June 25, 2026 | Vol. 30 No. 8 | Archives
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New CMS Guidance – More Restrictive Medicaid Work Requirements
- New HUD Funding -- 100,000 People at Risk of Re-Entering Homelessness
- Congress Approves More Funding for ICE
- Appropriations Watch (+ action!)
- Recent Administration Developments
- What (Else) We’re Reading
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New CMS Guidance – More Restrictive Medicaid Work Requirements |
CMS released an Interim Final Rule on Medicaid work reporting requirements, outlining how states must implement the new requirements from H.R. 1. The guidance is stricter than what is required in the law and differs drastically from the informal guidance CMS provided to states for months. The biggest change is a more restrictive definition of medical frailty that requires individuals to prove their medical condition “significantly impairs” their ability to work.
The change in guidance is forcing states to scrap their plans and rebuild their Medicaid systems differently. In response, six state governors warned HHS about the harms to beneficiaries, calling on CMS to provide additional written guidance and to allow for flexible implementation.
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Be On the Look Out: National Health Care for the Homeless Council will publish an analysis of the guidance along with suggested advocacy actions soon through our Closer Look blog.
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In the meantime, here is related reading:
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New HUD Funding -- 100,000 People at Risk of Re-Entering Homelessness |
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HUD made major changes to homelessness policy through the newly issued FY 2026 Continuum of Care Notice of Funding Opportunity (CoC NOFO). The revised NOFO moves away from Housing First, an evidence-based practice, and instead focuses on transitional housing. The new NOFO only protects 60% of permanent supportive housing placements (down from a current 90%), a change that the National Alliance to End Homelessness estimates will result in 97,000 people losing housing. Other changes allow HUD to prioritize funding to cities that criminalize homelessness, encourage forced treatment, and “promote public safety.”
These policy changes are counter to what we know works. They also come after newly released PIT data shows the first reduction in homelessness since 2016, largely attributed to the public policies that have been working: Housing First, harm reduction, permanent supportive housing, and Medicaid-funded care. All policies that the Trump administration is cutting back.
In response to the NOFO, National Alliance to End Homelessness, along with a coalition of local governments and nonprofit organizations, submitted a supplemental filing asking the U.S. District Court of Rhode Island to stop the implementation of the FY26 NOFO. This is a supplement to their ongoing lawsuit against HUD over the FY25 NOFO in December.
Related Reading:
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Congress Approves More Funding for ICE |
Congress passed an additional $70 billion in immigration enforcement funding, including $38 billion for Immigration and Customs Enforcement (ICE), $26 billion for Customs and Border Protection, and $5 billion for the Department of Homeland Security (DHS). The funds were passed through the budget reconciliation process, meaning they only needed a simple majority to pass.
Now signed into law by President Trump, this bill fully funds these agencies through the rest of Trump’s second term - more than tripling ICE’s previous funding levels. Of note, despite months of fighting, these funds failed to include safeguards on ICE such as protections for sensitive locations, body camera requirements, and additional training requirements. The lack of safeguards is a concern for communities and individuals across the country, especially as ICE detainees continue to report mistreatment and medical neglect.
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The House Appropriations Committee approved the FY27 Labor, Health and Human Services, Education and Related Agencies bill, which included $1.9 billion for health centers, level funding from FY26. Although not a technical cut, flat funding acts as a cut, especially given the increased needs health centers and patients are going to experience due to upcoming cuts to Medicaid.
It total, the House LHHS bill provides $111 billion for HHS, a $4 billion cut from FY26 levels. Of that, $7.6 billion is appropriated to HRSA, a $440 million decrease from 2026. The cuts would eliminate the Title X Family Planning Program and decrease funds for maternal and child health and Ryan White HIV/AIDS programs.
In the Senate, lawmakers remain in a stand-still over topline spending amounts – delaying a markup of spending bills.
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Legislative Summaries for Labor, Health and Human Services, Education and related Agencies (Majority and Minority summaries)
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Members of Congress need to understand the importance of health centers and the Health Care for the Homeless Program! Call your members at 202-224-3121 and urge them to provide the highest possible funding for the Community Health Center program. Describe why the funding is critical to your community, especially given the upcoming Medicaid cuts.
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Recent Administrative Developments |
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New Funding Opportunities on Behavioral Health, Addiction, Homelessness:
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$700 Million to Address Mental Illness, Addiction, Homelessness: HHS announced new federal funding opportunities aligned with the Executive Order on Ending Crime and Disorder on America’s Streets (which encourages the use of civil commitment) and the “Great American Recovery Initiative.”
- $40 Million in SAMHSA Behavioral Health Grants: New funding opportunities aligned with the Great American Recovery Initiative will fund eight grant programs focused on addiction prevention, strengthening the behavioral health workforce, and supporting efforts to address mental illness and prevent suicide.
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DOJ Announces “Model Cities Initiative”: The Department of Justice announced $300 million in grants for 2-4 cities to “reduce crime, restore law and order, and enhance public safety.” Grants are to be used for a range of safety initiatives, including mental health and substance use services such as civil commitment and assisted outpatient treatment.
- New Over-The-Counter Intranasal Naloxone Approved: The FDA approved Rextovy, a 4mg naloxone nasal spray to treat opioid overdose.
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New Executive Order on Childhood Vaccines: The Order, “Realigning United States Core Childhood Vaccine Recommendations With Best Practices From Peer, Developed Countries”, directs the CDC to review a recent HHS assessment of childhood vaccines and use it as a guide for country, potentially narrowing the number of childhood vaccine recommendations.
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What (Else) We're Reading |
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The Council's Merch Shop is Open 24/7 |
Make a statement. Support the movement.
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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 © 2026 National Health Care for the Homeless Council, Inc.
www.nhchc.org | (615) 226-2292
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