CHIP and such... Visit our website at ccf.georgetown.edu

2,854 Followers  |  425 Following  |  480 Posts  |  Joined: 29.09.2023
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Posts by Joan Alker (@joanalker1.bsky.social)

And ICYMI here is the latest blog by my veteran Medicaid expert colleague Andy Schneider on what is happening with the actions against Minnesota.
Hint: They are unprecedented.
ccf.georgetown.edu/2026/03/02/c...

03.03.2026 19:26 — 👍 8    🔁 7    💬 0    📌 0
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Minnesota Sues Federal Government Over Withheld Medicaid Funds

Minnesota Sues Federal Government Over Withheld Medicaid Funds www.nytimes.com/2026/03/03/u...

03.03.2026 18:06 — 👍 21    🔁 14    💬 0    📌 2
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CMS Releases Long-Awaited EPSDT Behavioral Health Toolkit for States Say Ahhh! readers will recall that when we blogged about the behavioral health section of the Center for Medicare & Medicaid Services (CMS) landmark 2024 EPSDT guidance, we noted that CMS had an addit...

Better late than never - CMS releases a useful Congressionally mandated toolkit related to improving behavioral health services for children covered by Medicaid.

My colleague Anne Dwyer's blog explains.
ccf.georgetown.edu/2026/02/24/c...

02.03.2026 22:44 — 👍 1    🔁 2    💬 0    📌 0
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CMS Weaponizes Fraud Against Medicaid in Minnesota: Part 2 At a White House press conference last Wednesday, Vice President J.D. Vance, newly tasked with leading a war on fraud, announced that “we have decided to temporarily halt” $259 million in federal matc...

My colleague Andy Schneider,a Medicaid program integrity expert, breaks down the Trump Administration's latest attack on Minnesota -- which cuts their Medicaid federal $ by c. 9%.

CMS Weaponizes Fraud Against Medicaid in Minnesota: Part 2 ccf.georgetown.edu/2026/03/02/c... via
@GeorgetownCCF

02.03.2026 21:59 — 👍 1    🔁 0    💬 0    📌 0
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Trump Pardons Former WellCare Execs Convicted In Florida Medicaid Fraud Case FBI agents raided WellCare's Tampa headquarters in 2007 as part of the investigation. A statement issued by the White House said the prosecution has been “widely cited as a case study in overcriminali...

One big case of fraud against Medicaid was perpetrated by the Medicaid managed care company then known as "Wellcare" in Florida.

Guess which President pardoned WellCare company execs convicted of Medicaid fraud?

www.wusf.org/courts-law/2...

27.02.2026 17:44 — 👍 5    🔁 3    💬 0    📌 0
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State by State Medicaid and CHIP Enrollment Data This tracker shows enrollment data for Medicaid and the Children’s Health Insurance Program (CHIP) in all 50 states and DC, from January 2025 to the most recent month available. Data include total Med...

In 2025, the # of children covered by Medicaid declined by 1 million.

This is troubling b/c when the # of kids covered by Medicaid goes down, it usually means that the # of uninsured kids is going up.

Check out how Medicaid enrollment is changing in your state.

ccf.georgetown.edu/feature/stat...

27.02.2026 01:34 — 👍 2    🔁 1    💬 0    📌 0
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New State-by-State Medicaid and CHIP Tracker Shows Declining Enrollment as H.R. 1 Cuts Loom Georgetown CCF has been closely tracking Medicaid and CHIP enrollment periodically over the past decade, – most recently as states began “unwinding” continuous coverage protections put in place during...

@georgetownccf.bsky.social expanded Medicaid enrollment tracker is now live for all 50 states + DC.

New State-by-State Medicaid and CHIP Tracker Shows Declining Enrollment as H.R. 1 Cuts Loom ccf.georgetown.edu/2026/02/26/n... via
@GeorgetownCCF

27.02.2026 01:34 — 👍 3    🔁 5    💬 1    📌 0
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@mrbimpact.bsky.social talks repercussions of H.R.1, $1 trillion in Medicaid cuts, work reporting requirements and big policy shifts with @joanalker1.bsky.social, @georgetownccf.bsky.social Dr. Shannon Dowler, @aafp.org @amorganrural.bsky.social @ruralhealth.bsky.social 🎧 🔗 tinyurl.com/y49jpts5

26.02.2026 21:04 — 👍 6    🔁 4    💬 0    📌 1

Attack on MN is an effort to distract voters from the fact that Trump Administration and their allies in Congress made the largest cuts to Medicaid in history -- almost $1 trillion which will result in an estimated 7.5 million people becoming uninsured according to CBO.
www.cbo.gov/publication/...

26.02.2026 01:18 — 👍 8    🔁 2    💬 1    📌 0

Disgusted by this Administration’s ongoing attacks on the state of Minnesota - now an unlawful act to withhold federal Medicaid funding preemptively.
Medicaid serves children, people with disabilities etc.

25.02.2026 22:26 — 👍 17    🔁 5    💬 1    📌 1

A serious effort to detect fraud against Medicaid would not dump data online with no context.

CMS itself indicates elsewhere on their website that in 22 states the underlying data that was dumped by the Trump Administration was “unusable” or of “high concern”.

25.02.2026 17:39 — 👍 9    🔁 10    💬 0    📌 0
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Florida Bill Would Waste Money on a Lose-Lose Plan to Punish Very Low-Income Parents As readers of the SayAhhh! Health Policy blog know, states that have taken up the Affordable Care Act’s (ACA) Medicaid expansion are now mandated to impose a punitive work reporting requirement as of ...

My new blog w/ Jade Little explains why a bill that Florida's legislature is considering on Medicaid work requirements is a Catch-22

Bcuz Florida has not expanded Medicaid very poor parents would lose Medicaid if they don't meet the new rules --- and if they do!

ccf.georgetown.edu/2026/02/20/f...

20.02.2026 22:55 — 👍 2    🔁 1    💬 0    📌 0
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Implementing Costly Medicaid Work Reporting Requirements: Who Will Foot the Bill? Introduction The budget reconciliation bill enacted in July 2025 (H.R. 1) includes two major changes to federal Medicaid law that will impose large implementation costs on most states. One mandates th...

Our new brief explores how states can draw down federal dollars to finance the administrative costs of Medicaid work reporting requirements. Don't be misled by the $200 million in HR 1 -- this will cost taxpayers WAY more.

Much of the $ will go to large vendors.

ccf.georgetown.edu/2026/02/11/i...

20.02.2026 19:53 — 👍 3    🔁 3    💬 0    📌 0
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Wisconsin Legislators Finally Pass Lifesaving Postpartum Care for New Moms - Kids Forward For Release: Thursday, February 19, 2026 Contact: Emily Miota, 262-853-6863 Today, the Wisconsin state assembly voted to ensure that new moms on Medicaid have health insurance for a year after giving ...

Wisconsin just became the 49th state to adopt 12 months postpartum overage in Medicaid.

Only state in the country that has not adopted this policy for new moms is … Arkansas…

Congrats to our colleagues in Wisconsin @kidsforward.bsky.social
who had been working on this for many years.

20.02.2026 16:13 — 👍 4    🔁 4    💬 0    📌 0
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Work Requirements

Yet there's no mention of this that I can find anywhere on NE website.

The state can easily remove this group from being cutoff which I am assuming they will do 🤞

But for parents who are new applicants to Medicaid they will not know that and may not even apply.

dhhs.ne.gov/Pages/WorkRe...

18.02.2026 19:25 — 👍 1    🔁 1    💬 0    📌 0
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Which Parents Would Still be Covered if Medicaid Expansion Goes Away? Given discussions in Congress to eliminate the Medicaid expansion over time, the question has arisen as to which parents would still be covered if expansion went away. In the first year of ACA impleme...

Here is a refresher on who Section 1931 parents are that I did years ago that's still relevant.

These are the lowest income parents in Medicaid; income level varies by state.

In Nebraska these are parents below 58-63% of FPL regardless of how old their kids are

ccf.georgetown.edu/2017/06/14/w...

18.02.2026 19:25 — 👍 2    🔁 0    💬 1    📌 0

One of the many problems with implementing Medicaid work reporting requirements is that those who are supposed to be exempt will not know that.

Exhibit A -- in Nebraska the 1st state to implement WRR (coming on 5/1) does not mention on their website that "Section 1931" parents are excluded.

18.02.2026 19:25 — 👍 6    🔁 1    💬 1    📌 0

Check out @edwincpark.bsky.social thread on the new CBO Medicaid baseline. You will see a few things:
1. ACA Medicaid expansion enrollees decline by 41% - ouch
2. Child enrollment declines by 2 million
3. Seniors enrollment goes up (aging pop)
4. Admin costs go up (the cost of red tape)

17.02.2026 18:36 — 👍 1    🔁 2    💬 0    📌 0
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Pediatricians confront HHS in vaccine showdown And other biotech news brought to you by The Readout

The American Academy of Pediatrics has emerged as the chief institutional opponent to RFK Jr.'s vaccine policy overhaul.

The group is suing to restore the earlier childhood immunization schedule, and challenging changes to federal advisory panels. www.statnews.com/2026/02/13/b...

13.02.2026 17:51 — 👍 156    🔁 65    💬 2    📌 1

This $ came from Medicaid cuts.

14.02.2026 04:22 — 👍 22    🔁 6    💬 0    📌 0

Roses are red, Violets are blue, HR 1 blew a hole in state budgets and healthcare too #healthpolicyvalentines

13.02.2026 21:26 — 👍 4    🔁 3    💬 0    📌 0

It is really unbelievable.

12.02.2026 23:04 — 👍 0    🔁 0    💬 0    📌 0
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Florida’s stalled Medicaid plan is putting lives at risk Florida hospitals warn that delayed CMS approval of the state’s Medicaid payment plan is pushing maternity, psych and pediatric care to the brink.

👀Last year to grease the wheels of historic Medicaid cuts, the House Florida R delegation was told that the state would be able to rush in a request for a hospital payment arrangement and Trump CMS would approve it.

Apparently the feds have not followed thru.

www.floridatoday.com/story/opinio...

12.02.2026 23:03 — 👍 9    🔁 3    💬 0    📌 0
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‘He’s not the same’: Father of Liam Conejo Ramos says 5-year-old continues to suffer Some people thought they say the 5-year-old during the Super Bowl halftime show. But Liam is still in hiding with his family, after he and his father were detained and then released from a Texas deten...

Super Bowl viewers Sunday speculated that 5-year-old Liam Conejo Ramos appeared in the halftime show. In fact, he has been in hiding with his family.

“He can’t sleep well at night. He wakes up three or four times a night screaming, ‘Daddy, Daddy,’” Liam's father Adrian Conejo Arias, said.

10.02.2026 01:10 — 👍 13921    🔁 5364    💬 374    📌 525
Oz: CMS Planning To Take ‘Dramatic And Drastic Action’ Against Health Care Fraud | InsideHealthPolicy.com CMS Administrator Mehmet Oz assured rural advocates the next crack down on health care fraud would not affect rural providers -- a commitment he made after reviewing with rural health advocates Tuesda...

So anyone who wants to commit fraud against Medicaid has now been alerted by CMS Administrator Dr. Oz that if you do it in rural areas you will not be prosecuted.

insidehealthpolicy.com/daily-news/o...

11.02.2026 20:44 — 👍 3    🔁 3    💬 2    📌 0
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New Medicaid Work Rules Likely To Hit Middle-Aged Adults Hard - KFF Health News Republicans have said new rules requiring many Medicaid participants to work 80 hours a month will pinpoint unemployed young people who should have jobs. Policy researchers say the rules are more like...

We heard a lot from GOP leaders last year that Medicaid work reporting requirements were designed to get 29 yr old men "off their couches."

The reality will be quite different with many older women age 50-64 at risk of losing their health insurance.

kffhealthnews.org/news/article...

11.02.2026 15:51 — 👍 3    🔁 1    💬 0    📌 0

Bad bunny knocked it out of the park.

09.02.2026 01:35 — 👍 5    🔁 0    💬 0    📌 0
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'Perfect storm': Why Teton Valley Health Care chose to lay off staff, close infusion clinic - East Idaho News DRIGGS — Facing difficult decisions as state and federal funding stalls, Teton Valley Health Care administrators made the decision to lay off dozens of employees and close an infusion clinic. In all, ...

Rural health transformation fund” in HR1 was peddled as saving rural hospitals from draconian federal Medicaid cuts.

Yet a rural hospital in Idaho is already on the brink and the fund won’t save them

And this in Sen. Crapo Ch. Senate Finance Ctte’s home state

www.eastidahonews.com/2026/01/perf...

07.02.2026 00:16 — 👍 2    🔁 4    💬 0    📌 1

The order says that the state of Florida and federal CMS are discussing how to resolve the issue.

Florida currently has a Section 1115 waiver to expand CHIP for kids between 200 and 300%FPL which it has not implemented. Many families are desperate for this coverage.

06.02.2026 23:24 — 👍 0    🔁 0    💬 0    📌 0

Today Florida dropped its lawsuit against the federal government related to federal continuous coverage requirements for children in CHIP which Florida does not want to comply with. The suit was filed during Biden years and was dismissed by a judge - the state then appealed.

06.02.2026 23:24 — 👍 2    🔁 0    💬 1    📌 0