Adam Searing

Unpacking the Rural Health Transformation Fund Created by Congress to Soften Impact of Medicaid Cuts on Rural Hospitals I grew up in North Carolina and often split my time between the urban center of the state and some of its most beautiful and rural areas on the back sounds “Down East.” This part of NC is so rural …

From @adamsearing.bsky.social the latest on the budget reconciliation law rural health fund. Trump Admin is telling states they can’t use more than 15% of $ for provider payments including to rural hospitals & wants states to expand enrollment in short term plans. ccf.georgetown.edu/2025/09/19/u...

Federal watchdog report on Georgia's Medicaid program raises concerns about administrative costs A government watchdog has raised concerns about high administrative costs in Georgia's Medicaid program. The U.S.

Georgia's Medicaid work requirement program spends more on administrative costs than on providing care and has enrolled less than 3% of the eligible population. Thanks to HR 1, we'll be rolling it out to the whole country. Senseless. @apnews.com apnews.com/article/geor...

Unpacking the Rural Health Transformation Fund Created by Congress to Soften Impact of Medicaid Cuts on Rural Hospitals I grew up in North Carolina and often split my time between the urban center of the state and some of its most beautiful and rural areas on the back sounds “Down East.” This part of NC is so rural …

I‘m thinking today about Saint Ignatius, the Budget Reconciliation Bill’s “Rural Health Transformation Fund” and Down East North Carolina:

Will the Trump Administration use the Rural Health Fund to try and improve rural health or is it all politics?

ccf.georgetown.edu/2025/09/19/u...

Medicaid, CHIP, and Affordable Care Act Marketplace Cuts and Other Health Provisions in the Budget Reconciliation Law, Explained Editor’s Note: this brief was updated on August 13, 2025 to reflect additional Congressional Budget Office coverage estimates of the reconciliation law issued on August 11, 2025 In partnership with…

ICYMI: from Georgetown CCF and CHIR our comprehensive analysis of the budget reconciliation law's draconian #Medicaid, CHIP, ACA Marketplace cuts as well as other health provisions. We now have an easier-to-print PDF version. ccf.georgetown.edu/2025/07/22/m...

Buried in grant docs for HR1 Rural Health Fund:

States more likely to get $ by passing GOP priorities like getting rid of CON laws, expanding skimpy health plans, limiting SNAP and changing scope of practice. Plus Govs rqd to agree in writing - by 11/5
www.grants.gov/search-resul...

Is West Virginia ready for Capito Care? • West Virginia Watch By 2027, the largest cuts to Medicaid in history will have been ushered in by HB 1 hurting a broad swath of West Virginia families.

Commentary - Is West Virginia ready for Capito Care?

westvirginiawatch.com/2025/07/31/i...

Untangling the Current Debate Around Federal Medicaid Cuts, the “Rural Health Transformation Program” and State Medicaid Budgets The Congressional Budget Office estimates that the budget reconciliation law signed into law by President Trump (HR1) will result in a gross reduction of $990 billion in federal Medicaid/CHIP spend…

Messaging spin v. actual wording of the law that passed Congress:

Coming federal Medicaid cuts hitting state budgets will not be negated by the newly-created but misnamed Rural Health Transformation Program.

ccf.georgetown.edu/2025/09/02/u...

Senate passed billion reduces federal #Medicaid spending by $1 trillion over 10 years and will have major implications for millions of people who rely on Medicaid coverage, states and providers.

Truth to Power:  A Republican Senator Stands Up for Medicaid and His Constituents; Then Announces Retirement With Vice President breaking the tie, the U.S. Senate just voted 50-50 “One Big Beautiful Bill Act”, the crown jewel of President Trump’s legislative agenda.  With final text not even availabl…

My home state GOP Senator Thom Tillis dug up the facts and said it best this week on $1 trillion in cuts to Medicaid. @JoanAlker1, Andy Schneider, and I let his words speak for themselves in our new blog. ccf.georgetown.edu/2025/07/01/t...

The “One Big Beautiful Bill” is an Attack on the Affordable Care Act’s Vision of Health System that Works for Everyone For over 100 years, the unfinished business of creating a health care system that covers all Americans has raged on. With President Obama making this a top priority, in 2010 this effort took an unp…

@adamsearing.bsky.social and I wrote a blog about the "One Big Beautiful Bill" -- its an attack on the vision of universal coverage of the Affordable Care Act - President Obama's legacy.

ccf.georgetown.edu/2025/06/11/t...

Rural fund is thus a "fig leaf" to placate R Senators concerned about #Medicaid cuts. It's small/capped, temporary while the cuts are permanent, poorly targeted, gives discretion to Trump Admin to send $ to favored states, and may not even go to help rural hospitals actually hurt by the cuts (8/x)

The Senate version of the Medicaid work requirement in the "OBBB" doubles down and worsens a bad policy advanced by the House.

It also gives the Trump Administration enormous leverage to protect their Governor friends and punish their enemies.
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One more thread on a new provision in Senate reconciliation bill that Senate GOP will misleadingly tout as expanding access to home- and community-based services for seniors and people with disabilities (section 71123) but in context of the bill, it won't be meaningful (1/x)

Want to know what Congress did to Medicaid in the middle of the night?

🔥 off the presses our georgetownccf.bsky.com explains.

ccf.georgetown.edu/2025/05/27/m...

Our new report on the role of Medicaid for women of child-bearing age in rural areas w/ state by state data is here

Medicaid covers 47% births in rural areas

Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.

Medicaid Cuts Grow Harsher as GOP Attempts to Ram Trump Agenda Through House Before Memorial Day The full court press is on to pass the “One Big Beautiful Bill” with President Trump visiting the House Republican Caucus this morning to pressure competing factions to just say “yes” and pass the …

New blog from @joanalker1.bsky.social & me on the latest developments with the draconian #Medicaid cuts in the House GOP reconciliation bill including new CBO estimates and Rules Committee changes making the cuts even harsher: ccf.georgetown.edu/2025/05/20/m...

House GOP lawmakers are proposing $1 trillion in cuts to Medicaid and food stamps. Here’s who could be impacted | CNN Politics House Republicans are pushing to slash at least $1 trillion from two of the nation’s bedrock safety net programs, Medicaid and food stamps, as part of their sweeping package aimed at enacting Presiden...

CNN: "House Republicans are pushing to slash nearly $1 trillion from two of the nation’s bedrock safety net programs, Medicaid and food stamps....millions of Americans could lose access to these benefits as a result of a historic pullback in federal support."

www.cnn.com/2025/05/21/p...

The Truth About Medicaid Coverage for Immigrants – and the Looming Threats There has been a lot of information and misinformation about Medicaid coverage for immigrants circulating in the news, including wildly inaccurate reporting that undocumented immigrants are driving…

My @georgetownccf.bsky.social colleague Leo Cuello's detailed overview of Medicaid and immigrant health coverage - and how kids and pregnant women who are legal immigrants are now being targeted for health coverage cuts by the House "big beautiful bill" ccf.georgetown.edu/2025/05/21/t...

Our new report on the role of Medicaid for women of child-bearing age in rural areas w/ state by state data is here

Medicaid covers 47% births in rural areas

Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.

An under-appreciated aspect of a Medicaid work requirement is the enormous administrative expense involved in managing reporting by enrollees of their work hours or eligibility for an exemption.

Welcome! You are invited to join a webinar: Webinar and Report Release: Medicaid Key to Maternal and Infant Health in Rural America. After registering, you will receive a confirmation email about join... Georgetown University CCF will share a new report with state-by-state data on Medicaid coverage of women of reproductive age and how cuts could impact their access to obstetric care in small towns and...

Thursday May 15th at9:45 ET we release a new report on Medicaid's role for women of child-bearing age in rural America. Open to all.

We have some great speakers including @katybkoz.bsky.social

@edwincpark.bsky.social will share the latest from the House markup

georgetown.zoom.us/webinar/regi...

How Do We Know Congress’s Work Requirements in Medicaid Will Fail? They Already Have. As expected, the House’s rushed attempt to finance the Trump Administration’s immigration and tax agenda by cutting Medicaid includes a “work requirement.” Proponents claim that it is intended to s…

My Georgetown CCF colleague Leo Cuello examines the harsh #Medicaid work requirement provision being considered in the House Energy and Commerce Committee as we speak: ccf.georgetown.edu/2025/05/13/h...

House Energy and Commerce Committee Reconciliation Bill Would Restrict State Use of Provider Taxes and Undermine State Financing of Medicaid The House Energy and Commerce Committee is completing its markup of its section of the House Republican budget reconciliation bill.   The bill includes draconian Medicaid cuts, as well as…

My new Georgetown CCF blog on harmful impact of the House Energy and Commerce Committee reconciliation bill’s restrictions on state use of #Medicaid provider taxes which will make it much harder for states to finance their share of Medicaid costs: ccf.georgetown.edu/2025/05/13/h...

Cuts to Medicaid Expansion in the Proposed Budget Reconciliation Bill being Considered by Congress FMAP Cuts Tied to State Decisions to Expand Comprehensive Health Coverage with State-Only Funds to Children Regardless of Immigration Status Section 44111 of the proposed budget reconciliation bill…

My new @georgetownccf.bsky.social blog on some of the cuts (and an attempt to change state policy toward immigrants) targeting Medicaid expansion in the House’s budget reconciliation bill ccf.georgetown.edu/2025/05/13/c...

How Would Changes to Federal Medicaid Expansion Funding Impact People in “Trigger” States and Those with Expansion Enshrined in State Constitutions? Congress is currently considering draconian cuts to Medicaid that would mean millions of low-income Americans lose access to affordable health care. But both the type of federal cuts and how the jo…

Citations/text of all Medicaid expansion trigger law provisions and text of all three Medicaid expansion constitutional amendments: How proposed federal Medicaid cuts will translate to coverage losses in these states. My new blog: ccf.georgetown.edu/2025/04/30/h...

New State-by-State Estimates of the Federal Funding Cuts from Imposing a Per Capita Cap on the Medicaid Expansion I previously warned about how imposing a per capita cap on the Medicaid expansion would effectively lead to a sharp cut to the current 90 percent matching rate for the 40 states and the District of…

My blog on new state-level estimates from @kff.org & @urbaninstitute.bsky.social of cost-shifts to states from imposing a #Medicaid per capita cap on federal expansion $, likely resulting in states terminating expansion as under direct cuts to the 90% match rate: ccf.georgetown.edu/2025/04/28/n...

5 Key Facts About Medicaid Expansion | KFF This issue brief examines Medicaid expansion enrollment and Medicaid spending in expansion and non-expansion states and describes the characteristics of adults covered by the Medicaid expansion.

As Congress considers proposals to reduce federal #Medicaid spending to offset tax cuts, proposals to target the expansion group may be on the table. Check our 5 Key Facts about the expansion group: www.kff.org/medicaid/iss...

House GOP now talking openly talking about "quarterly elig checks for Medicaid"

This would repeal a vital protection for nearly 1/2 of the children in the US and lead to an ⬆️ in more children having periods of being uninsured.

This is an important new blog from my colleague Edwin Park looking at the direct impacts of potential Congressional Medicaid cuts under discussion right now.

Cuts to ACA’s Medicaid Expansion Under Consideration by Congress would Lead to Large Coverage Losses Hitting some States Harder than Others Next week, the House Energy and Commerce Committee is expected to consider fast-track budget reconciliation legislation that could cut Medicaid by as much as $880 billion over 10 years or more. Thi…

Important new Georgetown CCF blog from my colleague @adamsearing.bsky.social on harmful impact of cutting federal #Medicaid expansion $ including how per capita caps would interact with state trigger laws and effect of enshrining expansion in state constitutions: ccf.georgetown.edu/2025/04/28/c...