The 80 Million Podcast

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...

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. Me...

Americans are rapidly aging, which is accelerating the demand for the long-term services and supports (LTSS) necessary to their care, as well as the care of a diverse range of children and adults with disabilities. Medicaid is the primary payer for LTSS. Since the early 1980s, that coverage has included home and community-based services (HCBS), which have proven better for health, less expensive a...

The scale of federal retrenchment is no longer theoretical. In Massachusetts alone, the state is bracing for an estimated $3.5 billion annual loss in federal Medicaid funding once H.R. 1 is fully implemented, against a total Medicaid budget of over $20 billion. Even with aggressive mitigation, the state could still see about 300,000 residents lose coverage. The idea that H.R. 1 simply “right-sizes...

The evidence that addressing social needs like food and transportation improves health outcomes and reduces Medicaid costs is no longer theoretical. We’ve seen recent data from two efforts:  North Carolina’s Healthy Opportunities Pilots  (HOP) generated $164 in savings per member per month, according to  a new, multiyear evaluation  of 31,000 Medicaid enrollees by the Sheps Center at University of...

State Medicaid programs are under extraordinary pressure as they navigate federal funding uncertainty, H.R. 1 implementation, and health care cost growth that consistently outpaces both inflation and state revenue growth. States have myriad technology vendors pitching solutions to help alleviate those burdens, particularly around helping drive down the costs associated with certain clinical condit...

Innovate or die: That’s the conversation health systems are having as they navigate tightening finances due to new federal policy in Medicaid, including H.R. 1, a national health care affordability crisis, rising patient acuity and a workforce depleted by burnout.  Hospital at Home may signal a paradigm shift among hospital systems driven by “losing less money.” That’s good news for Medicaid. 80 M...

Medicaid, which is jointly funded by states and the federal government, has always operated under pressure, but this moment feels different. The program is facing a unique period of change, defined by factors that are significant on their own but far more consequential together. Centrally, the 2025 health care cuts to Medicaid and beyond, to the tune of $1 trillion over the next decade, will add n...

For those of us at The 80 Million , our name represents a vital segment of the American population — nearly one-fifth of the nation — who rely on Medicaid for their health, financial security and in some cases, survival. Today, the program stands at a critical inflection point. As Medicaid faces what many policy experts consider its most significant existential threat since its inception, we are e...