Clipboard with a sheet of paper with "Medicaid" written at the top on a desk with stethoscope and other medical equip ment.

Work Requirements for Medicaid Could Be Returning as Republicans Take Back the Power

During the first Trump Administration, states were encouraged to submit waiver requests to implement Medicaid work requirements, a decision which signaled the weaponization of the Section 1115 authority as a means of achieving a long-standing Republican policy goal. Ultimately, thirteen such waivers were approved. Federal lawsuits soon followed and stories about how these requirements could impact rural communities began to emerge. 

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At Catholic Hospitals, a Mission of Charity Runs Up Against High Care Costs for Patients

Catholic health systems like CommonSpirit Health, Ascension, PeaceHealth, Trinity Health, and Providence St. Joseph pay their chief executives millions of dollars a year. CommonSpirit Health’s then-CEO Lloyd Dean earned roughly $28 million in 2022; he was among nearly three dozen executives who pulled down more than $1 million that fiscal year, according to the health system’s tax filings. Elsewhere, Rod Hochman, CEO of Providence St. Joseph Health, earned $12.1 million. Ascension CEO Joseph Impicciche was paid $9.1 million, according to corporate tax filings.

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Why Many Nonprofit (Wink, Wink) Hospitals Are Rolling in Money

“Hospitals are some of the biggest businesses in the U.S. — nonprofit in name only,” said Martin Gaynor, an economics and public policy professor at Carnegie Mellon University. “They realized they could own for-profit businesses and keep their not-for-profit status. So the parking lot is for-profit; the laundry service is for-profit; they open up for-profit entities in other countries that are expressly for making money. Great work if you can get it.”

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States struggle to help patients navigate insurance hurdle known as ‘step therapy’

Millions of Americans have experienced similar frustrations under protocols known as step therapy, or fail-first policies. Insurance companies, and the pharmacy benefit management companies that handle prescriptions for them, often refuse to cover a specific drug until after the patient has tried cheaper alternatives. Insurers argue that step therapy — taking drug treatment one step a time — prevents wasteful spending by directing patients to less expensive, but still effective, treatments.

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