Jan. 29, 2026  |  Vol. 30 No. 3 |  Archives

A Message to the HCH Community:

Many of us feel exhausted, sad, and angry right now.  Week after week, we see people being targeted because of the color of their skin, families being separated, children afraid to go to school, and patients avoiding critical health care. All because of fear.  

These attacks can make us feel powerless. So what can we do? Mobilize, speak up, stand with our neighbors. Join local protests, actions, and mobilizing calls. Write to elected officials demanding they stop funding hate and targeting communities. And, as always, deliver care with compassion.  

Thank you all for being part of this community. We are stronger together.

“There may be times when we are powerless to prevent injustice, but there must never be a time when we fail to protest.”

— Elie Wiesel, Holocaust survivor and activist

The New Year has been off to a busy start, making this a longer (than usual) Mobilizer. Two big issues in this edition: Medicaid and Immigration

In This Issue

Most state legislative sessions kicked off this month with one big goal in mind: shape the state’s Medicaid policies around H.R.1’s work requirements and other provisions. Advocacy actions remain critical right now as states begin deciding how to shape these policies:

At the end of December, awards for the Rural Health Transformation Fund were announced with all 50 states receiving funding – ranging widely from less than $100 per rural resident to more than $500. Two states received good news for the HCH Community:

States are shaping their policies right now. Use our new implementation recommendations letter to urge your Medicaid offices and legislative leadership to mitigate harm from HR 1. Please share the letter as is or tailor it to add more state specific details.

Related Resources:

Related Readings:

A federal court ruled that HHS can share personal Medicaid data with ICE for individuals not lawfully residing in the US, including citizenship and immigration status, address, phone number, date of birth and Medicaid ID number. The ruling applies to all states, including the 20 that previously sued to block data sharing due to privacy concerns.

This decision has immediate and dangerous implications, including deterring individuals from enrolling in Medicaid out of fear for themselves and their family. Patients, including those here lawfully, are avoiding Medicaid enrollment and health care access out of fear for their safety. And providers are being roped into the attacks, including recently in Minneapolis where DHS issued a subpoena to verify health system employees identities and work eligibility.

Reporting across the country continues to document how patients are forced to choose between safety and health care: 

Watch: Press Conference - Minnesota physicians on ICE presence in hospitals

Hospitals are seeing ICE agents in exam rooms. Patients are avoiding care out of fear of deportation. Staff are experiencing moral injury as they struggle to protect the people they serve.

NHCHC spoke with health care providers in 15 communities to understand how increased immigration enforcement is reshaping care delivery and what HCH programs are doing to respond. Our new blog highlights the real impacts on patients and staff, along with concrete strategies to maintain access, safety, and dignity. Read our recent blog post to hear directly from the field and learn what actions providers can take.

The Administration unexpectedly revoked nearly $2 billion of Substance Abuse Mental Health Services Administration (SAMHSA) grants after a late night notice immediately ended funds for nearly 3,000 federal grantees, including members of the HCH community. Lawmakers and organizations called out the administration’s actions. As a result, less than 24 hours later, the funds were reinstated with no communication on why they were cut or restored.

Please tell our partners at the Drug Policy Alliance how you were affected by SAMHSA’s funding disruption by going to this google form.

Read: National Health Care for the Homeless Council’s statement calling for stability after the SAMHSA grant cuts.

Related: The Administration did the same thing with CDC grants this past weekend.

After acknowledging that “chaos seems to be the point,” a federal judge granted a preliminary injunction ordering HUD to reinstate the FY 24/25 Continuum of Care Notice of Funding Opportunity (CoC NOFO) and begin processing eligible renewals. A few weeks later, on January 8, 2026, HUD issued a notice that the agency is accepting applications under the FY 24/25 NOFO for FY25 until February 9.

Congressional Action: Congress is expected to pass FY 25 appropriations bills which included language instructing HUD to fund the CoC program. Specifically, the legislation requires HUD to noncompetitively renew all expiring projects for 12 months if the funds have been delayed, with renewals phasing in quarterly.

Related Reading:

Progress on appropriations bills to keep the government open has unraveled in the wake of the fatal shooting of Alex Pretti, who was killed by immigration agents over the weekend. Last week the House passed a six bill FY26 appropriations package with strong bipartisan support, including funding for housing, health center funding, and DHS. The package fully funds HHS at levels largely consistent with last year including $4.6 billion in mandatory and $1.857 billion in discretionary funds for community health centers but would eliminate CDC’s social determinants of health work. 

The package now sits in the Senate where lawmakers are expected to vote today on the full 6 bill package ahead of the January 30 funding deadline. However, Senate Democrats have warned they will block passage of the entire package unless the DHS bill is separated so the remaining 5 bills can move forward while negotiations over DHS reforms continue. With funding set to lapse soon, lawmakers have very little time to agree on these contentious issues before the government shuts down. As of this writing, many things are in flux on this issue.

HCH member Circle the City mobilized in full force after the Phoenix City Council gave 7 days notice on a new ordinance to ban medical care in the city parks. After hearing from dozens of community members, the City Council passed the proposal on an 8-1 vote. The ordinance goes into effect on March 30, giving the community just a couple months to work with the city to improve the language.    

WATCH: After the City Council hearing, Circle the City CEO, Kim Despres, spoke with local news explaining the life-saving work of the organization’s street medicine teams and mobile medical units.

Restrictions on providing care seem to be rising. In Philadelphia, new restrictions on mobile health and harm reduction providers took effect in December, limiting where and when providers can operate. Harm reduction programs across the country are also struggling to operate after the Trump administration restricted funding for harm reduction. For example, Indiana is looking to end its syringe services programs.

HHS issued a new “declaration” claiming that gender affirming care (GAC) is not safe or effective for children/adolescents, simultaneously issuing a series of proposed rules to restrict access to GAC for minors. The proposed rules, which the American Academy of Pediatrics strongly opposes, apply to hormone therapy and surgery, but NOT behavioral health services:

The Trump administration announced they were changing the childhood vaccination schedule to better “align” the US with “international best practices.” In reality, the administration has made deep cuts to the list of recommended immunizations, including no longer recommending hepatitis B vaccines for all newborns or requiring states to report childhood vaccination levels. Doctors warn these moves will likely confuse parents, undermine trust in care, and ultimately harm children. Even Republican Senator Cassidy stated these changes will “make America sicker.”

Related Reading:

We found four new studies and reports this month related to our policy priorities:

Laura Brennan
Senior Policy Manager
National Health Care for the Homeless Council

lbrennan@nhchc.org

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