iiinova — where your digital self keeps evolving

Reposted by Joan Alker

davidasuper.bsky.social @davidasuper.bsky.social · 02/10/2026

My latest on the Administration's increasingly brazen violations of law impounding funds Congress appropriated. It must be bad if Susan Collins can get beyond "concerned". Balkinization: More Fiscal Mismanagement share.google/uFIZ3IZJQM7q...

share.google

More Fiscal Mismanagement

Happy New Year! I wish you all a joyous, fulfilling, and constitutionally compliant new federal fiscal year. ...

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Joan Alker @joanalker1.bsky.social · 02/10/2026

The # of kids covered by Medicaid/CHIP since Jan 2025 continues to decline As of August 2026, the ⬇️ was 2.575 million 2026 is a more rapid ⬇️ than the already large ⬇️ in 2025 This is very worrying bcuz drops in child Medicaid enrollment usually means kid uninsured rate is ⬆️

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Joan Alker @joanalker1.bsky.social · 01/10/2026

The state of Nebraska has released data on the 1st few months of Medicaid work reporting requirements Over 1,000 people have lost/been denied coverage Vast majority are losing not bcuz they aren't working but bcuz they can't get thru the red tape My new blog: ccf.georgetown.edu/2026/09/30/n...

ccf.georgetown.edu

Nebraska Releases First Data on Medicaid Work Reporting Requirement: As Expected, Coverage Losses Start to Mount Due to Red Tape

At a recent Medicaid Advisory Committee meeting, the state of Nebraska, the first in the nation to implement what will soon be a mandatory Medicaid work reporting requirement (WRR), shared the first d...

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Joan Alker @joanalker1.bsky.social · 28/09/2026

Tennessee letter is here: www.medicaid.gov/medicaid/sec...

medicaid.gov

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Joan Alker @joanalker1.bsky.social · 28/09/2026

A few observations so far: Tennessee has a parent only waiver expansion to 100% of the poverty line. The letter confirms these parents WILL be subject to new work rules. But CMS says they expect ALL parents to be exempt. But CMS says state has to do outreach on the new rules. Horribly confusing.

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Joan Alker @joanalker1.bsky.social · 28/09/2026

Friday PM big drop from CMS on Medicaid Section 1115 waivers and compliance with OBBA. Many states received "overlay" letters which include conforming change such as cutting all lawfully residing immigrants from Medicaid benefits as of 10/1 except (LPRs, Cuban/Haitian entrants, COFA migrants, 214)

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Joan Alker @joanalker1.bsky.social · 26/09/2026

I’m not sure I can even read this article - what more can be done by this Administration to make America unhealthier? But thank you @apoorvanyt.bsky.social and colleagues for your work.

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Reposted by Joan Alker

Edwin Park @edwincpark.bsky.social · 23/09/2026

From @brucelesley.bsky.social a comprehensive dismantling of the Paragon Institute's attempt to explain away a well over 2 million decline in #Medicaid and CHIP enrollment among children since the start of the Trump Administration even before most of H.R. 1's massive Medicaid cuts take effect.

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Joan Alker @joanalker1.bsky.social · 23/09/2026

A heartfelt thank you to @brucelesley.bsky.social and Jenny Rudisill for so thoroughly explaining why efforts to deny or ignore this Medicaid decline is just plain wrong.

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Reposted by Joan Alker

Liz Szabo @lizszabo.bsky.social · 23/09/2026

Vaccinating children is especially important early in life; infants have one of the highest hospitalization rates from Covid after the 65-plus age group. “Those are kids that have never been exposed to Covid,” he said, and vaccination can help prevent these severe outcomes.

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Reposted by Joan Alker

Edwin Park @edwincpark.bsky.social · 23/09/2026

It’s just not credible to directly compare administrative enrollment data to unadjusted Census survey data (as Trump Admin & the Paragon Institute do to falsely claim a big share of Marketplace enrollees are ineligible). You have to adjust for differences in how income & household size are counted.

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Joan Alker @joanalker1.bsky.social · 22/09/2026

@birdy.bsky.social has scooped the 1st data I have seen on Nebraska Medicaid work reporting requirements and it is worse than I expected. Incomplete data shows that 1,000 have explicitly lost/denied coverage and almost half of new applicants are not getting thru the red tape/ineligibility.

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Joan Alker @joanalker1.bsky.social · 18/09/2026

A second lawsuit has been filed with respect to the Trump Administration's flawed interpretation of the medically frail provision of the Medicaid work reporting requirement coming to a neighborhood near you on 1/1/27. Thank you to the plaintiffs and litigators!

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Reposted by Joan Alker

Edwin Park @edwincpark.bsky.social · 18/09/2026

White House is expected today to tout its #Medicaid MFN drug pricing agreements under its GENEROUS model. Many key questions remain unanswered: (1) Can Rx companies pick and choose what products to offer? (2) How do MFN prices compare to existing rebates and will states actually see lower Rx costs?

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Joan Alker @joanalker1.bsky.social · 14/09/2026

We will be tracking the change in child uninsured rate from the Census CPS data coming tomorrow and have quick analysis. However, our usual work analyzing Census ACS data for our annual report is delayed b/c for the 1st time the ACS is not coming out this week. The Bureau has "delayed" the data 😜

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Joan Alker @joanalker1.bsky.social · 14/09/2026

Federal law protecting children from losing coverage is being violated in Florida and tens of thousands of kids are losing CHIP. The Trump Administration is not enforcing the law. Still no answers from DeSantis administration on KidCare disenrollments, challenges floridaphoenix.com/2026/09/14/s...

floridaphoenix.com

Still no answers from DeSantis administration on KidCare disenrollments, challenges • Florida Phoenix

The administration of Gov. Ron DeSantis is still not giving firm answers on when — or whether — it intends to expand a safety-net healthcare program for low-income children that the Florida Legislatur...

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Reposted by Joan Alker

Edward Swaine @edswaine.bsky.social · 13/09/2026

The WH and DHS seem to have decided that it's best not only to crater higher ed, but also to assess fees that'll directly deprive the federal and state gov'ts of tax revenues. It's not even killing the goose that laid the golden eggs; it's making sure the geese land elsewhere.

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Reposted by Joan Alker

Don Moynihan @donmoyn.bsky.social · 12/09/2026

Thanks to @joanalker1.bsky.social & @edwincpark.bsky.social for rebutting the editorial. A conservative think tank said lots of people on Medicaid are not working. The Post just went with that without sourcing the claim or methods or noting it contradicts multiple credible nonpartisan studies. Awful

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Joan Alker @joanalker1.bsky.social · 02/09/2026

I don't recall press releases like this - I find them notable because they quote only Republican Members of Congress. The length relates to the # of Rs. PA was missing one moderate R. Hawaii just came out and they don't have any R members so the Governor (a D) was quoted but no Members.

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Joan Alker @joanalker1.bsky.social · 31/08/2026

The 5 states with the largest # declines are: CA, TX, IN, FL, OH The 5 states with the largest % declines are: IN(23.2%), AK (15.3%), AZ (12.3%), VA (11.6%), KY (11.6%) KY was a late "unwinder" for kids. All data and sources are here: ccf.georgetown.edu/feature/stat...

ccf.georgetown.edu

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...

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Joan Alker @joanalker1.bsky.social · 31/08/2026

Our Medicaid tracker is updated and # of kids enrolled since Jan 2025 in ths US is now ⬇️ 2.45 million. That's a lot. Why is this important? When Medicaid child enrollment declines, the # of uninsured kids typically goes up.

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Joan Alker @joanalker1.bsky.social · 28/08/2026

As you can see from reading this it is very complicated. This is not what you want to spend your time doing to keep your health care when your house has been destroyed or damaged. Heavy sigh.

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Joan Alker @joanalker1.bsky.social · 28/08/2026

A preview of the chaos to come when Medicaid work reporting requirements sweep the nation in 2027. Nebraska which began implementing in June just got approval for counties to be exempt that had tornados, storms etc. last spring! www.centralnebraskatoday.com/2026/08/26/4...

centralnebraskatoday.com

Counties affected by wildfires, severe weather receive Temporary Disaster Hardship for Medicaid work requirements

NEBRASKA - The Nebraska Department of Health and Human Services (DHHS) announced today that recent federal act...

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Joan Alker @joanalker1.bsky.social · 28/08/2026

See slide 12 here: www.medicaid.gov/resources-fo...

medicaid.gov

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Joan Alker @joanalker1.bsky.social · 28/08/2026

👀New: Monthly Medicaid/CHIP data is out from federal CMS and shows a 2 million drop in children from May 2025 to May 2026 -- a 5% decline in 1 yr.👀 This is very alarming because when the number of children covered by Medicaid goes down, the number of uninsured children goes up.

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Joan Alker @joanalker1.bsky.social · 28/08/2026

Gov. Spanberger issued an Executive Order on mitigating harm from Trump’s budget bill which will result in $2-6 billion loss of federal funding to VA annually. Virginia won't be able to cover federal SNAP, Medicaid funding cuts, governor warns cardinalnews.org/2026/08/26/v...

cardinalnews.org

Virginia won’t be able to cover federal SNAP, Medicaid funding cuts, governor warns

Gov. Abigail Spanberger issued an executive order aimed at protecting Virginians’ access to federal healthcare and food assistance programs.

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Joan Alker @joanalker1.bsky.social · 27/08/2026

Good question. For one we don’t know how many people are now deterred from applying. On the number of people who will lose their coverage there are various national models with percent ranges that @urbaninstitute and others have done. I’m a cynic, NE may keep the number down before the election?

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Joan Alker @joanalker1.bsky.social · 27/08/2026

Agreed but it’s clearly illegal to waive the match rate and both Obama and Trump 1 turned down prior requests for partial expansion. We shall see. I don’t think it’s a door they want to open. GA should just expand the regular old way!

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Joan Alker @joanalker1.bsky.social · 27/08/2026

Our new issue brief: How Are Parents Impacted By Medicaid Work Reporting Requirements? ccf.georgetown.edu/2026/08/26/h... via @GeorgetownCCF 👀 In 27 states + DC custodial parents should NOT lose Medicaid due to work reporting requirements coming 1/1/27.👀 Spread the word. Ask your state.

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Joan Alker @joanalker1.bsky.social · 24/08/2026

Our latest @georgetownccf.bsky.social report looks at uninsured rates for children under 3. The # is going up, and this is before Medicaid enrollment losses post-unwinding which have been huge. States in blue have highest rates. No baby should be uninsured. ccf.georgetown.edu/2026/08/18/h...

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Reposted by Joan Alker

Sharon Parrott @sharonparrott.bsky.social · 21/08/2026

The President’s threat of legal action against @amprog (CAP) marks another disturbing, anti-democratic effort to silence those with whom he disagrees. Our Constitution protects our right to engage in vigorous debate, debate that makes our nation stronger.

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Reposted by Joan Alker

National Immigration Law Center @nilc.org · 17/08/2026

In this era of government-sanctioned cruelty and relentless attacks on immigrants, we're committed to fighting back & defending our communities. That's why we created a Solidarity Guide with ways you can protect your immigrant neighbors, your community & yourself. Read more: bit.ly/4bPRRcq

bit.ly

Solidarity Guide for Defending Immigrant Communities

This solidarity guide is designed to help everyone continue to fight back with practical guidance to help protect your immigrant neighbors, your community, and yourself.

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Joan Alker @joanalker1.bsky.social · 17/08/2026

The Washington Post editorialized in favor of Medicaid work requirements based on a garbage paper by the Foundation for Govt Accountability - a new low for the Post’s editorial board. FGA is the leading proponent of work requirements at state an fed level.

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Joan Alker @joanalker1.bsky.social · 17/08/2026

The 90% expansion match is under fierce attack from leading conservative voices to cut Medicaid like the Paragon Institute and the FGA. Opening the door to match for partial expansion would have big precedential implications. And given recent CMS guidance on waivers its not "budget neutral".

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Joan Alker @joanalker1.bsky.social · 17/08/2026

Very interesting. Georgia is requesting the full 90% Medicaid expansion match w/o full expansion. Both Obama and Trump 1 administations said no to similar requests. Georgia officials say new federal Medicaid rules threaten state’s partial expansion program georgiarecorder.com/2026/08/14/g...

georgiarecorder.com

Georgia officials say new federal Medicaid rules threaten state’s partial expansion program • Georgia Recorder

New federal guidelines would make the state’s Medicaid program financially unsustainable, state health officials said.

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Joan Alker @joanalker1.bsky.social · 14/08/2026

Nebraska is the first state to implement Medicaid work reporting requirements. NE Medicaid director (who came from right wing groups that promote them) just resigned as disenrollments are about to heat up. governor.nebraska.gov/gov-pillen-ann…

governor.nebraska.gov

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Reposted by Joan Alker

Edwin Park @edwincpark.bsky.social · 14/08/2026

Just to clarify, this is due to Trump Admin guidance from June that again goes far beyond what H.R. 1 required by making it difficult for states to renew existing #Medicaid waivers/apply for new ones. H.R. 1 only codified longstanding budget neutrality policy. ccf.georgetown.edu/2026/06/25/t...

ccf.georgetown.edu

Trump Administration Issues Section 1115 Medicaid Waiver Financing Guidance Which Goes Far Further Than H.R. 1 (Again)

On Friday, June 11 the Centers for Medicare and Medicaid Services (CMS) issued new guidance on the Secretary’s approach to implementing Section 1115(g) which was added to the Social Security Act by H....

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Joan Alker @joanalker1.bsky.social · 13/08/2026

These are the 27 states + DC where parents and caretaker relatives should be exempt from Medicaid work reporting requirements regardless of the age of their kids. AK, AZ, CA, CO, CT, DC, DE, HI, IL, IA, MA, ME, MD, MI, MN, NE, NH, NM, NY, ND, OH, PA, RI, SD, VT, VA, WA, WI.

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