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
Pinned
‘A Big Positive’: How One Company Plans to Profit From Medicaid Cuts
www.nytimes.com
An excellent piece of journalism here from the New York Times about just one large vendor, Equifax, who will profit from the new Medicaid work requirement that will cause people who desperately need health insurance to lose it while for profit companies benefit.
www.nytimes.com/2025/11/03/h...
www.nytimes.com/2025/11/03/h...
My colleagues @ewburak.bsky.social and Kay Johnson sobering outlook on the many threats to federal funding to promote maternal and infant health.
ccf.georgetown.edu/2025/11/04/t...
ccf.georgetown.edu/2025/11/04/t...
Threats to Maternal and Infant Health Won’t End After Shutdown Resolved
The current federal government shutdown is driven by failure of the Congress to finalize this year’s federal budget appropriations or adopt a Continuing Resolution (CR). The shutdown is already imp…
ccf.georgetown.edu
November 7, 2025 at 12:13 AM
My colleagues @ewburak.bsky.social and Kay Johnson sobering outlook on the many threats to federal funding to promote maternal and infant health.
ccf.georgetown.edu/2025/11/04/t...
ccf.georgetown.edu/2025/11/04/t...
‘This perfect storm:’ How Idaho Medicaid cuts could affect everyone’s health care access idahocapitalsun.com/2025/11/04/t...
‘This perfect storm:’ How Idaho Medicaid cuts could affect everyone’s health care access • Idaho Capital Sun
Cuts are coming to Idaho Medicaid: doctor pay cuts, reforms in state law, the “One Big Beautiful Bill Act” and potentially expiring health insurance subsidies.
idahocapitalsun.com
November 5, 2025 at 6:22 PM
‘This perfect storm:’ How Idaho Medicaid cuts could affect everyone’s health care access idahocapitalsun.com/2025/11/04/t...
An excellent piece of journalism here from the New York Times about just one large vendor, Equifax, who will profit from the new Medicaid work requirement that will cause people who desperately need health insurance to lose it while for profit companies benefit.
www.nytimes.com/2025/11/03/h...
www.nytimes.com/2025/11/03/h...
‘A Big Positive’: How One Company Plans to Profit From Medicaid Cuts
www.nytimes.com
November 3, 2025 at 6:19 PM
An excellent piece of journalism here from the New York Times about just one large vendor, Equifax, who will profit from the new Medicaid work requirement that will cause people who desperately need health insurance to lose it while for profit companies benefit.
www.nytimes.com/2025/11/03/h...
www.nytimes.com/2025/11/03/h...
My latest blog on how instead of learning the lessons from Georgia of a failed, costly public policy choice (Medicaid work reporting requirements), Congress and the Trump Administration decided to mandate it on the nation.
ccf.georgetown.edu/2025/10/30/c...
ccf.georgetown.edu/2025/10/30/c...
CMS’s Georgia Waiver Extension Underscores the Failure of Medicaid Work Requirements
As regular readers of SayAhhh! know, on January 1, 2027, 42 states and DC will be required by HR 1 to impose work reporting requirements on many adults covered by Medicaid. The only state in the co…
ccf.georgetown.edu
October 31, 2025 at 2:39 AM
My latest blog on how instead of learning the lessons from Georgia of a failed, costly public policy choice (Medicaid work reporting requirements), Congress and the Trump Administration decided to mandate it on the nation.
ccf.georgetown.edu/2025/10/30/c...
ccf.georgetown.edu/2025/10/30/c...
3.8% of citizen children in the U.S. live with undocumented parents and are at risk in a mass deportation situation of having no parents.
Figure 3: Number of U.S. citizen children with any undocumented household member, by state www.brookings.edu/interactive/...
Figure 3: Number of U.S. citizen children with any undocumented household member, by state www.brookings.edu/interactive/...
Figure 3: Number of U.S. citizen children with any undocumented household member, by state | Brookings
www.brookings.edu
October 28, 2025 at 4:46 PM
3.8% of citizen children in the U.S. live with undocumented parents and are at risk in a mass deportation situation of having no parents.
Figure 3: Number of U.S. citizen children with any undocumented household member, by state www.brookings.edu/interactive/...
Figure 3: Number of U.S. citizen children with any undocumented household member, by state www.brookings.edu/interactive/...
Very informative story about what is going on with the Rural Health "Transformation" Fund... Corporate vendors lining up.
kffhealthnews.org/news/article...
kffhealthnews.org/news/article...
States Jostle Over $50B Rural Health Fund as Trump’s Medicaid Cuts Trigger Scramble - KFF Health News
States are battling for their piece of $50 billion in federal rural health funding, but it’s not just hospitals vying for the money. Tech startups and policy demands are raising the stakes as Medicaid...
kffhealthnews.org
October 24, 2025 at 1:21 AM
Very informative story about what is going on with the Rural Health "Transformation" Fund... Corporate vendors lining up.
kffhealthnews.org/news/article...
kffhealthnews.org/news/article...
Must read -- Dr. Oz's claims that they are working on an app that will solve all of the reporting problems related to Medicaid work requirements are largely a fantasy. When piloted the app had a 7% response rate and does nothing to address key issues like exemptions.
www.cnn.com/2025/10/22/h...
www.cnn.com/2025/10/22/h...
Officials show little proof that new tech will help Medicaid enrollees meet work rules | CNN
The Trump administration says it’s developing a digital tool to help people prove they’re meeting new Medicaid work requirements. KFF Health News talked to officials from the two states running pilot ...
www.cnn.com
October 23, 2025 at 12:33 AM
Must read -- Dr. Oz's claims that they are working on an app that will solve all of the reporting problems related to Medicaid work requirements are largely a fantasy. When piloted the app had a 7% response rate and does nothing to address key issues like exemptions.
www.cnn.com/2025/10/22/h...
www.cnn.com/2025/10/22/h...
Remember how Congressional leaders were worried that concern over rural hospitals might tank the budget bill? This led to inclusion of a $50 billion fund for Rural Health - but guess what - guidance from the Trump Administrations limits the amount rural hospitals can get to 15%.
October 21, 2025 at 8:44 PM
Remember how Congressional leaders were worried that concern over rural hospitals might tank the budget bill? This led to inclusion of a $50 billion fund for Rural Health - but guess what - guidance from the Trump Administrations limits the amount rural hospitals can get to 15%.
A closer look at what’s driving the rising rate of uninsured children stateline.org/2025/10/14/a...
A closer look at what’s driving the rising rate of uninsured children • Stateline
Hundreds of thousands of more children in the United States are going without health insurance, and experts warn that actions by the Trump administration and Congress will likely make the problem wors...
stateline.org
October 15, 2025 at 2:03 PM
A closer look at what’s driving the rising rate of uninsured children stateline.org/2025/10/14/a...
Our colleague Kay Johnson explains the history of VFC and what a success it has been.
The Vaccines for Children Program: A Solution to a Complex Challenge ccf.georgetown.edu/2025/10/08/t... via
@georgetownccf.bsky.social
The Vaccines for Children Program: A Solution to a Complex Challenge ccf.georgetown.edu/2025/10/08/t... via
@georgetownccf.bsky.social
The Vaccines for Children Program: A Solution to a Complex Challenge
Between 1982 and 1986, a vaccine liability crisis loomed as the greatest threat to immunizing our children. In this light, the National Childhood Vaccine Injury Act of 1986 (P.L. 99-660) was enacte…
ccf.georgetown.edu
October 14, 2025 at 2:11 PM
Our colleague Kay Johnson explains the history of VFC and what a success it has been.
The Vaccines for Children Program: A Solution to a Complex Challenge ccf.georgetown.edu/2025/10/08/t... via
@georgetownccf.bsky.social
The Vaccines for Children Program: A Solution to a Complex Challenge ccf.georgetown.edu/2025/10/08/t... via
@georgetownccf.bsky.social
Florida is violating federal law for children covered by CHIP and thousands are losing coverage. The Trump Adminstrarion is not enforcing the law.
www.wusf.org/health-news-...
www.wusf.org/health-news-...
More than 43,000 children dropped from KidCare program for nonpayment, report shows
A state agency may have underestimated the number of children removed from subsidized health insurance in Florida, according to a report by the Florida Phoenix.
www.wusf.org
October 10, 2025 at 12:56 PM
Florida is violating federal law for children covered by CHIP and thousands are losing coverage. The Trump Adminstrarion is not enforcing the law.
www.wusf.org/health-news-...
www.wusf.org/health-news-...
Latest from Florida - as the # of uninsured kids rises in FL, the bipartisan CHIP expansion continues to be stalled by the Governor.
State reveals how many kids lost health coverage after being unable to do so in Senate committee floridaphoenix.com/2025/10/07/s...
State reveals how many kids lost health coverage after being unable to do so in Senate committee floridaphoenix.com/2025/10/07/s...
State reveals how many kids lost health coverage after being unable to do so in Senate committee • Florida Phoenix
Florida’s top Medicaid official came before the Legislature Tuesday to update state senators on a pending legal battle with the federal government over expansion of the popular children’s health insur...
floridaphoenix.com
October 8, 2025 at 8:46 PM
Latest from Florida - as the # of uninsured kids rises in FL, the bipartisan CHIP expansion continues to be stalled by the Governor.
State reveals how many kids lost health coverage after being unable to do so in Senate committee floridaphoenix.com/2025/10/07/s...
State reveals how many kids lost health coverage after being unable to do so in Senate committee floridaphoenix.com/2025/10/07/s...
My colleague Leo Cuello checks the facts on the government shutdown and health care for immigrants.
ccf.georgetown.edu/2025/10/02/f...
ccf.georgetown.edu/2025/10/02/f...
Factchecking Claims about Medicaid and Marketplace Health Coverage for Immigrants – Government Shutdown Edition
We are getting a lot of questions about the U.S. government shutdown that began on October 1, 2025, after a bipartisan failure to reach a deal to fund the government. The main point reporters are t…
ccf.georgetown.edu
October 4, 2025 at 2:10 PM
My colleague Leo Cuello checks the facts on the government shutdown and health care for immigrants.
ccf.georgetown.edu/2025/10/02/f...
ccf.georgetown.edu/2025/10/02/f...
Reposted by Joan Alker
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...
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 …
ccf.georgetown.edu
September 20, 2025 at 12:10 AM
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...
As states around the country are mandated by HR1 to rush to implement Medicaid work requirements by HR 1 the risk for waste of taxpayer $$ to corporate vendors is huge.
Federal watchdog report on Georgia's Medicaid program raises concerns about administrative costs apnews.com/article/geor...
Federal watchdog report on Georgia's Medicaid program raises concerns about administrative costs apnews.com/article/geor...
Federal watchdog report on Georgia's Medicaid program raises concerns about administrative costs
A government watchdog has raised concerns about high administrative costs in Georgia's Medicaid program. The U.S.
apnews.com
September 19, 2025 at 1:57 AM
As states around the country are mandated by HR1 to rush to implement Medicaid work requirements by HR 1 the risk for waste of taxpayer $$ to corporate vendors is huge.
Federal watchdog report on Georgia's Medicaid program raises concerns about administrative costs apnews.com/article/geor...
Federal watchdog report on Georgia's Medicaid program raises concerns about administrative costs apnews.com/article/geor...
Even before huge Medicaid cuts from HR 1 kick in, the state of Idaho is moving quickly to make Medicaid cuts.
Our blog, written with our colleagues in Idaho, explains:
ccf.georgetown.edu/2025/09/17/m...
Our blog, written with our colleagues in Idaho, explains:
ccf.georgetown.edu/2025/09/17/m...
Medicaid Cuts Kick in Quickly and Quietly in Idaho
Amber and Darrell Daniels with three of their four children. They live in Caldwell, Idaho. Darrell works for a pest control company while Amber enjoys being a stay-at-home mom to care for their chi…
ccf.georgetown.edu
September 18, 2025 at 7:31 PM
Even before huge Medicaid cuts from HR 1 kick in, the state of Idaho is moving quickly to make Medicaid cuts.
Our blog, written with our colleagues in Idaho, explains:
ccf.georgetown.edu/2025/09/17/m...
Our blog, written with our colleagues in Idaho, explains:
ccf.georgetown.edu/2025/09/17/m...
Remember that last week we shared new analysis of the child uninsured rate going up by 18% from 2022 to 2024 due to some states doing a poor job with Medicaid unwinding.
ccf.georgetown.edu/2025/09/12/p...
Another 450,000 kids could soon lose coverage if enhanced tax credits expire in 2025.😢
ccf.georgetown.edu/2025/09/12/p...
Another 450,000 kids could soon lose coverage if enhanced tax credits expire in 2025.😢
According to the @urbaninstitute.bsky.social estimates, the number of uninsured children would increase by about 450,000 (a 14% increase: some because of loss of Marketplace coverage but also as parents lose Marketplace coverage fewer of their eligible children will enroll in #Medicaid & CHIP.
September 18, 2025 at 1:30 AM
Remember that last week we shared new analysis of the child uninsured rate going up by 18% from 2022 to 2024 due to some states doing a poor job with Medicaid unwinding.
ccf.georgetown.edu/2025/09/12/p...
Another 450,000 kids could soon lose coverage if enhanced tax credits expire in 2025.😢
ccf.georgetown.edu/2025/09/12/p...
Another 450,000 kids could soon lose coverage if enhanced tax credits expire in 2025.😢
Reposted by Joan Alker
New @urbaninstitute.bsky.social analysis finding 4.8M more uninsured in 2026 if the enhanced ACA premium tax credits are allowed to expire at the end of this year, with the coverage losses concentrated among those with low and moderate incomes: www.urban.org/research/pub...
September 17, 2025 at 7:09 PM
New @urbaninstitute.bsky.social analysis finding 4.8M more uninsured in 2026 if the enhanced ACA premium tax credits are allowed to expire at the end of this year, with the coverage losses concentrated among those with low and moderate incomes: www.urban.org/research/pub...
⬇️As we wait for the ACIP meeting later this week not enough attention has been paid to the enormous consequences for 1/2 of the children in the US for whom access to free vaccines is at stake.
Our @georgetownccf.bsky.social blog explains
ccf.georgetown.edu/2025/09/10/w...
Our @georgetownccf.bsky.social blog explains
ccf.georgetown.edu/2025/09/10/w...
September 17, 2025 at 1:27 AM
⬇️As we wait for the ACIP meeting later this week not enough attention has been paid to the enormous consequences for 1/2 of the children in the US for whom access to free vaccines is at stake.
Our @georgetownccf.bsky.social blog explains
ccf.georgetown.edu/2025/09/10/w...
Our @georgetownccf.bsky.social blog explains
ccf.georgetown.edu/2025/09/10/w...
The NOFO is out for the Rural Health Transformation Fund - very fast timeline. App deadline for states is 11/5 and Grants will be awarded 12/31.
Sounds like a fun holiday season for CMS employees!
grants.gov/search-resul...
Sounds like a fun holiday season for CMS employees!
grants.gov/search-resul...
Lock
grants.gov
September 15, 2025 at 2:55 PM
The NOFO is out for the Rural Health Transformation Fund - very fast timeline. App deadline for states is 11/5 and Grants will be awarded 12/31.
Sounds like a fun holiday season for CMS employees!
grants.gov/search-resul...
Sounds like a fun holiday season for CMS employees!
grants.gov/search-resul...
I will be joining @floridapolicy.bsky.social for a press conference Monday 1130am ET to dive into the new data on Florida's child uninsured rate which went up in 2024.
Also Florida leg passed unanimously a CHIP expansion in 2023 but the Governor has not implemented it yet. We will discuss.
Also Florida leg passed unanimously a CHIP expansion in 2023 but the Governor has not implemented it yet. We will discuss.
September 14, 2025 at 5:10 PM
I will be joining @floridapolicy.bsky.social for a press conference Monday 1130am ET to dive into the new data on Florida's child uninsured rate which went up in 2024.
Also Florida leg passed unanimously a CHIP expansion in 2023 but the Governor has not implemented it yet. We will discuss.
Also Florida leg passed unanimously a CHIP expansion in 2023 but the Governor has not implemented it yet. We will discuss.
The number of uninsured children rose 18% in the US from 2022 to 2024. Adult uninsured rate stayed the same.
This is very likely due to states that did a poor job during Medicaid unwinding.
🧵
My blog explains:
ccf.georgetown.edu/2025/09/12/p...
This is very likely due to states that did a poor job during Medicaid unwinding.
🧵
My blog explains:
ccf.georgetown.edu/2025/09/12/p...
Progress for Children is Eroding as Child Uninsured Rate Spikes to Highest Level since 2014
State-By-State Data Every year we examine data provided by the U.S. Census Bureau’s American Community Survey (ACS) which provides the most comprehensive look nationally and by state at important t…
ccf.georgetown.edu
September 13, 2025 at 4:08 PM
The number of uninsured children rose 18% in the US from 2022 to 2024. Adult uninsured rate stayed the same.
This is very likely due to states that did a poor job during Medicaid unwinding.
🧵
My blog explains:
ccf.georgetown.edu/2025/09/12/p...
This is very likely due to states that did a poor job during Medicaid unwinding.
🧵
My blog explains:
ccf.georgetown.edu/2025/09/12/p...
Pop quiz: Which state saw the biggest increase in its child uninsured rate during Medicaid unwinding.
The answer will be revealed on our webinar today at 1p ET - sign up below.
The answer will be revealed on our webinar today at 1p ET - sign up below.
NEW: Census ACS data shows child uninsured rate went up to 6% in 2024 - the highest it has been since 2014
1. Medicaid unwinding likely cause
2. Lots of state variability
3. Negative trend is likely to continue
To learn more join our webinar at 1p ET Friday
georgetown.zoom.us/webinar/regi...
1. Medicaid unwinding likely cause
2. Lots of state variability
3. Negative trend is likely to continue
To learn more join our webinar at 1p ET Friday
georgetown.zoom.us/webinar/regi...
Welcome! You are invited to join a webinar: State-by-State Child Health Coverage Trends. After registering, you will receive a confirmation email about joining the webinar.
Join the Georgetown University Center for Children and Families for a rapid analysis of newly released U.S. Census American Community Survey (ACS) data. The webinar will take place on Friday, Septembe...
georgetown.zoom.us
September 12, 2025 at 2:51 PM
Pop quiz: Which state saw the biggest increase in its child uninsured rate during Medicaid unwinding.
The answer will be revealed on our webinar today at 1p ET - sign up below.
The answer will be revealed on our webinar today at 1p ET - sign up below.