What the Health? From KFF Health News A Shrinking Safety Net
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Jul 23, 2026 
Alice Miranda Ollstein, Politico health reporter, offers policy reporting and analysis. Bill Cassidy, U.S. Senator and HELP Committee chair, outlines his MVP health proposals. Joanne Kenen, public health fellow and writer, brings public health perspective. Margot Sanger-Katz, NYT health policy reporter, digs into federal program trends. They discuss plunging SNAP enrollment, looming Medicaid changes, work requirement rollouts, surprise-billing arbitration, and drug supply and vaccine trust issues.
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Rapid SNAP Decline After 2025 Law
- SNAP enrollment fell ~11% (4.5 million people) after the 2025 Republican bill added paperwork and penalties that spooked states.
- Arizona lost nearly half its recipients; children make up nearly half of those kicked off the rolls.
June Rule Forces Individual Medical Workups For Medicaid
- June CMS interim rule removed much state flexibility for Medicaid medical exemptions, forcing individual medical workups for people claiming inability to work.
- Joanne warns this will raise coverage losses, state costs, and clinician burden diagnosing disability status.
State Variation Will Drive Uneven Coverage Losses
- Outcomes will vary sharply by state because Medicaid and SNAP are federally funded but state-administered with different capacities and risk tolerances.
- Arizona's aggressive paperwork contrasts with other states that may be slower or make more errors.