Congressional proposals create barriers to continuous health care coverage under Medicaid by reducing retroactive coverage, shortening redetermination periods, and giving states the option to institute work requirements as a condition of getting health coverage. These administrative and procedural barriers have been demonstrated to reduce access to benefits in health care as well as the other programs. In addition, the bills penalize people purchasing coverage on the nongroup market who have experienced gaps in health insurance. By reducing access, eviscerating Medicaid expansion efforts, adding administrative costs, and penalizing people for caps in coverage, these bills will make Americans sicker and health care more expensive. Moreover, these bills would be a sharp departure from recent bipartisan efforts by states to reduce administrative costs, streamline eligibility, and improve efficiency in Medicaid and other work supports, such as efforts under the Work Support Strategies initiative.