December 8, 2025

Bringing you the latest news impacting our network from Congress and the Administration.

In this edition: CMS Guidance on Work Requirements Expected Soon; Road to Housing Bill Hits Roadblock & Upcoming Capitol Conversation; More Workforce Impacts; Another Budget Reconciliation bill; Charitable Tax implications in H.R. 1; & more

CMS Guidance on Work Requirements

We expect CMS to release guidance as soon as this week on Medicaid Community Engagement (aka Work Reporting) Requirements. We will share more as details become available. Early intel suggests more challenges ahead.

Is the Housing Bill Moving?

ROAD to Housing Act Hits Roadblock & Upcoming "Capitol Conversations" Webinar on Housing

Despite public support from the White House for the inclusion of the ROAD to Housing Act in the National Defense Authorization Act (NDAA), negotiators ultimately omitted it in the final text which was released over the weekend and is headed for imminent final votes. Disagreements between the Senate and the House over multiple provisions in the package seem to have led to the move.

Now What? 

House Financial Services Chair French Hill (R-AR) has promised hearings later this month on a slate of housing bills, while Senator Elizabeth Warren (D-MA), a sponsor of the original bill, has vowed that “the fight to get the ROAD to Housing Act signed into law isn’t over.”

Want to know more?  Join us!

The December 18 Capitol Conversations webinar will include an update on this issue.

More Workforce Impacts

Proposed Student Loan Change Could Affect Nursing and Other Health Professions, Nonprofit Workforce

The U.S. Department of Education has proposed redefining what counts as a “professional degree program,” and nursing, occupational therapy, physical therapy, social work, and physician assistant would no longer be included under that designation. If finalized, this change would lower federal loan limits for graduate students in these fields compared to fields like medicine or pharmacy. Instead of higher borrowing caps available to professional programs, students in these professions would face a maximum of about $100,000 in federal loans, which could make advanced education less accessible.

For healthcare nonprofits that employ workers in these fields, this proposal could have long-term implications. Reduced access to graduate education financing may slow the pipeline of advanced practice nurses, for example, potentially affecting staffing for critical roles in primary care, behavioral health, and specialty services. While the rule is not yet final, we will continue to monitor developments closely, as the changes are scheduled to take effect in mid-2026.

Outlook for Second Budget Reconciliation Package

We continue to track movement on a potential second “budget reconciliation” bill as we also continue our work with stakeholders and decision makers on the Hill and in the Administration related to the ongoing rollout of H.R. 1. Based on recent Hill and coalition meetings, it seems increasingly unlikely that the Republican majority will reach consensus to move forward. Despite public support from House Republican leaders and the relevant Senate and House committee chairs for a second budget package—which would likely include additional and significant impacts on health care with more cuts—many rank-and-file Republican lawmakers have expressed skepticism about both the content of such a bill and the likelihood of securing the necessary votes on the floor to move a budget bill forward. Nevertheless, we are tracking movement on this effort closely and will update you as we learn more. Our Ask: Please continue to engage with your members of Congress to inform and educate them on the challenges of current cuts and to urge them to oppose any new cuts.  

What Else?

H.R. 1 Tax Changes for Charitable Giving

The new H.R. 1 law introduces several changes that will affect charitable giving starting next year. First, taxpayers who do not itemize deductions will nevertheless be able to claim an above-the-line charitable deduction: up to $1,000 for single filers and $2,000 for married couples filing jointly for cash gifts to qualifying charities. This means millions of households that take the standard deduction can still benefit from giving. Second, for those who do itemize, the law introduces a new “floor” before deductions apply: individuals must give at least 0.5% of their adjusted gross income. Separately, a new floor has also been introduced for corporate giving: now, corporations must give at least 1% of taxable income before claiming charitable deductions. These changes aim to encourage larger gifts but may require donors to plan ahead.

The Department of the Treasury is expected to issue regulations relatively soon to clarify details. In the meantime, nonprofits can help donors by:

• Explaining the new rules: Let donors know about the $1,000/$2,000 deduction for non-itemizers and the minimum giving thresholds for itemizers (individual and corporate.)
• Encouraging early planning: Suggest donors review their giving strategy now to maximize tax benefits.
• Highlighting eligible contributions: Remind donors that cash gifts qualify, and future guidance may clarify other allowable expenses.

We’ll share more updates as soon as Treasury guidance is released.

What We're Reading

• Medicaid Provider Taxes: Changes to Medicaid Provider Taxes Could Lead to Cuts in 31 States 
• Medicaid Work Requirements: Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements
• Medicaid Work Requirements - People with Disabilities: Recommendations for Mitigating Harms to People with Disabilities, Older Adults, and Caregivers from Medicaid Work Requirements
• Medicaid Work Requirements - Children, Youth, and Families: Children’s Access to Healthcare in Schools: Strategies to Address Medicaid Cuts
• Nursing Homes: CMS Nursing Home Staffing Mandate Repealed
• Philanthropy:  As FEMA Falters, Philanthropy Is Forced to Step Up
• Public Charge: What Advocates Need to Know About the November 2025 Proposed Rule

For more information, please contact Sarah Dobson, Senior Director of Public Policy and Advocacy, or Bill Kallestad, Senior Director, Public Policy and Advocacy, Disability Network.