Despite our nation’s relatively poor performance on many major health indicators (eg, life expectancy, infant mortality, obesity rates), the United States has the most expensive health care system in the world.1 As a nation, we spend 17.9% of our gross domestic product on health care, or ∼$10 348 per person per year.2 The largest share of this spending comes from the federal government. Because increased focus has been turned to curbing health care costs, a possible approach to reducing federal health care spending would be to tighten eligibility requirements for public insurance, including Medicaid and the Children’s Health Insurance Program (CHIP). Indeed, President Trump’s proposed 2018 budget included a plan to reduce eligibility for CHIP, which was projected to result in a net saving of $5.8 billion over 10 years.3 Although Congress recently reauthorized the CHIP at stable funding levels, the administration’s 2019 budget proposal continues to...

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