Couverture de The 80 Million Podcast

The 80 Million Podcast

The 80 Million Podcast

De : Manatt Phelps & Phillips LLP
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Welcome to The 80 Million Podcast, powered by Manatt Health and hosted by Patti Boozang. Think of us as the proverbial water cooler where you can listen to health care policy discussions particularly focusing on federal and state Medicaid policy, and the potential impact on your organization — whether you’re part of government, a provider system, health plan, life sciences company or another organization within the health care ecosystem that Medicaid touches. Our Substack blog and podcast will feel like talking to your smartest friend (who happens to be deeply entrenched in Medicaid). Subscribe for notifications about new episodes, review our The 80 Million blog and find more information on our services at manatt.com. The views expressed on the podcast reflect the personal views and opinions of the participants and are not intended to constitute legal advice or counsel, nor the views of Manatt Health.

Credits:

Host and Executive Producer: Patti Boozang, Senior Managing Director, Manatt Health

Editorial Director: Amanda Eisenberg, Consultant, Manatt Health

Editor:

Anthony Vito

Copyright 2026 All rights reserved. Hygiène et vie saine Politique et gouvernement Sciences politiques
Épisodes
  • The H.R. 1 Implementation Squeeze Is Here

    The H.R. 1 Implementation Squeeze Is Here
    Oct 23 2026
    In this episode of The 80 Million Podcast, Manatt Health Senior Managing Director and 80 Million Editor Patti Boozang speaks with Professor of the Practice at Princeton University’s School of Public and International Affairs and State Health and Value Strategies Director Heather Howard and Manatt Health Partner Allison Orris about what H.R. 1 implementation looks like on the ground as states build against a moving target and work to minimize avoidable coverage losses.Authors: Heather Howard and Allison OrrisEditors: Patti Boozang and Amanda Eisenbergtl;dr* Last year’s reconciliation law made unprecedented cuts to Medicaid that will shape the program and our health care ecosystem for years to come. States are building against a moving target even as their implementation efforts are well underway — such as stripping Medicaid coverage from certain lawfully present immigrants as required by H.R. 1 and operationalizing work reporting requirements, more frequent eligibility redeterminations and limits on retroactive eligibility that take effect in January 2027.* States are adapting their systems and policies to major, late-breaking policy changes in the administration’s work reporting requirements rule. At the same time, they are making critical policy and budget decisions as federal rules governing Section 1115 demonstrations, provider taxes, and state-directed payments continue to evolve ahead of key implementation deadlines.* Coverage losses are a major part of the story. Rising uncompensated care and financing changes made by H.R. 1 will also put pressure on Medicaid agencies, providers and state budgets in ways that will be broadly felt beyond people enrolled in Medicaid.* This next year will generate critical evidence. Hard data could take longer but providers will soon see evidence of rising coverage losses and uncompensated care. Other early indicators — most especially enrollees’ experiences navigating new systems — can help policymakers understand how implementation is working in practice.The 80 Million ImpactH.R. 1’s Medicaid changes are arriving in waves, but states are already feeling the cumulative pressure as they prepare to implement various provisions of the law and consider how they will respond to the fallout from rising uninsurance, uncompensated care and budgetary constraints.The law cut nearly $1 trillion in federal Medicaid funding over the next decade, making major structural changes to significant parts of how the program operates. Although some of its biggest provisions do not take effect until 2027 or later — and federal guidance on some provisions is still pending — states have been working to implement these changes at record speed because of tight timelines and high stakes for their enrollees. Getting ready to implement the new Medicaid work reporting requirement in states that expanded Medicaid has garnered significant attention over the last year.There are other near-term changes that states have also been preparing for by updating eligibility systems, communicating with enrollees and providers, and by forecasting how changes will impact their budgets.Beginning Oct. 1, federal Medicaid funding was eliminated for certain categories of lawfully present immigrants. The effects could extend beyond the individuals who lose eligibility. Confusion about the new rules, coupled with new public charge rules, may discourage eligible family members, including children, from enrolling or staying covered. At the same time, the federal matching rate to help Medicaid expansion states cover the cost of emergency Medicaid services for some immigrants who are not eligible for Medicaid was reduced.More changes will arrive in January. In addition to work reporting requirements, Medicaid expansion adults will move from annual to twice-yearly eligibility redeterminations, creating two opportunities each year for eligible people to lose coverage because of paperwork problems or other administrative issues. Retroactive eligibility will also shrink from up to 90 days before application to 30 days for the expansion population and 60 days for other eligibility groups. Together, these policies could mean more medical debt for consumers and more uncompensated care for providers, who will bear the brunt of Medicaid cuts that will take effect later in 2027 and in 2028.States Are Implementing. The Rules Are Changing.States have taken steps to prepare for provisions in H.R. 1, which became law in July 2025, yet they didn’t receive firm implementation direction on work reporting requirements, for example, until June 2026. The Centers for Medicare & Medicaid Services’ interim final rule, which included a narrower reading of the medical frailty exemption, changed key policy elements states had already been building their systems, workflows and policies around.States pivoted quickly but are still awaiting guidance in other areas that will influence their programmatic plans and budget ...
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    32 min
  • Beyond Coverage — What It Will Take to Fix American Health Care

    Beyond Coverage — What It Will Take to Fix American Health Care
    Jul 1 2026

    The Affordable Care Act (ACA) fundamentally changed American health care — expanding coverage, establishing consumer protections that are now broadly expected, and helping cement the idea that access to health care is a basic human need rather than a privilege tied to health status, gender or income.

    The next challenge is no longer just whether people have coverage, but whether they can afford to get it, keep it and use it. Rising premiums, deductibles, cost-sharing and administrative barriers are straining people across Medicaid, the ACA Marketplaces, Medicare and employer-sponsored insurance.

    Fixing American health care will require looking across the whole system: reducing friction for patients and providers, rebuilding a durable federal floor for coverage and access, resisting efforts to retreat to a pre-ACA coverage framework, supporting state innovation, and accepting that meaningful reform will require mutual sacrifice across the health care ecosystem.

    The challenge before us is creating a health care system that is affordable, usable and sustainable for patients, providers, employers and taxpayers alike — wherever they live and whatever their income, gender, race or age. We have a great deal of work to do.
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    37 min
  • Paying for Cures — Medicaid’s Next Financing Test

    Paying for Cures — Medicaid’s Next Financing Test
    Jun 25 2026

    High-cost therapies like cell and gene therapies could transform care for Medicaid beneficiaries with serious conditions, but their upfront prices — often $500,000 to $5 million per patient — do not fit a financing system built around predictable, chronic-care spending.

    The pressure will only grow as the pipeline expands, eligible populations broaden and treatments become easier to administer. Medicaid’s fixed budgets, enrollment churn and limited data infrastructure make it hard to pay for these therapies at scale or capture their long-term value.

    Outcomes-based payment and Centers for Medicare & Medicaid Services (CMS) models are important near-term tools, but they are not enough. Durable access will require bolder federal financing solutions such as reinsurance, risk pooling or a dedicated funding stream for transformative therapies.

    Listen to the full conversation on Spotify, Apple Podcasts, or wherever you get your podcasts to hear Patti Boozang, Terry Cothran and Ross Margulies unpack the promise of curative therapies, the limits of Medicaid’s current financing model and the policy choices needed to make access real.
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    29 min
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