Community-engagement requirements are now federal law. The one US state that fully implemented them, Arkansas, produced a two-year study: 18,000 lost coverage, and employment did not rise.
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ANALYSISA study of Current Population Survey data finds 19.8% of likely expansion enrollees sit near the 20-hour threshold or report variable hours. Women are at higher risk than men.
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Across 26 states, expansion raised the Medicaid-paid share of deliveries by 5.2% and changed the severe maternal morbidity rate by 0.02% — an interval that includes zero in both directions.
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Twenty-five states wanted the rule paused while they sued. The judge said the 90% federal reimbursement for setup costs undercut their case for emergency relief — not that their underlying legal argument was wrong.
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ANALYSISThe first large-scale policy evaluation of medically tailored meals covers 1,866 recipients across 11 health systems. It is quasi-experimental, not randomised — and that is the finding's main limit.
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