New budget bill changes health policy

The recent budget bill has many provisions, and some of them affect health care. KFF Health News highlighted some changes. Perhaps most significantly, Medicaid comes with a so-called "work requirement", which requires beneficiaries to either have a qualifying exemption ("such as caring for a young child") or "regularly file paperwork proving that they are working, volunteering, or attending school at least 80 hours a month." Another change is to limit a practice known as "provider taxes," where states impose taxes on providers to match federal Medicaid dollars, ultimately bringing in more revenue to the providers. Additionally, enrollees in Affordable Care Act policies "will be required to update their income, immigration status, and other information each year, rather than be allowed to automatically reenroll," making it more difficult for people to maintain coverage.

The Medicaid work requirement sounds reasonable on paper (requiring able-bodied adults to show evidence of being "productive"), but the article points out the "astronomical" costs of administering the program. Georgia implemented such a requirement in 2023, spending over $90 million on Medicaid. Of that amount, only $26 million was spent on health benefits (according to one research organization). It seems incredulous that a state would spend more money on overhead than on benefits.