Federal Reforms to Medicaid Financing: What Counties Should Know (Part 1)
This event will take place on Zoom Webinar. Please email nacomeetings@naco.org with any questions regarding registration or login issues.
This two-part webinar series will examine the vital role Medicaid plays in supporting county-administered behavioral health and primary care services. It will also explore how proposed and ongoing federal financing reforms could impact counties—fiscally, operationally and in their ability to serve residents.
The series will highlight key areas for county engagement and advocacy, offering insights on how local leaders can help shape Medicaid’s future.
Advocacy
Federal cuts to Medicaid: What counties should know
Medicaid is a joint federal, state and local program that provides health coverage to low-income individuals, including children, pregnant women, elderly adults and people with disabilities. The program accounts for over half of all federal funding to states and is the largest source of federal funding in state budgets.
House E&C Committee advances SUPPORT Act reauthorization
On April 9, the U.S. House Energy and Commerce Committee marked up the SUPPORT for Patients and Communities Reauthorization Act of 2025 (H.R. 2483). The bipartisan bill aims to reauthorize critical programs that target overdose prevention amid the renewal of the opioid crisis Public Health Emergency declaration. In the Senate, these reauthorizations were incorporated into a larger bipartisan package, the Bipartisan Health Care Act (S.891).
HHS issues termination notices for health grant funding
On March 25, the U.S. Department of Health and Human Services (HHS) sent letters to state authorities and counties with direct grant funding announcing the immediate termination of several pandemic-related grants, which was previously set to run through September 2025.
HHS announces major restructuring
On March 27, the U.S. Department of Health and Human Services (HHS) announced a sweeping reorganization that will consolidate agencies, shift key programs under a new framework and eliminate thousands of positions. This change brings HHS in line with President Trump's Executive Order, “Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.”
HHS moves to reduce public comment in rulemaking
On February 28, the U.S. Department of Health and Human Services (HHS) announced a policy change limiting public comment opportunities to only those required by law. Published in the Federal Register on March 3, the decision rescinds the “Richardson Waiver,” a 1971 directive from then-HHS Secretary Elliot Richardson that encouraged broader public input on regulations related to public benefits, grants and healthcare policies.
HHS renews Public Health Emergency Declaration to address national opioid crisis
On March 18, the U.S. Department of Health and Human Services (HHS), under the direction of Secretary Robert F. Kennedy, Jr. renewed the public health emergency (PHE) declaration to address the ongoing opioid crisis, extending critical federal support for coordination, treatment expansion and research efforts. While overdose deaths have declined by 25.5 percent over the past year, synthetic opioids like fentanyl continue to drive fatalities, with approximately 150 Americans dying daily from overdoses.
CMS announces extended funding application period to improve the continuity of care for justice-involved individuals
On September 27, the Centers for Medicare & Medicaid Services announced $106.5 million in state planning grants aimed at improving healthcare continuity for individuals transitioning from incarceration.