Medicaid is the United States’ public health insurance program for people with low incomes and chronic health conditions. Medicaid covers one in five Americans; mostly children, people with disabilities, and the elderly. The Affordable Care Act (ACA; aka Obamacare) expanded Medicaid coverage to include the working poor (those who make 138% of the Federal Poverty Level or below) who do not typically have access to affordable care. Thirty-two states have implemented the ACA’s Medicaid expansion. Some states, along with the Trump administration, have pushed for imposing a work requirement for Medicaid recipients.

Of the 25 million affected by the Medicaid expansion nearly 80% live in working families, many of whom are self-employed. Close to half of working Medicaid enrollees work for small businesses which often do not offer health coverage. Most of those who are not working report inability to work due to illness, disability, or caregiving responsibilities.

Kentucky

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In a previous blog post, we explored the proposed replacement for the Affordable Care Act (ACA; aka Obamacare) known as the American Health Care Act (AHCA). Since then, the bill has been indefinitely tabled after it could not secure the required number of votes to pass the U.S. House of Representatives.

Prior to the new full law being proposed and pulled, the Centers for Medicare and Medicaid Services (CMS) announced changes to the Affordable Care Act exchanges. The new changes include some long-considered ideas to improve the law, including strengthening rules for those signing up for insurance outside the open-enrollment period to ensure that people are not waiting until they are sick before getting coverage.  They’ve also proposed to be more flexible for insurers in the exchanges Bronze level plans to reduce cost burdens as was proposed under Obama.

Other ideas put forward have deviated into some pretty striking departures from previous proposals. The new rules suggest cutting

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