Thread by @JStein_WaPo

People are dramatically underestimating the scope and significance of the Trump administration's order on work requirements for Medicaid.

GOP-led states are gearing up to dismantle Medicaid in ways that go far beyond work requirements. Story coming soon

I spent last +24hrs combing thru GOP plans on Medicaid.

Here are some policies theyre aiming for:

- Impose new premiums on poor (like earning $5K/yr)
- Kick poor off who dont make payments
- Fines for "improper" ER use
- New fees 4 smokers

Story:
washingtonpost.com/news/wonk/wp/2…

Several states -- Wis., Maine, Ky -- want poorest of poor to pay Medicaid premiums

$8/month is virtually impossible if you're homeless

& then they'd lose insurance - for 6 months in some places, for 1yr elsewhere - for failure to pay

“This is the untold story of the next chapter in the Trump administration's assault on health policy,” @aneeman says.

“It's a series of technocratic-sounding changes that amounts to the slow bleeding of the health-care systems for low-income Americans."
washingtonpost.com/news/wonk/wp/2…

1 other key point: At least 3 states want “lifetime caps,” which would kick ppl off Medicaid after 3-5 yrs.

Nothing like it exists. Itd be a massive change

Unlike other changes, no sign yet Trump would approve caps. But nothing stopping him from trying
washingtonpost.com/amphtml/news/w…

Another huge one: If youre sick & poor, docs treat you knowing Medicaid will likely pay them retroactively even if youre not enrolled yet

Some states want to sharply limit this “retroactive eligibility” rule

This has already been approved in Iowa & other states likely to follow