Thread with thoughts about the new CMS info on how Most Favored Nation drug pricing agreements would interact with the existing Medicaid Drug Rebate Program. Bottom line: still unclear if this will produce any significant savings for state #Medicaid programs (1/x): www.cms.gov/priorities/i...

Federal judge in Rhode Island is ordering the Trump administration to pay full SNAP benefits for November, saying the USDA lost the discretion to pay partial benefits when it failed to get those funds to recipients fast enough. "USDA arbitrarily and capriciously created this problem." Story TK

HAPPENING NOW: Judge McConnell is sharply rebuking the Trump administration for what he said was defying his order to make full SNAP payments by Nov. 5. He has ordered USDA to make the *full* payment to states by tomorrow.

New data: CBPP analyzed USDA’s contingency fund spending plan & found it is only going to release 2/3 of the funding they committed to in court filings, cutting families’ SNAP benefits far more than necessary, violating USDA’s own regulations & shortchanging millions of families.

‘This perfect storm:’ How Idaho #Medicaid cuts could affect everyone’s health care access idahocapitalsun.com/2025/11/04/t...

I am trying and struggling to remember a previous time when multiple state officials publicly rebuked a CMS administrator for spreading misinformation kffhealthnews.org/news/article...

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...

Evergreen: there has never been and never will be a credible Trump/GOP Congress plan to repeal & replace the ACA. The only plan has always been repealing/deeply cutting the ACA coverage expansions & cutting rest of #Medicaid to help pay for tax cuts for the wealthy. That’s what HR 1 did this summer.

November 1: All Saints' Day, Day of the Dead, and the start of ACA open enrollment, when people start realizing that their out-of-pocket premiums are increasing an average of 114% due to expiration of enhanced tax credits.

Today’s rulings confirm what’s been clear all along: the Administration has been sitting on billions of available dollars that it is legally required to use to fund November benefits for the 1 in 8 Americans who need SNAP to afford their groceries.

New @urbaninstitute.bsky.social analysis on the increasing importance of ACA Marketplace coverage for families. About 40% of current Marketplace enrollees are parents and children: www.urban.org/research/pub...

My colleague @joanalker1.bsky.social explains how Georgia's #Medicaid work reporting requirements waiver (recently extended by Trump Admin) underscores the severe harm and waste that will result from imposing such requirements on all expansion states under H.R. 1: ccf.georgetown.edu/2025/10/30/c...

The White House plans to bar hospitals that treat transgender children and youth from getting any Medicare and Medicaid payments. The move would affect trans youth who have private insurance, too. n.pr/4qFa1mY

My new blog on the many unanswered questions about the Trump Admin’s Most Favored Nation drug pricing agreements especially how MFN prices would interact with existing #Medicaid rebates & whether MFN prices will save any $ (and may even increase Medicaid Rx costs). ccf.georgetown.edu/2025/10/29/m...

My new blog on the many unanswered questions about the Trump Admin’s Most Favored Nation drug pricing agreements especially how MFN prices would interact with existing #Medicaid rebates & whether MFN prices will save any $ (and may even increase Medicaid Rx costs). ccf.georgetown.edu/2025/10/29/m...

The contrast with SNAP is deafening. The White House is stretching well beyond what anyone could claim is legal in order to pay the troops — while simultaneously stretching beyond what’s legal to NOT pay SNAP benefits.

There are two different KFF numbers about the ACA out there. Both are accurate, but mean different things. 114%: The average increase in out-of-pocket premiums if enhanced tax credits expire. 26%: The average increase in what insurers are charging for benchmark ACA plans.

Evergreen: there has never been and never will be a credible Trump/GOP Congress plan to repeal & replace the ACA. The only plan has always been repealing/deeply cutting the ACA coverage expansions & cutting rest of #Medicaid to help pay for tax cuts for the wealthy. That’s what HR 1 did this summer.

Lots of reporting on SNAP getting the details wrong. SNAP is not set to run out of money on November 1. There’s money in the contingency fund to pay benefits. The Trump admin is illegally refusing to deliver benefits on November 1, despite having funding to pay benefits.

Some new detail from CBO about the draconian #Medicaid cuts in the budget reconciliation law: 800,000 fewer low-income seniors & people with disabilities on Medicare will be enrolled in the Medicare Savings Programs that help pay for Medicare premiums & cost-sharing: www.cbo.gov/publication/...

The Trump Administration’s assertion that it can't use SNAP’s contingency reserves for SNAP benefits is contrary to: ▪️The plain language of the law ▪️Their own (now deleted) shutdown plan ▪️Guidance from prior Administrations We have the receipts:

LAO report notes big Medi-Cal challenges ahead. "The state does not have fiscal capacity to backfill all of the lost federal revenue." #CABudget jasonsisney.substack.com/p/lao-report...

USDA is legally required to use the contingency funds on SNAP benefits for November. In July, President Trump and Congressional Republicans enacted the largest cuts to SNAP in history. The reason they aren't planning on providing SNAP benefits is that they don't want to.

Evergreen: there has never been and never will be a credible Trump/GOP Congress plan to repeal & replace the ACA. The only plan has always been repealing/deeply cutting the ACA coverage expansions & cutting rest of #Medicaid to help pay for tax cuts for the wealthy. That’s what HR 1 did this summer.

NEW: The White House is reprogramming billions in congressionally approved spending during the shutdown, aiming to pay troops, ICE agents and others who work on programs that fulfill the president's political agenda. Some of the money comes from Trump's tax cuts. www.nytimes.com/2025/10/21/u...

Mike Johnson shamelessly lies: "We strengthened Medicaid. We improved healthcare access and we lowered premiums with our legislation."

USDA has warned that #SNAP funding could run out in Nov, leaving 40M people without food assistance. Nearly two-thirds of needed funds are available in the contingency reserve; the Administration needs to release them now so families can eat next month: www.cbpp.org/blog/the-tru...

My colleague @adamsearing.bsky.social notes how Trump Admin will allow only 15% of the $50B in rural health funds in H.R. 1 to be used to reimburse rural hospitals despite being framed as a way to mitigate the draconian #Medicaid cuts harming rural hospitals: ccf.georgetown.edu/2025/10/21/t...

Trump's "Big Beautiful" Law included a $50B rural health fund, added at last minute to win votes from Rs who worried Medicaid cuts would hurt rural hospitals Much of this "rural health fund" $ is instead being awarded on things like whether states cut food aid and add the Presidential Fitness Test

Get the key facts about the ACA’s enhanced premium tax credits at the center of the ongoing government shutdown.

Despite repeatedly promising not to cut Social Security, the Trump Admin is reportedly preparing a proposed rule that could reduce the share of applicants who qualify for Social Security Disability Insurance by up to 20%--which would be the largest cut ever. 🧵 www.cbpp.org/blog/trump-a...

CMS seems to be reversing itself after earlier announcing it was going to delay all Medicare physician payments despite no basis to do so.

This seems troubling. It’s not a situation like when the physician payment formula was in flux in 2015 & all Medicare physician claims were temporarily held (or paid at lower rates and then later reprocessed). Most payments should flow normally with only certain telemedicine/other claims held.

Seems bad. www.wsj.com/politics/pol...

Trump's mechanism to pay the troops during the shutdown is by far the most illegal budgetary action he's taken as POTUS, potentially setting the stage to break everything. It's also needless because Congress would easily pass a troop pay bill if Johnson were willing to gavel in. Long thread.

Important @hamiltonproject.org analysis on how harsh SNAP cuts undermine its vital countercyclical role. Also true of budget reconciliation law’s #Medicaid cuts especially those targeting expansion & restricting state provider tax financing. Medicaid is largest source of federal funding for states.

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-...

States are ratcheting down Medicaid reimbursement rates, squeezing providers already bracing for short- and long-term cuts from state and federal governments.

For a succinct explanation of the fight that's led to a government shutdown, join us this Friday: 📅 Oct 10 | 1–2:15 PM EDT: "Rationing Medicine for America's Marginalized" 🔗 Register here: bit.ly/RationingMedicine Organized by the Urban Institute/Georgetown Law Project on Health Equity

Last Friday, USDA issued new info about how some of the Republican megabill’s deepest #SNAP cuts will take effect. This guidance goes beyond what's required by law, setting states up to fail with implementation & increasing the risk eligible people lose SNAP unnecessarily.🧵

Since it needs to be said: states' #Medicaid reimbursement rates to hospitals don't vary by eligibility group, the applicable federal matching rate or if it's for emergency Medicaid. Like within Medicare & private insurance, Medicaid rates will only vary based on patients' diagnosis/severity.

Former OMB associate director on personnel here: This is blatantly false and inexplicably undermines Congress's authority. Congress made extremely clear in 2019 that furloughed feds are to be paid, full stop, period. There is no question, except why the Speaker would make such a statement.

Feel free to attribute the following to a former OMB General Counsel: The supposed "new legal analysis" is, to use a technical legal term, horseshit. What the law actually says is that when Congress enacts a law ending a lapse, furloughed employees get paid at the earliest date possible. Period.

"We've done it" = the budget reconciliation law imposed the largest #Medicaid cuts in history and will increase the number of uninsured people by 10 million

My colleague Leo Cuello debunks the false claims about immigrants and health care made by Trump Admin & GOP Congressional leadership being used to oppose extending the enhanced Marketplace credits & reversing the draconian #Medicaid cuts. ccf.georgetown.edu/2025/10/02/f...

In addition to blocking important enrollment simplifications for the Medicare Savings Programs, the #Medicaid cost shifts to states will likely lead to other cuts affecting low-income people on Medicare including cuts to long-term care especially home- and community-based care.

North Carolina and Idaho have cut their Medicaid programs to bridge budget gaps, raising fears that providers will stop taking patients and that hospitals will close even before the brunt of a new federal tax-and-budget law takes effect.

“.. an overhaul of the federal safety net for poor, older and disabled people that could result in hundreds of thousands of people losing benefits ..” @washingtonpost.com www.washingtonpost.com/politics/202...

“People are going to have to travel longer distances, or they’re going to go without care,” said Olivia Pennington, director of advocacy for Maine Family Planning. “We are a cornerstone of Maine’s health care system, and forcing us into this position puts even greater strain on that system.”

Fragile N.C. Residents Lose #Medicaid Support for Food and Housing www.nytimes.com/2025/09/29/h...