Unexpected medical bills top the list of health care costs Americans are afraid they will not be able to afford, with 4 in 10 people saying they had received a surprisingly large invoice within the past year, according to a new poll.

The Kaiser Family Foundation poll found that 67 percent of people worry about unexpected medical bills, more than they dread insurance deductibles, prescription drug costs or the basic staples of life: rent, food and gas.

President Trump has a message for millions of able-bodied Medicaid recipients: Get a job.

Since January, the administration has allowed states to require Medicaid beneficiaries who are not disabled to engage in 80 hours per month of work, volunteering, job training, or school in return for taxpayer-funded health coverage. The purpose of this reform is twofold — to conserve taxpayer dollars, and to break the culture of dependency that saps our communities of dynamism and prosperity.

Comments close soon on New Hampshire’s new Medicaid waiver application. The Granite State is one of several states to already have a work requirement approved, and they want to continue it, which is what understandably gets the most attention.

But New Hampshire is also making another change to their Medicaid expansion plan, one that helps signal the end of an era for the program, the quiet death of what was once thought to be a promising conservative alternative to a conventional Medicaid expansion.

New Hampshire wants to end its Medicaid premium assistance program.

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Based on the facts, Obamacare should be a disaster for Democrats this fall. As Bill Clinton observed, people are paying twice as much for half the coverage. Among those who don’t get any federal subsidy (everyone making more than, say, $50,000), premiums have doubled and tripled and there has been a 29% drop off – even though they face a fine for being uninsured next April 15th.

States have often been an incubator for innovative ideas in health technology pricing and reimbursement. In another example of necessity being the mother of invention, Medicaid expansion coupled with rising drug costs have forced state Medicaid authorities to seek new payment mechanisms that would contain drug costs. In June of this year, the Centers for Medicare and Medicaid Services (CMS) gave the green light to Oklahoma to pursue a Medicaid drug pricing initiative.

Californians have always had the freedom to purchase “short-term” health insurance. Short-term plans have traditionally filled gaps in coverage, such as when consumers are between jobs or nearing Medicare eligibility. They often cost 70 percent less and offer greater choice of doctors than ACA plans.

Money once reserved for wage increases is now diverted to pay for employer-provided health insurance. A new study provides stunning estimates: For the bottom 60 percent of U.S. workers, wage gains have been completely wiped out by contributions for employer-provided health insurance.

“For many workers, rising health insurance premiums were eating up every last cent of their pay increases and more,” the study said.”