“Lawsuit targets 'medically frail' Medicaid work requirement exemption”, 22 September 2026 (Photo via The Hill — the original report)
As it ran on the front
Eight hundred and twenty-three million dollars added to one contract, and not a single competing bid — you will have read that and assumed a favour went through a side door. Read the exemption instead. A sole-source award breaks no rule; it is the clause by which a state excuses itself from asking a second firm the price. Sole source, mind you. Source, not bid.
In 2023 the Hochul administration set out to fold the Medicaid applications still processed by counties into one statewide portal, at $177 million. By August the state had agreed to pay a billion, and the contract sat among its hundred most expensive active contracts. One billion. And what did the state buy by never learning what another firm would charge? The portal ... the same portal.…
…(cont) On 22 September, enrollees, health care organisations and the city of Columbus, Ohio sued the Trump administration over its rule narrowly defining who is exempt from Medicaid work requirements.
Two exemptions. One of them is being narrowed.
A man digs one well. Each summer the water carrier still comes.
“They tell you Medicaid costs too much, then hand one firm a billion dollars for an application portal nobody else got to price. And the same week, a federal rule gets drafted to shrink the list of people sick enough to skip the work paperwork. There's money — it just goes to the vendor, not to the guy sitting on hold waiting to find out if he's covered.”
“Sole-source procurement is in the statute, it's a tool, so by definition there's no scandal — did I say no scandal? That doesn't sound like me. The scope grew because the need grew, and you cannot go out to bid on a system that's already live. I am not saying a billion is small. I'm saying the process was followed, and following the process is what people asked for.”
A new lawsuit is challenging how the Trump administration plans to exempt medically frail people from Medicaid work requirements. Medicaid enrollees, alongside several major health care advocacy organizations and the city of Columbus, Ohio, said the administration’s final rule implementing work requirements is not what Congress intended.…
What began as a $177 million project to centralize the fraction of Medicaid application processes still handled by counties into a single statewide portal in 2023 exploded into one of the Gov. Kathy Hochul’s administration’s top 100 most expensive active contracts in August.
This page is a back-issue: the story as it ran, receipts as they were. The current edition is at the front. The byline is a pen name for a column drafted by a machine and checked by the editor: how this is made.
