March 27, 2025  |  Vol. 29 No. 3  |  Archives

In This Issue

Coming Up on A Closer Look

Speak up now for Medicaid before it's too late!

We must demonstrate the critical importance of Medicaid and how devastating the proposed cuts will be to our community. Learn how you can take action in our next Closer Look blog post, including by sharing your Medicaid story with the Council.  

Government funding has been extended yet again through September 2025 after the House and Senate passed a Continuing Resolution in mid-March. An important note – the Continuing Resolution funding is for discretionary programs and is different from budget reconciliation which covers mandatory funding like Medicaid (learn more about the differences here).

With government funding (temporarily) secured, Congress is focused back on the budget resolution. After the House and Senate passed very different versions in February, they must now find a way to meet in the middle. The House is urging the Senate to adopt their version, but if the Senate chooses not to, Senators will need to draft a new budget resolution and send it back to the House for a vote, which seems like the most likely outcome, as the House resolution proposes $880 billion in cuts to the committee that oversees Medicaid and many Republican Senators seem hesitant to make such substantial cuts to the program.

To be clear, the plan to cut $880 billion still has no specifics and is not currently outlined in any law. However, based on the budget menu released, we know Medicaid-related cuts being considered include work requirements, eliminating provider taxes, and per capita caps – all of which would force states to make tough budget decisions or cut services. These proposed cuts would harm the HCH community, tribal communities, and millions of others who rely on Medicaid, including leaving millions without dental care. These cuts go against the preferences of the American people, most of who support funding increases and less than one in five of who want to see Medicaid funding decreased.

Due to the unpopularity of these proposals, lawmakers have gotten creative trying to reframe the issue, claiming they’re only addressing “waste, fraud and abuse,” with no real cuts to the program. However, a report released by the Congressional Budget Office earlier this month confirmed that it’s impossible for the Energy and Commerce committee to cut $880 billion without touching Medicaid. Let’s call this what it is: a direct attack on the health care that millions of people rely on. 

Lawmakers still need to hear from you that any cuts or changes to Medicaid will harm millions of people. Call 202-224-3121 and tell your elected officials no cuts to Medicaid! See talking points and tips from last month’s Closer Look blog. Congress will also be in district the week of April 14. Contact your district office now to schedule an in-person meeting or site visit!

Partner Resource: Medicaid Cuts Would Rip Away Health Coverage from Millions of Americans, Disproportionately Harming People of Color | Unidos US

Resources for Advocacy:

Related Reading: 

Hill Visits During Conference: Are you attending the 2025 National Health Care for the Homeless Conference & Policy Symposium in Baltimore, May 12-15? Want to visit D.C. to meet with your elected officials' offices? Email Laura Brennan (Lbrennan@nhchc.org) to learn more about scheduling Hill visits and connecting with folks in your state!

Department of Housing and Urban Development: After DOGE requested HUD employees to indicate which contracts are critical and identify those related to DEI, eight technical assistance awards were canceled with Trump’s DEI Executive Orders cited as the reason. Further cuts to HUD staff are expected that would have serious impact on HUD services and will impact people’s ability to afford housing. Additionally, DOGE employees gained access to the HUD Enforcement Management System which contains confidential medical records, financial information, and housing discrimination details.

Department of Health and Human Services (HHS): In the same vein as HUD, the DOGE team has been at HHS, laying off at least 10% of staff  at the Substance Abuse and Mental Health Services Administration, which is impacting the 988 hotline. The Department is bracing for more layoffs and a restructuring that could include the possible elimination of HIV prevention at CDC or moving it into another department within HHS. Learn more about recently announced cuts below.

Social Security Administration: A judge recently blocked DOGE from accessing the personal data of millions of Americans through the Social Security system. However, in an “effort to limit fraud,” beginning March 31, the Social Security Administration will require recipients and applicants to verify their identity at agency field offices rather than over the phone. This change will make it harder for people to receive SSI payments, especially those who live far from an office, have limited access to transportation, and who may have to leave their belongings to go into the office to verify identity. Further, the social security system has crashed four times in 10 days this month because of the destabilizing actions of the past two months.

New Executive Order: Designating English as the Official Language of The United States
On March 1, the President issued an order designating English as the official language of the U.S. This order rescinds a prior policy requiring agencies to provide assistance programs for people with limited English proficiency, according to a White House fact sheet. The order allows agencies to voluntarily keep those support systems in place.

New Executive Direction: Clean Up the District of Columbia
On March 5, President Trump ordered DC Mayor Bowser to “clean up all of the unsightly homeless encampments” in Washington DC or he would order federal officials to do so. Mayor Bowser immediately removed one encampment, but this is likely just the beginning of high-level attacks on people experiencing homelessness across the country.

New Executive Order: Continuing the Reduction of the Federal Bureaucracy
On March 14, the President effectively eliminated the U.S. Interagency Council on Homelessness (along with six other federal agencies), deeming them “unnecessary.” We disagree and issued a statement describing the benefits that USICH has brought to a coordinated federal approach to homelessness. Their absence will be missed.

New Executive Order: Improving Education Outcomes by Empowering Parents, States, and Communities
On March 20, the President directed the Secretary of the U.S. Department of Education to take “all necessary steps” to facilitate the agency’s closure, though only Congress can truly eliminate a Department established in federal law. Importantly, all federal education laws protecting children and youth who are homeless remain in effect. This includes provisions under the McKinney-Vento Act that allow homeless students to stay at their school of origin and can immediately enroll in school.

Take Action: SchoolHouse Connection has an advocacy action alert to tell Congress about the need to protect educational access and stability for children and youth who are homeless and those in foster care. For more information about how federal policy changes are impacting child and youth homelessness, see their March 26 webinar.

Legal Challenges to Executive Orders: Lawsuits against the Trump Administration’s Executive Orders are moving fast and can be hard to keep up with. Most major threats have been paused by the court at the time this newsletter was published.

Blocked: Gender Affirming Care for Trans Youth – the temporary restraining order was set to expire, but a Seattle judge blocked the executive order to pull federal funding from places that provide GAC to youth.

Related reading:

Centers for Medicare & Medicaid Services (CMS): Senate Finance committee held the confirmation hearing for Dr. Oz to be Administrator of CMS where the former daytime talk show host was questioned about plans to cut Medicaid. Oz responded saying, “I cherish Medicaid” but said he supports Medicaid work requirements and declined to answer whether he would oppose cuts to the program. He awaits a committee and Senate floor vote.  

Centers for Disease Control and Prevention (CDC): The White House withdrew its nomination of Dave Weldon, former Florida Congressman, to lead CDC hours before his confirmation hearing was set to begin. Weldon raised concern from Senators on both sides of the aisle due to his vaccine skepticism. Earlier this week, the White House announced it selected Susan Monarez, acting director of CDC to run the agency. Monarez previously worked as deputy director of Advanced Research Projects Agency for Health, a biomedical research group, and has experience in AI and health technology. A date for the confirmation hearing has not been set.

Related Reading: From TV to CMS: How Dr. Oz could shape Medicare and Medicaid | NPR

10,000 Staff to be Cut from HHS: Earlier today, Secretary RFK Jr announced that HHS plans to cut 10,000 positions, adding to the 10,000 employees who have already left voluntarily. In addition to staff cuts, RFK Jr announced a major restructuring plan that will consolidate 28 HHS divisions into 15 and close half of the regional offices. A major part of the restructuring is the creation of a new subdivision, the Administration for a Healthy America, which combines several HHS offices including the Office of the Assistant Secretary for Health, the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA). This centralization will impact focus on areas including, Primary Care, Maternal and Child Health, Mental Health, Environmental Health, HIV/AIDS, and Workforce development.

Rescission of 1115 Medicaid Waiver Guidance on Health-Related Social Needs: Earlier this month, CMS rescinded federal guidance to states related to health-related social needs (HRSN) which allows services like medical respite care, tenancy supports, and rent. Important note: This recission does not rescind approved waivers but does cast doubt on whether any HRSN waivers will be approved moving forward.

HUD CoC Funding: After six weeks of waiting, HUD finally sent out Continuum of Care (CoC) contracts but included provisions that prohibit funds from being used on DEI, gender ideology, and immigrants, while also removing the requirement for Housing First. Originally, awardees were required to agree to the new terms or lose funding. 48 hours later, HUD rescinded those contracts and providers are still waiting on revised contracts and funding to be released.

Related Reading: HUD Staff Cuts and Grant Delays Endanger Homelessness Services | ShelterForce

The National Alliance to End Homelessness has an Action Alert related to the HUD funding.  Call your Congressional representative to tell them how important it is that HUD funding for Continuums of Care be released quickly to avoid destabilizing housing for those who were formally homeless. 

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

lbrennan@nhchc.org

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