Bringing you the latest news impacting our network from Congress and the Administration.
In this Edition
Medicaid: House Moves on Reconciliation 3.0; What We're Hearing; and How to TAKE ACTION
Road to Housing Act Passes; Implementation Ahead
Join Us on August 20 for the Next "Capitol Conversations" Webinar on Key Housing Issues
New CMS Models: Share your Input
Senate Majority Tightens
Congress Introduces New Legislation Supporting Direct Care Workforce, People with Disabilities
What We Are Reading and More
Our Network in Action
Chris Tonniges, President & CEO of Lutheran Family Services, was quoted in NBC News' national coverage of Nebraska's work reporting requirements rollout.
How can you get involved? See Here We Stand. below.
Medicaid: What We're Hearing on the Hill
Reconciliation 3.0 – Expected House Action
House Republicans plan to mark-up a budget resolution on Wednesday, which they will use to advance another round of budget reconciliation legislation. This is an important time for federal policymakers on Capitol Hill to hear from you about the importance of "no more cuts to Medicaid."
TAKE ACTION NOW:
Here We Stand.
For People. For Care. For Medicaid.
Four ways to stand with the people we serve as Medicaid changes take effect — starting with the August recess.
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Take action in two minutes. Use our turn-key advocacy tool to send a message to your lawmakers urging them not to make further cuts to Medicaid funding.
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Schedule an in-district meeting. Members of Congress are home during the August recess. Our Action Guide walks you through the ask.
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Share your impact story. How are Medicaid changes affecting your organization and the people you serve? Share your insights with us.
LSA staff recently held a series of meetings with key House and Senate offices — including staff for Senate Finance, Senate HELP, House Energy and Commerce, and House Ways and Means, along with Montana, Nebraska, and Iowa offices — to discuss the impact of H.R. 1's Medicaid changes and gather insight on a potential third budget reconciliation package.
What did we learn?
Work reporting requirements are rolling out state by state. Staff noted that Nebraska's rollout is underway, with Iowa, Montana, and Arkansas beginning soon. Offices asked to stay informed as implementation continues.
Views on how a third reconciliation bill will proceed vary. Some staff believe a package is likely to pass the House but face hurdles in the Senate while others noted they were only aware of early-stage discussions centered on tax policy. Committee jurisdiction and timing for each step of the process remain as open questions.
The DOJ Olmstead statement is drawing concern. Multiple offices raised alarm about the statement's implications for home and community-based services and encouraged strong advocacy on the issue.
Congress wants to hear from you. Nearly every office asked for the same things: personal stories, data — including estimates of coverage loss — and local news coverage showing district-level impact. One committee also suggested submitting formal comments on the Interim Final Rule on work reporting requirements.
ROAD to Housing Act Passes; Implementation Ahead
After months of negotiations and an unusual standoff between the White House and Congress the 21st Century ROAD to Housing Act became law on July 11—advancing without President Trump’s signature.
The final package is widely viewed as the most significant federal housing legislation in decades. The law includes a broad set of bipartisan provisions designed to increase housing supply, reduce barriers to development, and improve affordability. Per the National Housing Trust, some provisions include:
An increase in the cap on the number of units that can be preserved in the Rental Assistance Demonstration (RAD) program will unlock the preservation or redevelopment of another 100k homes that serve very low-income households using private capital;
An increase in the Public Welfare Investment makes it easier for banks to invest more in affordable rental housing;
Reforms to the HOME program around environmental review, Community Housing Development Organization (CHDO) qualification, debt forgiveness and inspection requirements will all make it faster and easier to build and operate new homes and preserve the homes we have now;
And by making the Multifamily Preservation and Revitalization Program permanent and authorizing rental assistance decoupling, the new law provides a needed predictable toolkit for preserving affordable rental homes.
Join Us in August for the Next "Capitol Conversations" Webinar
With the 21st Century ROAD to Housing Act now enacted, efforts will shift to implementation of the bill, including with HUD and other key stakeholders. Join us on August 20 for our next Capitol Conversation that will explore all things housing – including insights on the implementation of ROAD. We will also discuss Yes, In God’s Backyard efforts including our new policy one-pager.
REMINDER: You must register for each Capitol Conversations Webinar individually. For more information, please contact Sarah Dobson.
NEW MEDICAID CMS MODELS: SHARE YOUR INPUT
As CMS works to launch two new Medicaid models, your input is needed. The Centers for Medicare and Medicaid Innovation (CMMI) is planning to launch ASPIRE and LEAD later this year/early next year.
What is ASPIRE?
ASPIRE: The Accelerating State Pediatric Innovation Readiness and Effectiveness (ASPIRE) Model will support whole-person care delivery for children up to age 21 who are enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) who either have or are at risk of developing complex medical and/or behavioral needs, aiming to improve health for some of America’s most vulnerable youth.
What is LEAD?
LEAD is focused on care coordination including for dual eligibles, specifically: LEAD, a successor to the ACO REACH Model, builds upon the CMS Innovation Center’s earlier accountable care work and utilizes improved benchmarking to appeal to a broader mix of health care providers, including those with specialized patient populations and those new to ACOs, such as smaller, independent or rural-based practices. With a 10-year performance period — the longest CMS has ever tested — LEAD offers a predictable window without rebasing and a pathway toward sustainable long-term benchmarks and savings. LEAD also will focus on better serving coordinated care for high-needs patients, such as those dually eligible for Medicare and Medicaid, and those who are homebound or home limited.”
Now what?
LSA staff will meet with CMS through the National Alliance to Impact Social Determinants of Health (NASDOH) on July 22nd and we want to make sure your feedback is part of the process. Please contact Sue Polis and Sarah Dobson with questions or feedback by July 17th.
Senate Majority Tightens
Changes Due to Sen. Graham's Passing and Sen. McConnell's On-going Absence
The Senate returns this week with Republicans facing an even narrower governing margin. Following the death of Sen. Lindsey Graham (R-SC), the chamber currently stands at 52 Republicans and 47 Democrats/independents. Sen. Mitch McConnell (R-KY) also remains absent and hospitalized due to health issues. That leaves Republicans with 51 available votes, and the Senate leadership with little room for defections on legislation, nominations, and procedural votes.
What does it mean?
While South Carolina’s governor is expected to appoint a temporary replacement in the near term, the combination of Graham’s vacancy and McConnell’s uncertain return makes it more difficult to move major legislation during a compressed summer work period.
CONGRESS INTRODUCES NEW LEGISLATION SUPPORTING DIRECT CARE WORKFORCE, PEOPLE WITH DISABILITIES
Congress is considering two new bipartisan measures aimed at strengthening community-based supports for older adults and people with disabilities.
Support for Direct Care Workers
Sen. Tim Kaine (D-VA) has introduced the Supporting Our Direct Care Workforce and Family Caregivers Act, which would provide grants to states and other eligible entities to recruit, train, retain, and advance direct care workers while also expanding education and support for family caregivers. The legislation would further codify and expand a federal technical assistance center that helps states develop workforce strategies, address staffing shortages, improve data collection, and share best practices for supporting both paid caregivers and family caregivers.
Strengthening Olmstead
Rep. Steve Cohen (D-TN) has reintroduced the Latonya Reeves Freedom Act, with a bipartisan group of House cosponsors and a Senate companion bill led by Sen. Michael Bennet (D-CO). The legislation seeks to strengthen enforcement of the Supreme Court’s Olmstead decision, which established the qualified right of people with disabilities to receive services in the most integrated setting appropriate to their needs and preferences.
What’s Next
While these bills are new and have distance to travel to build needed support, LSA staff will be working to help build support for these efforts. Contact Sarah Dobson or Bill Kallestad with questions or insights.
What We Are Reading and More
Medicaid: Two Upcoming Partner Webinars on Medicaid
Understanding New Medicaid Work Requirements Rules
On Wednesday, July 22, 2026 from 11am -12pm ET, Justice in Aging will host a webinar on the recently released Medicaid Work Requirement Rule. The session will cover emerging state actions and highlight issues that could lead to unnecessary coverage loss.
Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families”
On Thursday, July 23 at 12 p.m. ET/ 9 a.m. PT, join Kaiser Family Foundation and States Newsroom for a webinar focused on the impacts of work requirementsand other federal policy changes on states, health care systems, and the people who rely on Medicaid.
For more information, please contact Sarah Dobson, Senior Director of Public Policy and Advocacy.
Lutheran Services in America is one of the nation’s largest national networks of health and human service providers with a mission to cultivate caring communities that advance health and opportunity for all. With 300 nonprofit organizations across 1,400 U.S. communities and more than $26 billion in combined annual services, the Lutheran Services in America network advances equitable outcomes for children, youth and families, improves independence and choice for older adults, champions meaningful services and support for people with intellectual and developmental disabilities, and strengthens stability and purpose for veterans and others. Formed in 1997, Lutheran Services in America brings together a network of leaders, partners and funders to catalyze innovation, strengthen organizational capacity and advance public policy.
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