Nathan Chomilo, MD, FAAP, FACP Profile picture
Sep 18, 2019 7 tweets 4 min read Read on X
This @NEJM article on the Arkansas #Medicaid work requirements is....jarring

Cliff Notes version is Work Requirements:
- Significantly ⬇️ health insurance coverage
- Did NOT ⬆️ employment



A quick THREAD for more
#WorkRequirementsDontWork #mnleg (1/)
Among a survey of predominately rural Arkansas residents they found that >92% of the respondents — & nearly 97% btw 30 - 49 years of age — were ALREADY MEETING the community engagement requirement

#WorkRequirementsDontWork (2/)
Only 49.3% of those told they needed to report work were doing so.

Most common reason for not reporting?

A belief that they were not meeting the requirement (40.4%).

But looking at their other responses indicated that all of the respondents DID satisfy the requirements. (3/)
So nearly 1/4 of all people who lost coverage were likely to have kept it if they understood the policy.

But confusion is part of this policy’s intent & design.

In fact, one of the most prevalent other reasons for not reporting was confusion about reporting (17.8%). (4/)
And 32.9% of adults 30-49 years old who had #Medicaid or marketplace coverage HAD NOT HEARD ANYTHING about the policy!

Who was less likely to know about the requirements?
- Adults 19 to 29 years of age
- Men
- Those without a high-school diploma

#WorkRequirementsDontWork (5/)
In total, nearly HALF the target population was unsure whether requirements applied to them.

This is either an intentional, malicious act or negligence on behalf of those who pushed for & implemented this.

It highlights how #Medicaid work requirements are BAD policy. (6/)
Hopefully #Medicaid advocates across the country are using this study to push back against the other work requirements proposals that exist (7/7)

#WorkRequirementsDontWork Image

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More from @ChomiloMD

Jun 22, 2023
Kicking off Day 2 of @aspenideas #AspenIdeasHealth with 2 of my faves ☺️ @iamKSealsAllers & Dr. Emily Miller!🙌🏾
#AscendFellows
Catching up on a wonderful morning!
Started with this fantastic conversation on the Fight for Reproductive Health btw @ChelseaClinton & @ChanelPorchia moderated by @kwelkernbc

Chelsea & Chanel did not come to play!👏🏾

"we know what to do!" - CC
#AspenIdeasHealth
"We need to be angry about the fact we're letting moms die...This isnt a mystery. Its a failure of political will. Its a comfort w/misogyny & racism" @ChelseaClinton

@ChanelPorchia dropped so much fire about racism in medicine folks left w/a certificate 🔥🔥
#AspenIdeasHealth
Read 9 tweets
Jun 22, 2023
This is a devastating loss to all of our MN communities 😔

Dr. Charles Crutchfield III was ever present & a force within not only dermatology but organized medicine, among Black physicians in MN in particular.

#RestInPeace

spokesman-recorder.com/2023/06/21/acc…
How many dermatology clinics signed up to do #COVID19 shots?! Dr. C's did because he knew how important it was to get shots from a provider you trust.

He inspired @MNAADocs to begin a weekly column in @MNSpokesman sharing health education information🙌🏾

spokesman-recorder.com/2022/01/27/ple…
Dr. C was always down to help me in any way he could whenever asked. Whether a curbside consult or questions about my own families skin, he always got back & would follow up to see how things turned out if I didn't tell him.
Read 4 tweets
Jun 21, 2023
Made it! Let's get the IDEAS flowing & bring about the change needed in #Medicaid, racial health equity & early childhood 🙌🏾
#AspenIdeasHealth
#AscendFellow
Hey @AmerAcadPeds & @Vot_ER_org look at who I found @aspenideas #AspenIdeasHealth🙌🏾

#AHealthierDemocracy #VoteKids

"Interesting" start to this panel of HHS secretaries @aspenideas #AspenIdeasHealth

@SecBecerra when asked what he wishes folks knew about HHS replied, "we don't control health care"

@Sebelius agreed... 🤔
Read 4 tweets
Feb 26, 2021
Today’s MN #COVIDVaccine announcement is disappointing & largely fails to move the needle on equity.

I think understanding why & how it could likely worsen inequity requires a recap.

On 1/14 MN opened up vaccination to 65+ w/no subprioritization. What have we learned since?
🧵
1️⃣ There was no federal stockpile (as the previous WH administration HHS had eluded) to support this decision.

So now ~1 million Minnesotans believed they were at the front of the line but MN was getting ~60,000 new doses/week & still had not completed everyone in phase 1A
2️⃣ A new administration came in with equity as a priority & recommended expanding eligibility even more... but no new guidance around subprioritization for any groups incl those 65+

& still not enough shots to meet demand = scarce resource allocation

verywellhealth.com/biden-covid-19…
Read 14 tweets
Dec 15, 2020
I have enrolled in a #COVIDvaccine trial & last week got my first shot!!

But this wasn’t always my plan. I had a surprising amount of hesitancy early on. So I want to share how I worked through it.

This will probably be my longest thread ever. But stick w/me! (1/)
An avid advocate that #vaccinessavelives I found myself personally & professionally skeptical about the speed with which vaccines were being developed & politicized.

So I read about #COVIDvaccine development & listened to @NEJM’s podcast weekly podcasts.apple.com/us/podcast/new… (2/)
I also found this @nytimes #COVID19 vaccine tracker helpful

nytimes.com/interactive/20…
(3/)
Read 35 tweets
Oct 5, 2020
“When we fight to change children’s circumstances, THAT is when we keep children healthy. THAT is Socially-Responsive Pediatrics”

@DrOmolara opening up the final #AAP2020 plenary with powerful perspective
.@DrOmolara breaks down common frameworks:

Cultural competency doesn’t deliver justice

Structural competency doesn’t dismantle structural inequity

We need to move to Social responsiveness to deliver justice & dismantle structures of oppression

YES🙌🏾🙌🏾
#AAP2020
.@DrOmolara’s approach: bring care to the communities instead of working to fit communities into care settings w/historical trauma

Her practice has been setup next to community based organizations. In collaboration, no hierarchy

#AAP2020
Read 4 tweets

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