Health & Veritas Sara Rosenbaum: Expanding Coverage, One Step at a Time
Jan 15, 2026
Sara Rosenbaum, health law and policy expert and Professor Emerita who shaped Medicaid and children’s coverage. She recounts incremental reforms that expanded access. She warns about work reporting rules and their risks. She discusses how community health centers and provider funding interact with Medicaid.
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Incremental Change Drives Coverage Expansion
- Incrementalism has been the practical engine of U.S. health policy progress since the 1960s.
- Major reforms like Medicaid, Medicare, and the ACA built on decades of stepwise change.
Work Reporting Can Be An Administrative Filter
- The proposed Medicaid work-reporting rules aim to remove people via administrative burdens rather than assess true work capacity.
- Prior examples (e.g., Georgia) show enrollment collapses when paperwork hurdles are imposed at application.
Leverage 'Serious Or Complex' To Protect Patients
- Use the statute's 'serious or complex' language to classify older, health-burdened Medicaid applicants as exempt.
- Mobilize community health centers to perform front-end evaluations and support re-certification processes.