A new House bill would require many Medicaid recipients to log 80 hours of work each month or risk losing coverage. Supporters say it promotes self-sufficiency, but critics warn the paperwork alone could drop thousands from the rolls. Experts say that even expansion states like New York, where about one in three residents depends on Medicaid, could see enrollment slip.

To help unpack it all, I spoke to Sarah Miller. Sarah is an associate professor of Business Economics and Public Policy at the University of Michigan’s Ross School of Business. Her studies have traced Medicaid’s ripple effects from reduced medical debt all the way to measurable drops in mortality, offering clear evidence that coverage saves both wallets and lives.

Today, we talk about what happens when states expand (or slash) Medicaid, why seemingly small paperwork burdens can shut out eligible patients, and how work-requirement rules could reverberate across other safety-net programs.