States are crafting new Medicaid policies, now that the feds have said they can require people to work in order to qualify for coverage.  That will likely mean more customer churn, people moving in and out of Medicaid programs as their employment status changes, or they learn to comply with new mandatory premiums. That means patients’ treatment could be interrupted, leading to more costs as they catch up on care when they qualify again. And that insurers could have a harder time predicting their costs or measuring their success.