In Reply In response to our Viewpoint on Medicaid reform, Dr Gabow discusses the need to establish and standardize eligibility criteria and benefits for beneficiaries in the Medicaid program. We agree that the current variation across US states results in unequal access and services. As Gabow points out, the federal government currently specifies core requirements of the Medicaid program as a condition of receiving funding. States have broad flexibility regarding eligibility and benefits and other aspects of their programs. We believe that these core Medicaid requirements should be strengthened and eligibility systems should be bolstered to ensure that all beneficiaries have equal access to medical care, including the essential health needs of underserved populations. President Biden’s administration has already sought to revise a number of these state decisions with the intent of providing broader beneficiary protections, such as those that have implemented strict work requirements, and has proposed to stabilize churn through initiatives such as buy-in programs, a public health insurance option, and premium subsidies, among other possible solutions.
