August 27, 2026  |  Vol. 30 No. 12 |  Archives

In This Issue

The attacks don’t stop. Just this month, the Trump administration continued to deepen and compound the harm of its health care policies this month, including by restricting provider taxes, issuing arcane budget rules for 1115 waivers, increasing the fraud crackdown, upending the childhood vaccine schedule, and barring Medicaid and CHIP for trans youth care. These changes add to the massive cuts to Medicaid and the ACA, which have already led to millions of people losing health coverage.

Related Resource & Webinar!

States reject self-attestation for medical frailty: Eight states (Arkansas, Idaho, Indiana, Iowa, North Carolina, North Dakota, Ohio, and Utah) will require documentation for medical frailty throughout 2027, rejecting the 1-year lifeline allowed by CMS. This will make it significantly more difficult for Medicaid recipients to maintain coverage by increasing the administrative barrier and documentation threshold to maintain coverage.

Work Requirement Litigation Update: A federal judge declined to pause implementation of the work requirements after 25 states and DC sued the administration. The court found the states did not prove the changes would cause irreparable harm and the judge argued that the tight implementation deadline could not be solely blamed on CMS, since the timeline was set by Congress. As a result, plaintiff states must prepare to implement Medicaid changes as the litigation proceeds, with an expedited hearing scheduled for October 20.

Current Status: States continue to make decisions about Medicaid implementation that will either help protect coverage or deepen harms. Nebraska, the first state to implement work requirements early, became the first state to disenroll Medicaid recipients this month.

Harmful Impacts: Reports continue to show the far-reaching impact of these decisions. Eligible people are going to fall through the cracks, while millions of people who work in low-wage jobs and depend on Medicaid, people with disabilities and chronic conditions, and people experiencing homelessness are all at risk of losing coverage and access to critical care that helps them work. These changes are going to cost counties millions, undo progress made to protect vulnerable populations, and harm everyone.

Related Reading:

Tell your lawmakers to support policies that save lives and money! A new study found that universal health care system using a single payer/Medicare for All approach would save 114,000 lives and $1 trillion EVERY year. Call 202-224-3121 and ask your lawmakers to cosponsor the Medicare for All legislation. 

Phoenix Bans Street Medicine: Circle the City (the HCH program in Phoenix) filed a lawsuit against the City of Phoenix in response to the city’s ordinance banning medical care and food distribution in city parks, effective June 7, 2026. The day before the hearing, the judge ruled against the preliminary injunction, arguing that the ordinance is not a violation of their first amendment right. The plaintiffs have 30 days to appeal or let the case progress in the same court.

Nashville Tases, Arrests, and Jails Joseph Williams: In Nashville, one of the country’s first felony charges against public camping were brought against Joseph Williams who was tased, arrested, and spent 9 days in jail, only to be released back to the same park.  Read the Council’s statement: Making Homelessness a Felony is Cruel and Counterproductive.

The Man Criminalizing Homelessness: This past week, both the Washington Post and the New York Times published long-reads on the billionaire who is using his money and power to stomp on people with neither. Read these articles to better understand the people behind the push to criminalize homelessness, sweep encampments, arrest and hospitalize people, and prevent the delivery of health care services.

In collaboration with SAMHSA and HUD, the White House released a Best Practices Toolkit: Addressing Homelessness and Addiction through “Treatment First”. The “toolkit” does not change federal law or require communities to change their service models. However, it is another clear indicator of the priority to move against housing first, arguing the approach has failed. Instead, the toolkit promotes treatment first and focuses on “self-sufficiency,” faith, and abstinence, citing the Civil Commitment Executive Order as the foundation for the approach. The “best practices” toolkit stands starkly opposed to what the evidence actually says about housing first.

Related Reading:

Days before the notice of funding opportunity (NOFO) applications were due, a Rhode Island judge vacated the FY26 CoC NOFO, ruling HUD violated the Administrative Procedure Act since they failed to follow the required notice-and-comment process. A few days after the ruling, HUD appealed, asking for an emergency stay in the case. Despite that, HUD is not allowed to implement the changes as proposed, including the major cuts to permanent housing that would leave 97,000 formerly unhoused people without a home.

Related Reading:

More Immigration Restrictions Set to Take Effect Soon

ICYMI, there are many immigration changes happening that impact who can enter into/stay in the country and who is eligible for health insurance. On August 14, we published a Closer Look blog that covers the gutting of the "public charge" rule and the elimination of Medicaid coverage for immigrants.  The blog lists both advocacy actions you can take and internal operations strategies that can help prepare for these changes.

Make a statement. Support the movement.

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

lbrennan@nhchc.org

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