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As States Figure Out How To Work Around Trump’s Mess, The Gold Trim Goes On

April 14, 2026
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As States Figure Out How To Work Around Trump’s Mess, The Gold Trim Goes On
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Health authorities in New York State are racing to devise strategies to blunt the new law that will restrict access to government health insurance programs, including Medicaid, that cover more than half of New York City’s residents.

To keep as many New Yorkers as possible from being cut from the Medicaid rolls next year, state and city officials are looking for ways to prove that patients are afflicted with addictions or are medically frail, conditions that would exempt them from the new restrictions. And they are considering how to sign people up for volunteer work — such as helping other New Yorkers navigate Medicaid’s new rules — which could satisfy the law’s work requirements.

“We’re getting very creative,” Dr. Alister Martin, the city’s new health commissioner, said in a recent interview.

When President Trump’s signature domestic policy bill passed last year, state health officials feared that perhaps 1.5 million people in New York might lose health coverage. Those predictions have grown somewhat less dire as officials have proposed possible methods to keep people insured and exempt from the new work requirements. Those requirements and other restrictions are expected to start next year.

You’re probably wondering what the point here is. I just wanted to note that Dementia Don has never, ever cared about poor people, working or otherwise. As a real estate developer, all he cares about is building garish new monuments to himself, preferably with excessive gold accents. Which reminds me of something I learned as an executive recruiter that every citizen would do well to learn and carry into the voting booth.

When you hire the wrong person for the job, he will make the only area that makes him feel confident the main focus of his tenure. He’ll ignore everything else or delegate it to incompetent underlings. Sure, he’s a terrible president, but look at all that gold trim he put in the Oval Office! Pretty cool, right?

Of course it isn’t. But it’s literally the only thing he knows how to do. So he’ll keep doing it until someone stops him, or he keels over. He doesn’t give a flying fig about people without health insurance; he doesn’t do empathy. The pathological narcissist in the Golden Office never has. He only likes shiny things, like Mar-A-Lago and Melania.

Definitely doing a post on what people think Medicare covers (and doesn’t) and what Medicaid might cover depending on what state you are in, what waivers they have, and how badly they are bleeding funds due to the big beautiful clusterfuck. There was a lot more to that thing than work requirements.

— Stephen Nuñez (@socio-steve.bsky.social) 2026-04-03T13:09:47.052Z

All 41 states that expanded Medicaid eligibility under the Affordable Care Act will see fewer people covered due to new federal work requirements and more frequent eligibility checks.

But the percentage of recipients who lose coverage will vary greatly from state to state.

From @stateline.org

— Pennsylvania Capital-Star (@penncapital-star.com) 2026-03-27T21:28:25.874Z



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