July 31, 2025 | Vol. 29 No. 7 | Archives
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- Two Executive Actions: Targeted Harm Against Non-Citizens and Those With Behavioral Health Conditions
- “One Big Beautiful Bill Act” Brings Steep Cuts to Medicaid
- States Moving Fast on Medicaid Work Requirements
- Take Action During August Recess!
- What’s Next in Congress? Even More Cuts.
- Other HHS Updates
- Great Legislation We Endorsed!
- Litigation Updates
- What (Else) We’re Reading (and Watching!)
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Two Executive Actions: Targeted Harm Against Non-Citizens and Those With Behavioral Health Conditions |
Two executive actions in July have significant impacts on the HCH Community:
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Executive Order titled “Ending Crime and Disorder on America’s Streets:” On July 24, President Trump released a new EO that calls for encampment sweeps, arrests and involuntary hospitalizations for unsheltered people living with mental health or substance use disorders. The EO calls for many changes, including changing federal grant funding away from Housing First and harm reduction, promoting civil commitments, and collecting/sharing health information with law enforcement. We cannot overstate the significant harm of this EO. Please read our statement and watch for our fact sheet with more information.
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New HHS policy announcement banning non-citizens from health center services: On July 10, HHS announced a new interpretation of federal law that redefines eligibility for services at community health centers (and 15 other federal health and education programs). Despite a 30-day comment period and a lack of implementation guidance, the policy states it goes into effect immediately. A few key points to consider:
- Federal law requires health centers to serve all residents in the service area.
- Legal experts have advised health centers to make no changes to current services in response to this announcement.
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A group of Attorneys General have sued to block implementation of this interpretation. At the time of this publication, the Federal government has agreed to pause any enforcement and application through September 3 in the 21 states that sued. The full list of states and more information can be found here.
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Public comments should be submitted before 11:59pm ET on August 13 (here are tips for submitting comments).
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Related News and Resources:
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“One Big Beautiful Bill Act” Brings Steep Cuts to Medicaid |
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After months of negotiating, a rushed vote, and last minute changes, President Trump signed the One Big Beautiful Bill Act (OBBBA) into law on July 4th. NHCHC strongly opposes this law and the devastating impacts it will have on the HCH community and others. While many of the provisions won’t be felt until after the 2026 midterm elections, here’s what we know so far about the impact:
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The impact of these cuts will be felt in both expansion and non-expansion states with significant revenue losses projected for all states. The $50 billion Rural Health Fund will do little to offset the financial harm, with critics calling it a ‘slush fund’ with no guarantees of who or what the money will go to. The National Association of Community Health Centers (NACHC) is offering to work with CMS to help Community Health Centers receive some of the funding.
HCH Community at Risk: See our updated fact sheet to learn how this law will bury patients in red tape, financially strain clinics, and worsen health outcomes. Key provisions that will cause direct harm include:
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- Medicaid Work Requirements
- Changes to Immigrant Coverage
- Address Verification Requirements
- Increased Frequency of Eligibility Checks
- Slashes to Retroactive Coverage
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States Moving Fast on Medicaid Work Requirements |
Thirteen states have already moved to implement Medicaid work requirements either through waivers, public comment, or the state legislature. States’ quick actions make it even more critical that the HCH community be engaging with their state governments, urging them to implement work requirements in a manner that is the least harmful. We encourage everyone to reach out to state legislators and executive offices and ask them to include homelessness as an exempted population. Here are the six states with waivers currently pending at CMS:
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Take Action During August Recess! |
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Congress is heading home for August recess, making this a great opportunity to engage with your lawmakers! Here are 3 ways to advocate next month:
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Host a site visit: Invite lawmakers to tour your program and witness your work in action. Check out our new advocacy guide for sample emails, agendas, and extra tips!
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Attend a town hall: Many lawmakers are looking to speak to and hear from constituents, show up at a town hall near you to voice your opinion on Medicaid cuts, proposed HUD cuts, or other priorities.
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Join a protest: Stand in solidarity with your community by joining a protest near you.
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What’s Next in Congress? Even More Cuts. |
First things first – appropriations. Government funding is set to expire on September 30. Lawmakers should be focused on the FY26 appropriations process, especially given that they are woefully behind and are about to spend a whole month at home for August recess. Instead, the House was sent home early after being caught up in the Epstein scandal, which held up all other business. This means that once they return, they will be under a massive time crunch to keep the government funded.
Once they are back in DC, their options are to pass appropriations bills, pass another continuing resolution, or shut down the government. President Trump’s FY26 budget proposed massive cuts to critical programs which Republicans are hoping to secure, however Democratic lawmakers are not in favor and have been strategizing on whether or not to let the government shutdown. Stay tuned for more updates in early September.
Related reading:
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Great Legislation We Endorsed!
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Housing is a Human Right Act: Reintroduced by Rep. Jayapal (D-WA-07) and Rep. Meng (D-NY-06), if passed, this bill would authorize over $300 billion for housing infrastructure to reduce homelessness in the US. Find out more here.
Medicare Mental Health Inpatient Equity Act: Reintroduced by Rep. Tonko (D-NY-20) and Rep. Huizenga (R-MI-4), if passed, this bill would repeal the Medicare 190-day limit for inpatient psychiatric care. Find out more here.
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Planned Parenthood Medicaid Funding: A federal judge ruled that the government must continue providing Medicaid reimbursements to Planned Parenthood, blocking an OBBBA provision that banned the funding for a year. This decision helps keep hundreds of clinics open and ensure access to reproductive health care.
Mass Firings Allowed: The Supreme Court ruled in favor of the Trump administration’s reductions in force, allowing them to move forward with massive layoffs across federal agencies as outlined in a February executive order.
Medical Debt Accumulating: A federal judge reversed a Biden-era Consumer Financial Protection Bureau rule that would have removed medical debt from credit reports. This will result in worsening credit scores for about 15 million Americans at the same time many will experience cuts to Medicaid.
New Lawsuit on Grant Conditions: A coalition of national partners filed a lawsuit requesting the court block the Trump administration from enforcing the new DEI provisions in HHS and HUD grants.
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Massive HIPAA violations: In line with the escalating attacks on immigrant families, the Trump administration also provided the personal Medicaid data of every enrollee, regardless of citizenship status, to ICE. These attacks will only worsen public health across the country as the fear of ICE raids deters people from accessing care.
- SOAR TA Ending: SAMHSA announced that the SOAR TA center will close on August 18, eliminating access to the training and support infrastructure.
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Fentanyl Overdose Response Funding Delayed: About $140 million in grants for fentanyl overdose response efforts have been delayed and may be canceled.
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Closed - LGBTQ+ Youth 988 Suicide Line: The program has officially ended. LGBTQ+ youth seeking support should reach out to counselors at Trevor Project’s 24/7 suicide line.
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Limit on Continuous Eligibility: CMS announced it will no longer approve 1115 waivers to allow continuous eligibility for certain Medicaid recipients. This is a huge loss for the HCH community as continuous eligibility helps people stay on insurance without interruptions.
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What (Else) We're Reading and Watching |
Finally: New Partner Resource: |
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| Laura Brennan
Senior Policy Manager
National Health Care for the Homeless Council
lbrennan@nhchc.org
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| Your support is crucial!
All our advocacy work — including this newsletter! — is funded by dues from NHCHC's members and private donations. Consider joining the Council or donating to support this work!
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Copyright © 2025 National Health Care for the Homeless Council, Inc.
www.nhchc.org | (615) 226-2292
100 Powell Place #1558 | Nashville, TN 37204 US
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