BOISE, Idaho — The public comment period is open on Idaho's application to the federal government to add work reporting requirements to its expanded Medicaid program.

State lawmakers passed a bill this year requiring that recipients age 19-59 work at least 20 hours a week to maintain Medicaid eligibility. But the waiver must first be approved by the Center for Medicare and Medicaid Services.

Liz Woodruff is a coordinator with Close the Gap Idaho, a network of more than 300 health-care and service organizations. She called the work benchmarks "punitive red tape" that would mean fewer Idahoans have health coverage.

"Idaho would be one of the most restrictive programs in the country,” Woodruff said. “It's a 'one-strike-you're-out' policy – so you miss your reporting for one month, you miss turning in your paperwork, and you lose your health coverage."

There are exemptions to the proposal, including parents of children under 18, people receiving disability insurance and caretakers. Supporters of the waiver are convinced it would encourage self-reliance among recipients.

The public comment period ends November 2.

Work requirements were struck down by federal judges in Arkansas, Kentucky and New Hampshire, and Woodruff said she expects Idaho's provision will also go to court if approved. She said the Idaho Department of Health and Welfare reviewed more than 700 pages of comments on the proposal – many from detractors – in just four days.

"We were disappointed that there were technical points made about how the work requirements would be administered, the costs that might be incurred,” she said. “The fact that Idaho is a large rural state, that would make it complicated for people to report. And, while they had a section in their new application that tried to ease our concerns over that, there were no actual changes made to the application itself."

The new application acknowledges that an estimated 16,000 Idahoans would be affected by the requirements. A federal decision on the proposal could take months or years.

Woodruff noted Medicaid expansion is going ahead as planned, with open enrollment starting Nov. 1 for coverage beginning in 2020.


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The Medicaid and CHIP programs are vital to rural Missouri, according to a report that says reliance on this safety-net health coverage is much higher in small towns than in cities - especially for children.

The Georgetown University report says proposed federal cuts threaten rural communities, where nearly 41% of children rely on Medicaid, compared to 38% in metro areas.

Dr. Shanon Luke, a pediatrician at a Federally Qualified Health Center in rural Missouri, said her clinic is essential to a community where the nearest hospital is 45 minutes away.

"The clinic being open is incredibly important to these kids receiving healthcare," said Luke. "Having Medicaid allows them to come in for their well-child checks, and for us to do some monitoring and treating of things before they get to scary points."

The report says to stay afloat, many rural hospitals have already been forced to close less profitable units. In 2022, 52% eliminated their maternity wards, compared to 36% of urban hospitals.

The report also reveals disparities, with about 40% of American Indian and Alaska Native people more likely to live in non-metro areas without access to adequate healthcare.

Joan Alker is the executive director and co-founder of the Center for Children and Families at Georgetown University. She said Medicaid helps recipients through much-needed preventive care.

"People wind up sicker and then, they're in the emergency room," said Alker, "and children can't get their asthma inhalers and they miss school."

Statistics show Medicaid helps prevent medical debt, covers most nursing home residents, and funds a significant portion of births and maternal care - issues Dr. Luke said her patients are familiar with, firsthand.

"For our families, both financially and medically, as well as mentally," said Luke, "it's really important to know that they have that coverage."

Just over 24% of Missouri's population lives in rural areas.

This month is National Blood Donor Month, and blood donor groups are making sure people know the importance of giving blood.

Blood can't be manufactured, so people need to donate blood at their local blood bank. Nearly 400 people a day donate blood to the American Red Cross in the DMV metro area.

Bethany Bray Patterson, communications director of the National Capital and Greater Chesapeake Region of the American Red Cross, said donor blood is used in a variety of medical situations.

"Donated blood," said Patterson, "goes to people who are heading into surgery, fighting cancer, newborn babies in the NICU and people who are living with sickle cell disease and other chronic illnesses."

Patterson added that someone in the U.S. needs a life-saving blood transfusion every two seconds.

However, only 3% of eligible donors donate each year. According to America's Blood Centers, if just 1% more of Americans donated, blood shortages would be alleviated.

Patterson said the blood supply in the country is stable, but organizations like the Red Cross are also on the look out for universal donors.

"There is an increased need right now for type O blood donation, and platelet donations," said Patterson. "Type O blood is always in demand. It's often going out to hospitals faster than it's coming in through blood donation, because it is the universal blood type. It's used the most by hospitals."

You can find blood donation locations and schedule an appointment at RedCrossblood.org.




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Community Health Centers are stepping up to meet a critical need for dental care across Tennessee.

Dental visits at these clinics have increased by 19% and patient numbers have risen by nearly 16%, underscoring the importance of these services.

Libby Thurman, CEO of the Tennessee Primary Care Association, said the demand has grown, especially as more people have gained dental coverage through TennCare, the state's Medicaid program. Thurman explains TennCare did not cover dental services for adults until recently, although it did cover children.

"In 2023, the state expanded access to dental services under TennCare for adults," Thurman noted. "We have had some challenges keeping up with that demand, and that really stems from just making sure we have enough dentists to serve all of those patients."

In 2023, Community Health Centers in the state provided more than 79,000 dental visits to more than 35,000 patients. Across the state, 24 of the 30 health centers now offer dental health services.

Thurman stressed the importance of having access to dental care, since it is so closely tied to a person's overall health. She added the clinics integrate dental services into their broader mission of providing whole-person care.

"Dental care, aside from just oral health, actually has a lot of links to systemic health," Thurman explained. "It's linked to a lot of chronic disease management - so, if your oral health care is unmanaged, likely your chronic disease could be worsened."

Thurman emphasized Community Health Centers provide care to all, regardless of a person's insurance or income status. They also have a sliding-fee scale, so patients are often able to get dental care at a lower cost than they might find elsewhere.