RISE summarizes recent regulatory-related headlines.
5M adults could lose Medicaid under federal work requirements
A new report by the Urban Institute and the Robert Wood Johnson Foundation determines that approximately five million adults could lose Medicaid coverage in 2026 if Congress enacts a work requirement in states that expanded their Medicaid programs.
Researchers analyzed policy proposals that would withhold federal funding for people enrolled in Medicaid expansion ages 19 to 55 who do not report working for at least 80 hours per month. They found:
- Between 4.6 and 5.2 million adults living in states that expanded Medicaid would lose Medicaid coverage next year under work requirements.
- More than nine in 10 adults with Medicaid expansion coverage already work, are looking for a job, attending school, are caring for family members, are in fair or poor health, or reported having a disability.
- If work requirements are not explicitly limited to the Medicaid expansion population, researchers say more than 30 million adults ages 19 to 55 could be subject to them, and coverage losses would be substantially higher.
The study said that most people who would lose coverage under a Medicaid work requirement would do so because of difficulty filling out paperwork, not because they can work and choose not to do so.
New report shows continued MA market growth despite headwinds
A new report, conducted in collaboration between Chartis and HealthScape Advisors, finds continued but decelerating growth in Medicare Advantage as the market undergoes a period of correction, following several years of rapid growth in the early 2020s.
The analysis explores enrollment trends, plan options and preferences, dominant players, quality ratings, and reaction to recent market disruption.
According to the 2025 Medicare Advantage competitive enrollment report, the Medicare Advantage market grew by 1.3 million beneficiaries to 34.5 million (up 3.9 percent) in 2024, down from 2.2 million (up 7.0 percent) in 2023 and half the record growth of 2.7 million (up 9.4 percent) in 2022. Prior to the AEP, many for-profit health plans signaled their intent to slow growth or even contract membership in response to a “perfect storm” of pressures—including rising utilization, lower-than-expected rate increases, and increased regulatory scrutiny around key financial levers.
The enrollment figures are based on Medicare Advantage enrollment, plan, and pricing data from the Centers for Medicare & Medicaid Services (CMS), February 2020 to February 2025 and Medicare fee for service (FFS) enrollment data from CMS, January 2019 to January 2025. The analysis includes all Medicare Part C plans, including regional PPO and Medicare cost data.
“Even with slowed growth, Medicare Advantage enrollment continues to show signs of strength, and it should for the foreseeable future,” said Nick Herro, a Chartis senior partner in strategic transformation and co-author of the report, in an announcement “Special Needs Plan popularity, anticipated regulatory support by the new administration, and consistent growth in the aging population present future growth opportunities and instill confidence in this market segment.”
Trump taps Dr. Susan Monarez to lead CDC, Thomas March Bell as HHS inspector general
President Donald Trump announced in a social media post that he has nominated Dr. Susan Monarez, who is currently the acting director of the Centers for Disease Control and Prevention (CDC) to serve as the next director of the public health agency. The date for her confirmation hearing has not been announced.
Trump, who pulled the nomination of his first pick, David Weldon, earlier this month, said that Dr. Monarez has championed innovation, transparency, and strong public health systems. “A dedicated public servant, she understands the importance of protecting children, communities, and our future,” he said.
Dr. Monarez has a Ph.D. from the University of Wisconsin and post-doctoral training in microbiology and Immunology at Stanford University School of Medicine. Prior to joining the CDC, she served as deputy director from the Advanced Research Projects Agency for Health.
President Donald Trump has also nominated attorney Thomas March Bell to serve as the Department of Health and Human Services’ (HHS) Inspector General, a position vacant since the end of January when Christi Grimm was fired along with several inspectors general. Grimm has joined a lawsuit with other inspectors general to get their jobs back.
Bell was a member of Trump’s first administration. He served as a senior advisor and chief of staff at the HHS Office for Civil Rights.
But Bell’s nomination to investigate waste, fraud, and abuse for HHS may prove controversial. Modern Healthcare reports that Bell lost his job as deputy director of the Virginia Department of Environmental Quality in 1997 after a state audit revealed he authorized an improper payment to a former employee.
In addition, the role of inspector general is typically a nonpartisan position. But Bell’s nomination may signal a new direction, according to the publication, as he currently serves as general counsel for the House Administration Committee and has had a long career as a Republican aide and official.