Literature Review

National Alliance: Medicaid cuts would adversely impact home-, community-based services Hospice News; by Jim Parker; 5/12/25 A tax bill currently before Congress could lead to Medicaid cuts that would inhibit access to home- and community-based services (HCBS). The bill, which promises sweeping tax and spending cuts, currently is undergoing a reconciliation process. The amount of tax cuts could reach $4.5 trillion, with spending cuts in the area of $4.5 billion, with a significant portion coming from Medicaid. However, the bill remains a work in progress for now with some resistance to the proposed cuts from both Democrats and a contingent of Republicans. The National Alliance for Care at Home released a statement Monday opposing the Medicaid reductions.

Research disrupted at the NIH Clinical Center STAT - Morning Rounds; by Theresa Gaffney; 5/6/25 The NIH Clinical Center — the nation’s largest hospital devoted solely to medical research — is in crisis. In 2023, the hospital ran around 1,500 studies with a permanent staff of more than 1,800 federal workers. But amid continued disruptions from the Trump administration, researchers are leaving, technicians have been let go, studies are facing major delays, and some patients are deciding to drop out of the hospital’s research.

Assembly passes bill to allow medically assisted death for terminally ill New Yorkers NNY360, Watertown Daily Times and Northern New York Newspapers, Watertown, NY; by Alex Gault; 4/2925 The New York state legislature is poised to pass a bill that would allow terminally ill people to seek a medication to end their lives, a process called medical aid in dying. On Tuesday, the Assembly voted for the first time to advance a bill, carried by Assemblywoman Amy Paulin, D-Westchester, that would allow a terminally ill patient to ask for a prescription for a lethal medication, to be taken at home on their own terms. 

HHS cuts funding for NIH-based Women's Health Initiative threatening decades-long study The American Journal of Managed Care (AJMC); by Giuliana Grossi; 4/23/25 HHS is defunding the regional research centers that have been conducting a long-term national health study focusing on preventive strategies for women's health since 1991, the largest study investigating women’s health in US history. The Women’s Health Initiative (WHI) regional centers will close by September 2025, at the end of the fiscal year, according to an announcement from the NIH-based initiative. Investigators at the WHI were informed by HHS earlier this week, although formal written notice from HHS is still pending.  

Legacy even in defeat? Nursing home experts anxious about next moves on staffing efforts McKnights Long-Term Care News; by Kimberly Marselas; 4/21/25 Two weeks after a judge struck down federal staffing standards for all US nursing homes, questions about the rule’s future continue to swirl within the industry. Will the government appeal the District Court’s ruling in Texas and continue to fight for regulations that would force nursing homes to create more than 100,000 new jobs in coming years? How will a judge hearing a similar challenge in Iowa interpret similar arguments, and what happens if the rulings conflict with one another? ... Regardless of whether the rule goes away, industry insiders have one clear expectation: Its legacy will continue to chafe nursing home leaders, who will still face intense pressure to recruit quality staff and improve patient care.

‘Medical aid in dying’ bill passes Nevada Assembly despite Lombardo veto threat Las Vegas Review-Journal; by McKenna Ross; 4/17/25 An effort to legalize medical aid in dying for terminally ill people has passed a crucial vote Thursday despite Gov. Joe Lombardo’s threat to veto the measure. Assembly Bill 346 would create a legal framework for competent and willing terminally ill patients to self-administer life-ending medicines. It passed in the Assembly on Thursday, 23-19.

Attorneys general challenge Trump’s deportations, citing impact on home health workforce McKnights Home Care; by Adam Healy; 4/16/25 Nineteen state attorneys general filed an amicus brief Monday challenging President Donald Trump’s deportation policies. Among their arguments, they contended that deportations would have an outsized, negative impact on the home health industry’s ability to deliver care. “From a public health perspective, [states] depend on noncitizen healthcare workers who, like other immigrants, are forced to live in a climate of fear — nationwide over 1 million immigrants work in healt hcare, including 40% of home health aides and 18% of nursing home staff,” the brief said. The brief aims to block the administration’s so-called “ideological deportation policy,” established by executive orders 14161 and 14188. These orders intimidate workers, impair healthcare delivery and harm states’ economies, the attorneys general argued. 

8 health system CEOs on the turbulence defining 2025 Becker's Hospital Review; by Kelly Gooch and Kristin Kuchno; 4/16/25 From capacity constraints to reimbursement pressures, health system CEOs are navigating a changing healthcare landscape. One of the top concerns in 2025 is the potential for Medicaid funding cuts. A recent report estimates hospitals could face a $31.9 billion loss in revenue if federal proposals to scale back Medicaid expansion move forward. CEOs from across the country — including safety-net systems, academic medical centers and expanding regional providers — recently shared how they are preparing for continued uncertainty and what strategies they are prioritizing in response.

CMS to withdraw federal Medicaid match for workforce, social needs, and infrastructure: What states, health care providers and community organizations need to know The National Law Review; by Margia Corner, Adam Herbst of Sheppard, Mullin, Richter & Hampton LLP; 4/16/25 In a move signaling a major shift in federal priorities, the Centers for Medicare & Medicaid Services (“CMS”) recently announced it will limit federal funding for state Medicaid initiatives that support services beyond direct medical care. ... On April 10, CMS notified states that it will no longer approve new, or renew existing, state proposals for Section 1115(a) Demonstration Project expenditure authority to provide federal matching funds for state expenditures for designated state health programs (“DSHP”) and designated state investment programs (“DSIP”). 

Attorney General Platkin co-leads multistate effort to protect Affordable Care Act from attack State of New Jersey - Department of Law & Public Safety, Trenton, NJ; Press Release by the Office of the Attorney General, Matthew J. Platkin; 4/14/25  Attorney General Matthew J. Platkin, along with the Attorneys General of California and Massachusetts, co-led a multistate letter regarding a raft of proposed changes that would undermine the Affordable Care Act (ACA), making it more difficult and expensive for individuals to enroll in health coverage on federal and state exchanges. The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would make a number of regulatory changes impacting access to insurance via the ACA. If allowed to take effect, the proposed changes would reduce access to ACA exchanges and risk causing between 750,000 and two million Americans to lose health insurance coverage in 2026. That would impose harms on States and their residents, both insured and uninsured, as when more individuals are forced to go without insurance, costs are driven up for everyone.

Closing the gap in end-of life care coverage: The role of nonprofits in policy advocacy Forbes; by James Dismond; 4/14/25... As the demand for end-of-life care grows, so will the gap between the care that patients need and what they receive. ... Workforce shortages, restrictive regulations, outdated reimbursement models and misconceptions around hospice services are keeping millions of Americans from accessing quality hospice and palliative care services. ... These barriers disproportionately affect low-income families, rural communities and communities of color. ... Unlike for-profit entities, we can prioritize community needs over shareholders. We can prioritize patient well-being over profits—or, to say it more directly, we put people over profits. And I’ve seen firsthand how advocacy can drive progress. Nonprofits must engage in:

Why cameras are popping up in eldercare facilities The New York Times; by Paula Span; 4/7/25 Roughly 20 states now have laws permitting families to place cameras in the rooms of loved ones. Facility operators are often opposed. ... The assisted-living facility in Edina, Minn., where Jean H. Peters and her siblings moved their mother in 2011, looked lovely. “But then you start uncovering things,” Ms. Peters said. Her mother, Jackie Hourigan, widowed and developing memory problems at 82, too often was still in bed when her children came to see her in mid-morning. So Ms. Peters bought an inexpensive camera at Best Buy. She and her sisters installed it atop the refrigerator in her mother’s apartment, ... Monitoring from an app on their phones, the family saw Ms. Hourigan going hours without being changed. They saw and heard an aide loudly berating her and handling her roughly as she helped her dress. ... Though they remain a contentious subject, cameras in care facilities are gaining ground. By 2020, eight states had joined Minnesota in enacting laws allowing them, according to the National Consumer Voice for Quality Long-Term Care: Illinois, Kansas, Louisiana, Missouri, New Mexico, Oklahoma, Texas and Washington. [Continue reading ...]

Medicare and Medicaid officials finalize rule to clarify that medical marijuana isn’t covered by federal health programsMarijuana Moment; by Kyle Jaeger; 4/8/25 The federal Centers for Medicare & Medicaid Services (CMS) has finalized a rule to clarify that marijuana products are not eligible for coverage under certain health plans for chronically ill patients because “they are illegal substances under Federal law.” In a notice set to be published in the Federal Register next week, CMS said that a series of policy and technical changes for its Medicare Advantage (MA) program and other services, including rulemaking related to cannabis products, will now take effect on June 3.[Continue reading ...]