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...
Reposted by Joan Alker
Just calculated our 2026 health insurance premium on the DC health exchange. It will be nearly a **300%** increase. We’d have to pay $50,590 for a family of 3, for a mid-range plan. Insane.
November 25, 2025 at 10:14 PM
Just calculated our 2026 health insurance premium on the DC health exchange. It will be nearly a **300%** increase. We’d have to pay $50,590 for a family of 3, for a mid-range plan. Insane.
These are the ridiculous things that happen in our country when a child is uninsured. Even short gaps in coverage put families at risk of huge, devastating medical bills.
I've been working on this issue for 20+ years now and I am tired of reading stories like this. We can do better.
I've been working on this issue for 20+ years now and I am tired of reading stories like this. We can do better.
Ambulance companies often negotiate with patients over large bills. “But you shouldn’t have to work so hard for it,” says an Ohio mom who was billed $9,250 for her toddler’s transport between hospitals.
kffhealthnews.org/news/article...
kffhealthnews.org/news/article...
Not Serious Enough To Turn on the Siren, Toddler’s 39-Mile Ambulance Ride Still Cost Over $9,000 - KFF Health News
After her son contracted a serious bacterial infection, an Ohio mother took the toddler to a nearby ER, and staffers there sent him to a children’s hospital in an ambulance. With no insurance, the fam...
kffhealthnews.org
November 26, 2025 at 2:02 AM
These are the ridiculous things that happen in our country when a child is uninsured. Even short gaps in coverage put families at risk of huge, devastating medical bills.
I've been working on this issue for 20+ years now and I am tired of reading stories like this. We can do better.
I've been working on this issue for 20+ years now and I am tired of reading stories like this. We can do better.
My latest blog on the dismal situation for kids in Florida.
Over 43,000 have lost CHIP this year in violation of federal law. No signs of Trump Administration enforcing it.
And the Gov still has not implemented a bipartisan CHIP expansion passed 2.5 yrs ago
ccf.georgetown.edu/2025/11/25/f...
Over 43,000 have lost CHIP this year in violation of federal law. No signs of Trump Administration enforcing it.
And the Gov still has not implemented a bipartisan CHIP expansion passed 2.5 yrs ago
ccf.georgetown.edu/2025/11/25/f...
Florida Leaders Have Failed to Implement Bipartisan Plan Approved Over 2 Years Ago to Help Families Afford Health Insurance for Their Children
Florida’s children are more likely to go without health insurance than children in most other states. In a rare display of bipartisan unity, the Florida Legislature recognized the need to address t…
ccf.georgetown.edu
November 26, 2025 at 1:44 AM
My latest blog on the dismal situation for kids in Florida.
Over 43,000 have lost CHIP this year in violation of federal law. No signs of Trump Administration enforcing it.
And the Gov still has not implemented a bipartisan CHIP expansion passed 2.5 yrs ago
ccf.georgetown.edu/2025/11/25/f...
Over 43,000 have lost CHIP this year in violation of federal law. No signs of Trump Administration enforcing it.
And the Gov still has not implemented a bipartisan CHIP expansion passed 2.5 yrs ago
ccf.georgetown.edu/2025/11/25/f...
ICYMI we have a great new resource to track state readiness to implement Medicaid work reporting requirements.
Despite the failure of this policy, most states are mandated to adopt it by 1/1/27
See how your state stacks up on 8 key performance indicators
ccf.georgetown.edu/2025/08/28/t...
Despite the failure of this policy, most states are mandated to adopt it by 1/1/27
See how your state stacks up on 8 key performance indicators
ccf.georgetown.edu/2025/08/28/t...
November 18, 2025 at 7:50 PM
ICYMI we have a great new resource to track state readiness to implement Medicaid work reporting requirements.
Despite the failure of this policy, most states are mandated to adopt it by 1/1/27
See how your state stacks up on 8 key performance indicators
ccf.georgetown.edu/2025/08/28/t...
Despite the failure of this policy, most states are mandated to adopt it by 1/1/27
See how your state stacks up on 8 key performance indicators
ccf.georgetown.edu/2025/08/28/t...
The Trump Administration rescinded the public charge rule last night which is very troubling -- we will see more uninsured citizen children because of the ongoing efforts by the Trump Administration to threaten mixed status immigrant families.
pifcoalition.org/resources/pr...
pifcoalition.org/resources/pr...
Public Charge Proposal Puts Millions at Risk, Advocates Warn - Protecting Immigrant Families
EL PASO, TEXAS — The U.S. Department of Homeland Security (DHS) released a proposal Monday to rescind current regulations concerning administration of federal immigration law’s “public charge” provisi...
pifcoalition.org
November 18, 2025 at 4:51 PM
The Trump Administration rescinded the public charge rule last night which is very troubling -- we will see more uninsured citizen children because of the ongoing efforts by the Trump Administration to threaten mixed status immigrant families.
pifcoalition.org/resources/pr...
pifcoalition.org/resources/pr...
While Medicaid is by far the biggest player for children's coverage, the Marketplace has become increasingly important.
New brief from @urbaninstitute.bsky.social finds that 453,000 children will become uninsured if subsidies expire.
ccf.georgetown.edu/2025/11/14/n...
New brief from @urbaninstitute.bsky.social finds that 453,000 children will become uninsured if subsidies expire.
ccf.georgetown.edu/2025/11/14/n...
New Data Highlight Risks to Children and Parents if Enhanced Marketplace Subsidies Expire
Marketplace subsidy enhancements which have been in place since 2021 are set to expire at the end of December 2025, and their fate is currently uncertain. Since 2014, when Affordable Care Act (ACA)…
ccf.georgetown.edu
November 18, 2025 at 4:40 PM
While Medicaid is by far the biggest player for children's coverage, the Marketplace has become increasingly important.
New brief from @urbaninstitute.bsky.social finds that 453,000 children will become uninsured if subsidies expire.
ccf.georgetown.edu/2025/11/14/n...
New brief from @urbaninstitute.bsky.social finds that 453,000 children will become uninsured if subsidies expire.
ccf.georgetown.edu/2025/11/14/n...
Important finding: 18% of immigrant parents report they’re avoiding signing up for government health care and other programs
This is the “chilling effect” in action which will lead to more uninsured kids
1/4 kids in U.S. have an immigrant parent; most kids are citizens
www.kff.org/immigrant-he...
This is the “chilling effect” in action which will lead to more uninsured kids
1/4 kids in U.S. have an immigrant parent; most kids are citizens
www.kff.org/immigrant-he...
KFF/New York Times 2025 Survey of Immigrants: Health and Health Care Experiences During the Second Trump Administration | KFF
This report, based on a KFF/New York Times survey from fall 2025, provides data on health and health care experiences of immigrant adults ages 18 and over in the current policy environment. Four in te...
www.kff.org
November 18, 2025 at 3:10 PM
Important finding: 18% of immigrant parents report they’re avoiding signing up for government health care and other programs
This is the “chilling effect” in action which will lead to more uninsured kids
1/4 kids in U.S. have an immigrant parent; most kids are citizens
www.kff.org/immigrant-he...
This is the “chilling effect” in action which will lead to more uninsured kids
1/4 kids in U.S. have an immigrant parent; most kids are citizens
www.kff.org/immigrant-he...
Our 20th anniversary @georgetownccf.bsky.social conference is a wrap with a surprise visit from Georgetown University’s official mascot Jack the Bulldog! He was a big hit.
W/ beloved colleagues Tricia Brooks and @edwincpark.bsky.social
W/ beloved colleagues Tricia Brooks and @edwincpark.bsky.social
November 15, 2025 at 2:22 PM
Our 20th anniversary @georgetownccf.bsky.social conference is a wrap with a surprise visit from Georgetown University’s official mascot Jack the Bulldog! He was a big hit.
W/ beloved colleagues Tricia Brooks and @edwincpark.bsky.social
W/ beloved colleagues Tricia Brooks and @edwincpark.bsky.social
Last day of our annual conference and we’re focusing on maternal health. Medicaid expansion, which is now under attack, has been a game changer for women of reproductive age.
November 14, 2025 at 9:15 PM
Last day of our annual conference and we’re focusing on maternal health. Medicaid expansion, which is now under attack, has been a game changer for women of reproductive age.
Yet another attempt by the Trump Administration to blame immigrants for high health care costs that Americans face rather than addressing the high health care costs themselves..
U.S. visas can be denied for obesity, cancer and diabetes, Rubio says.
www.washingtonpost.com/business/202...
www.washingtonpost.com/business/202...
U.S. visas can be denied for obesity, cancer and diabetes, Rubio says
The Trump administration has directed visa officers to consider obesity and other chronic health conditions when deciding whether to grant visas to immigrants.
www.washingtonpost.com
November 14, 2025 at 3:18 AM
Yet another attempt by the Trump Administration to blame immigrants for high health care costs that Americans face rather than addressing the high health care costs themselves..
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...