In the absence of insurance, prior Medicaid beneficiaries will have few options for care, likely becoming uninsured. The most likely options will be seeking primary care in the ED setting or delaying treatment for conditions otherwise preventable and treatable in the outpatient setting. The experiences of Arkansas and Georgia serve as cautionary tales, highlighting that bureaucratic barriers, not lack of effort, often drive disenrollment. Work requirements do not bode well for Medicaid recipients, the population as a whole, or emergency physicians and departments that face an unfunded mandate to keep the doors open to care for the nation’s most vulnerable Americans.

Dr. Medoff is an assistant professor of emergency medicine at Emory University. He is the director of Emory’s Health Equity, Advocacy, and Policy track for residents and fellows and co-leads the ACEP State Legislative and Regulatory Committee’s Medicaid objective.

Dr. Scott is a fourth-year emergency medicine resident at the University of Washington. She holds an MPhil in Public Health from the University of Cambridge, MD from Harvard Medical School, and PhD in Health Policy from Harvard University. Dr. Scott co-leads the ACEP State Legislative and Regulatory Committee’s Medicaid objective and is a 2026 EMRA-ACEP Health Policy Academy Fellow.

Dr. Cochran-Caggiano is an emergency medicine and EMS physician at Dartmouth Health and the Dartmouth Geisel School of Medicine. He previously served on NYACEP Government Affairs Committee for five years, completed an advocacy and policy internship with the American College of Physicians New York Chapter and joined the ACEP State Legislative and Regulatory Committee in 2024.

Dr. Kornas is the medical director of the emergency department and chief of staff at AdventHealth Avista. She has a passion for advocacy with a particular focus on the intricacies of Medicaid administration. She currently serves as Colorado state advocacy lead for her company, US Acute Care Solutions, and is a past president of Colorado ACEP.

Dr. Hsieh is an assistant professor at the University of California at Los Angeles School of Medicine, Harbor–UCLA Medical Center, and Chief Medical Officer at Contra Costa Health Plan.

Dr. Mitchiner is recently retired from Trinity Health Ann Arbor, where he practiced emergency medicine for 36 years, and from Chelsea Hospital in Chelsea, Michigan, where he was on the emergency department staff for 28 years. He also served as a clinical faculty member at the University of Michigan Medical School.  Dr. Mitchiner is also past president of the Michigan College of Emergency Physicians. He has served as Chair of ACEP’s State Legislative and Regulatory Committee, as a member of ACEP’s Federal Government Affairs Committee, and has participated on ACEP task forces covering EMTALA, emergency department crowding, health care and the uninsured, alternative payment methods, and single-payer/health care financing.