Social Current has released its 2025-27 Federal Public Policy Agenda, outlining key priorities and a bold vision for the 119th Congress.
This agenda is the culmination of months of research and development, incorporating the priorities of the Social Current network that were gathered through focus groups, surveys, and one-on-one conversations.
Rooted in the belief that strengthening the social sector strengthens communities, the agenda focuses on critical areas vital to the sector’s ability to deliver essential services, including:
- Workforce Stability and Sustainability
- Financial Health and Sustainability
- Insurance Affordability and Accessibility
- Health and Well-Being
View and download the full agenda online to learn more.
Exploring Benefits and Concerns of Permanent Tax Cuts for Working Families
On Jan. 14, the U.S. House Committee on Ways and Means convened a hearing to discuss making the tax cuts enacted during President Donald Trump’s previous administration permanent. Several witnesses, including small business owners as well as a parent, spoke of the positive effects of the Tax Cuts and Jobs Act. They emphasized economic growth and investment, particularly in light of the doubled standard deduction and the expanded child tax credit.
Several representatives, however, raised concerns about the increasing national debt, noting that tax reductions disproportionately benefited corporations and wealthy business owners. Brendan Duke, senior director for economic policy at the Center for American Progress, echoed representatives’ concerns through his testimony. He cautioned that any current or future spending cuts intended to offset the cost of tax reductions could make food, health care, and housing increasingly unaffordable for lower- and middle-class Americans.
ACF Calls for Stronger Response to Missing Children in Foster Care
To help communities enhance their response to children missing from foster care, the Administration for Children and Families (ACF) hosted a series of listening sessions in 2024, bringing together service providers, child welfare professionals, and law enforcement agencies.
Feedback revealed inconsistencies in the definition of the word “missing” and confusion over reporting responsibilities, which often result in delays in responding during critical periods for a youth’s safety and wellbeing. Participants recommended a coordinated, interagency response, including improved communication, clearer reporting protocols, and stronger cross-sector collaboration, to lead timely and effective interventions.
Additional recommendations included expanding training and resources for child welfare professionals, law enforcement, and service providers. Participants also emphasized the need for a focus on human trafficking, culturally competent care, and addressing the unique needs of Native youth.
SAMHSA Releases Updated National Behavioral Health Crisis Care Guidance
The Substance Abuse and Mental Health Services Administration (SAMHSA) has released the National Behavioral Health Crisis Care Guidance, including three documents:
- 2025 National Guidelines for a Behavioral Health Coordinated System of Crisis Care
- Model Definitions for Behavioral Health Emergency, Crisis, and Crisis-Related Services
- A draft Mobile Crisis Team Services: An Implementation Toolkit
The updated national guidance was created to help state, territory, tribal, and local governments, along with key stakeholders, understand, implement, and sustain effective behavioral health crisis services. It is based on three foundational elements crucial to an integrated crisis care system, with the ultimate goal that everyone should have access to:
- Someone to Contact: Services like the 988 Lifeline and other behavioral health hotlines provide immediate, accessible support.
- Someone to Respond: Mobile crisis teams deliver rapid, on-site interventions to de-escalate crises and link individuals to the care they need.
- A Safe Place for Help: Stabilization services offer a safe environment where individuals can receive care, crisis resolution assistance, and connections to appropriate resources for ongoing support.
The guidance highlights the importance of follow-up services, care coordination, key service intersections, and the development of crisis systems, reflecting the evolving national crisis landscape following the transition to the 988 Lifeline.
New Report Highlights Progress and Challenges in Mental Health Parity and Addiction Equity
The U.S. Departments of Labor, Health and Human Services, and the Treasury released their 2024 report to congress on the enforcement and implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA). The report details the progress made by group health plans and health insurance issuers in meeting compliance standards, while also identifying areas for improvement to ensure parity with medical and surgical benefits. It also outlines ongoing federal efforts to strengthen MHPAEA protections, reduce barriers for beneficiaries, and increase awareness of the Act’s protections.
Sector Updates from the Judiciary
Supreme Court to Review Student Loan Forgiveness for Fraudulent Practices by Schools
The U.S. Supreme Court will review the process for loan discharges in cases where students were misled or deceived by their schools. The regulations introduced by the Biden Administration aimed to simplify the loan discharge process for borrowers who could prove their school misled them, breached a contract, or engaged in aggressive recruitment tactics. The rules also expanded options for students to have their loans forgiven if their school closed.
The Supreme Court accepted the case after the U.S. Court of Appeals for the Fifth Circuit overturned the new procedures, ruling that the Department of Education lacked authority to directly forgive loans for students misled or defrauded. Instead, the court ruled that students must first default on their loans first and then raise fraud as a defense during debt-collection proceedings in court.
Federal Court Strikes Down Expansion of Title IX Rule
The U.S. District Court for the Eastern District of Kentucky struck down a federal rule implemented by the Biden Administration that aimed to ban discrimination based on sexual orientation and gender identity in federally funded schools. The rule sought to expand the protections under Title IX, but the court ruled Title IX’s prohibition of discrimination ‘on the basis of sex’ applies solely to an individual’s male or female sex.
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The Stop Institutional Child Abuse Act, introduced by Sens. Jeff Merkley (D-Ore.), John Cornyn (R-Texas), and Tommy Tuberville (R-Ala.), was created to study and prevent child abuse in youth residential programs. It was signed into law December 2024.
Key Provisions
The Stop Institutional Child Abuse Act requires the Secretary of the Department of Health and Human Services to contract with the National Academies of Sciences, Engineering, and Medicine to conduct a study examining youth residential programs. The findings will be published in a public report every two years for a period of 10 years. The study and recommendations should involve consultations with child advocates, health professionals, state and federal agencies, subject matter experts, and individuals with lived experience.
The report must include the following information:
- The nature, prevalence, severity, and scope of child abuse, neglect, and deaths in youth residential programs
- All federal and state funding sources for youth residential programs
- Existing regulation of youth residential programs
- Existing standards of care of national accreditation entities that provide accreditation or certification of youth residential programs
- Risk assessment tools
Additionally, the report must include recommendations to support the development and implementation of education and training resources for professional and paraprofessional personnel in several fields, including health care, law enforcement, judiciary, social work, child protection, education, and child care. The recommendations should center lived experience, interagency communication, evidence-based practices, and the legal rights of children in youth residential programs.
The report will also include recommendations for community-based alternatives to youth residential programs that are more accessible and follow evidence-based standards to support individuals’ health and safety, including by supporting continuity of education and providing mentorship.
Expected Impact on Human Service Sector
The Stop Institutional Child Abuse Act is expected to provide greater oversight and data transparency for institutional youth treatment programs. It affirms a longstanding commitment to rigorous evidence-based standards and children’s safety and well-being.
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Learn more about Social Current’s government affairs and advocacy work online.
Social Current has released its 2025-27 Federal Public Policy Agenda, outlining key priorities and a bold vision for the 119th Congress. Social Current is dedicated to building a more equitable society where all people can thrive, and this public policy agenda reaffirms our commitment to harnessing the power of the social sector as a catalyst for change.
“In the face of an unpredictable political landscape, Social Current remains committed to challenging the status quo and addressing ongoing inequities,” said Social Current President and CEO Jody Levison-Johnson. “We understand that meaningful progress requires collective action, and we are determined to work with our network of organizations, their communities, and all of our partners to drive forward essential public policy changes.”
The 2025-27 Federal Public Policy Agenda is the culmination of months of research and development, incorporating the priorities of the Social Current network gathered through focus groups, surveys, and one-on-one conversations. It reflects the diverse perspectives of our network organizations, the challenges they face, and the future they aspire to create.
This agenda translates our vision and values into concrete, actionable priorities that address systemic challenges, foster resilience, and empower organizations to increase their impact. Rooted in the belief that strengthening the social sector strengthens communities, the agenda focuses on critical areas vital to the sector’s ability to deliver essential services, including:
- Workforce Stability and Sustainability
- Financial Health and Sustainability
- Insurance Affordability and Accessibility
- Health and Well-Being
Access the full agenda online to learn more about our priority actions in each area.
To help human and social services professionals learn about pressing issues, build advocacy skills, and take collective action, Social Current will be hosting a free four-part Advocacy in Action webinar series. Register now to participate in the sessions:
- Social Current’s Federal Policy Agenda Jan. 22
- Strategies for Workforce Sustainability and Insurance Accessibility Feb. 19
- Financial Health and Equity-Focused Advocacy March 27
- Behavioral Health Integration and Systems Change April 22
“The 2025-27 Federal Policy Agenda is not only a roadmap for addressing the challenges facing our sector, but also a call to action to come together and advocate for the critical issues that will help us build a stronger, more equitable society,” said Blair Abelle-Kiser, senior director of government affairs. “I encourage everyone to join us for our upcoming Advocacy in Action webinar series, where we’ll dive deeper into how we can collectively advance these priorities.”
Join Social Current’s grassroots advocacy network to be alerted about new advocacy opportunities and tools and resources, and subscribe to the Policy and Advocacy Radar to receive our biweekly policy newsletter.
Learn more about Social Current’s government affairs and advocacy work online.
Martin Luther King Jr. Day, Jan. 20, 2025, is an annual observance to honor the life and legacy of the prominent civil rights leader. There are a variety of ways to recognize the holiday, including personal reflection, education, service projects, and advocacy.
“At Social Current, we say that equity is a journey, which always reminds me of the Martin Luther King Jr. quote, ‘If you can’t fly then run, if you can’t run then walk, if you can’t walk then crawl, but whatever you do, you have to keep moving forward,’” says Romero Davis, senior director of practice excellence at Social Current. “It’s a reminder of the principles of equity, justice, and the ongoing pursuit of a better, more inclusive society that Martin Luther King Jr. advocated for throughout his life.”
The King Center has given this year the theme, Mission Possible: Protecting Freedom, Justice, and Democracy in the Spirit of Nonviolence365. The center notes, “While apathy and despair tempt us, we must choose love-centered action and hope. We invite citizens of the world to rise with us … to co-labor with us in strategically addressing the inequities and ideologies that threaten our existence.”
Advancing Justice and Equity Through Federal Public Policy
Social Current is committed to advancing positive social change through public policy advocacy, learning opportunities, and full range of solutions. Our 2025-2027 Federal Public Policy agenda, which will be released Jan. 21, channels our vision and values into specific, actionable priorities that address systemic challenges, build resilience, and create opportunities for organizations to create positive impact.
We invite all human and social services professionals to join us in advancing key policies. Throughout 2025 and beyond, we will be sharing tools, resources, and training to help you and your organizations build your advocacy muscles. Join us for our free four-part advocacy webinar series to learn about key issues and how you can take action:
- Social Current’s Federal Policy Agenda: Jan. 22 from 1-2 p.m. ET
- Strategies for Workforce Sustainability and Insurance Accessibility: Feb. 19 from 1-2 p.m. ET
- Financial Health and Equity-Focused Advocacy: March 27 from 1-2 p.m. ET
- Behavioral Health Integration and Systems Change: April 22 from 1-2 p.m. ET
Register online to participate.
To receive information about opportunities to take action, gain access to exclusive resources, and work collaboratively alongside fellow social sector advocates, sign up for free to be a part of Social Current’s grassroots advocacy network.
“This federal public policy agenda is our roadmap for turning shared aspirations into action and ensuring that social sector organizations and leaders have the tools, resources, and support needed to thrive,” said Blair Abelle-Kiser, senior director of government affairs at Social Current. “It is a bold expression of our mission, vision, and values, designed to strengthen the sector and help create a society where all people can reach their full potential.”
Advancing EDI Strategies for Teams and Organizations
In addition to advancing public policies to create a more just and equitable society, it is important to advance parallel equity, diversity, and inclusion (EDI) goals within teams and organizations. Social Current is offering a four-part virtual learning series, starting March 26, that will delve into strategies for supporting workforce resilience.
The four-part series is rooted in EDI best practices for supervisors and leaders. Participants will learn how to help their diverse teams manage uncertainty and interpersonal conflict so they can create a healthy and resilient culture. Sessions in the series cover how to have crucial conversation, encourage psychological safety, and foster belonging.
The King Center affirms that its vision of the Beloved Community, “is not a lofty, unattainable utopia but an inclusive, achievable society, in which problems and conflict can exist, but are resolved peaceably.”
Learn more about Social Current’s work to support organizations in creating healthy and equitable society through its core Impact Areas.
On Jan. 1, 2025, a new out-of-pocket cap on drug costs went into effect for Medicare Part D patients. The new cap is set at $2,000 per year for all prescriptions covered by Part D plans.
The change was scheduled as part of the Inflation Reductions Act (IRA), which takes several steps to make health care more affordable and accessible.
In addition to caps on drug costs, the IRA introduced other critical changes:
- Insulin Costs: The cost of insulin is now capped at $35 per month for covered insulin products
- Zero-Cost Vaccines: Medicare Part D patients can access recommended vaccines (like flu, shingles, COVID-19 and RSV) for free.
- Pharmaceutical Negotiation: The law also allows Medicare to negotiate directly with drug companies each year to lower the prices of many of the most expensive and most commonly used prescription drugs
More information about the IRA changes can be found from the Centers of Medicaid and Medicare services.
The Children’s Bureau Releases Program Instructions
New guidance includes:
- ACF-ACYF-CB-PI-24-10: State Requirements for Electing Title IV-E Prevention and Family Services and Programs: The program instruction informs state Title IV-E agencies of the Title IV-E prevention program requirements and flexibility agencies may provide to tribes with whom they have agreements.
- ACYF-CB-PI-24-11: Tribal Title IV-E Agency Requirements for Electing Title IV-E Prevention and Family Services and Programs: The program instruction informs tribal Title IV-E agencies administering or supervising the administration of Title IV-E prevention program requirements. It additionally exempts tribal Title IV-E agencies from the evaluation waiver and continuous quality improvement requirements, extending flexibilities Title IV-E agencies offer.
ACF Publishes Additions to the Child Welfare Policy Manual
On Dec. 20, 2024, the Administration for Children and Families published two additions to the Child Welfare Policy Manual regarding access to services provided under Title IV-B of the Social Security Act and the Child Abuse Prevention and Treatment Act according to immigration status.
The additions can be found in:
- Question 3, 1 CAPTA, Assurances and Requirements: May a state agency deny access to services provided under CAPTA based solely on the immigration status of the child, parent, or family members?
- Question 3, 1 TITLE IV-B, Citizenship/Alienage Requirements: May a Title IV-B agency deny access to services provided under Title IV-B based solely on the immigration status of the child, parent, or family members?
President Biden Signs Key Legislation
- H.R. 9076, Supporting America’s Children and Families Act: Introduced by Rep. Darin LaHood (R-Ill.), the bill reauthorizes, entirely for the first time in over 15 years, child welfare programs under Title IV-B of the Social Security Act that provide federal resources to states, tribes, and territories for family preservation and to promote the safety, permanence, and well-being of children in foster care.
- H.R. 663, Native American Child Protection Act (NACPA): Introduced by U.S. Sens. Ben Ray Luján (D-N.M.) and Susan Collins (R-Maine), NACPA reauthorizes and reforms key programs related to the prevention, investigation, treatment, and prosecution of family violence, child abuse, and child neglect involving Indian children and families.
- S. 1351, Stop Institutional Child Abuse Act: Introduced by Sen. Jeff Merkley (D-Ore.), the bill requires the National Academies of Sciences, Engineering, and Medicine to study and issue recommendations to improve coordination and the implementation of best practices regarding the health, safety, care, and treatment of youth in youth residential programs.
- S. 1147, Jenna Quinn Law: Introduced by Sen. John Cornyn (R-Texas), the bill allows the Department of Health and Human Services (HHS) to provide grants for evidence-informed child sexual abuse awareness and prevention programs, which may be awarded for up to five years.
- H.R. 7213, Autism Collaboration, Accountability, Research, Education, and Support (CARES) Act of 2024: Introduced by Rep. Chris Smith (R-N.J.), the bill reauthorizes several programs that support autism education, research, and resources.
- H.R. 670, Think Differently Database Act: Introduced by Rep. Marcus Molinaro (R-N.Y.), the bill requires HHS to establish a website that provides information on resources available to individuals with a disability and their caregivers and families that is searchable by ZIP Code.
- H.R. 5536, Grant Transparency Act of 2023: Introduced by Rep. Russell Fry (R-S.C.), the bill establishes transparency requirements for notices of funding opportunity in applications for competitive grants awarded by federal agencies, excluding the Government Accountability Office.
- H.R. 1432, VSO Equal Tax Treatment Act: Introduced by Rep. Brad Wenstrup (R-Ohio), the bill expands the deductibility of charitable contributions to all federally chartered tax-exempt organizations serving current and former Armed Forces members.
- S. 2513, Veterans Benefits Improvement Act of 2024: Introduced by Sen. Jon Tester (D-Mont.), the bill addresses specific requirements for medical disability benefit claims processes and personnel.
- S. 141, the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act: Introduced by Sen. Jerry Moran (R-Kan.), the bill amends various Department of Veterans Affairs authorities related to health care, economic opportunity, disability and memorial affairs, veteran homelessness, and oversight and investigations.
Sector Updates from the Judiciary
Supreme Court Agrees to Hear a Lawsuit Surrounding Medicaid Patients’ Right to Provider Choice
The U.S. Supreme Court has agreed to hear a lawsuit to determine whether Medicaid beneficiaries can sue South Carolina for its decision to defund Planned Parenthood. Although Medicaid generally doesn’t cover abortion costs, Medicare patients were previously able to visit clinics that offered abortion care for other medical services, including screenings for cancer, high blood pressure, and cholesterol.
The lawsuit was brought by a patient with Medicaid who was diagnosed with diabetes and went to Planned Parenthood for birth control but wished to return to receive other care in the future. However, the patient was prevented from doing so due to a 2018 executive order issued by South Carolina Gov. Henry McMaster that ordered the state’s Department of Health and Human Services to stop abortion clinics from participating in the Medicaid program.
The lawsuit argued that McMaster’s order violated a provision of the Medicaid Act that allows Medicaid patients to seek health care from any “qualified” provider. McMaster maintained that the “payment of taxpayer funds to abortion clinics, for any purpose, results in the subsidy of abortion and the denial of the right to life.”
The initial ruling was issued in favor of Planned Parenthood, as the Fourth Circuit Court of Appeals determined that the case raises the larger question of whether Congress, through the Medicaid Act, grants individuals with Medicaid coverage the right to choose their health care provider freely.
The Supreme Court will now hear the lawsuit. If the Supreme Court rules against Planned Parenthood and their Medicaid funding is revoked, similar family planning clinics that provide abortion care among other medical services will also lose federal funding. The closure of family planning clinics is expected to significantly reduce Medicaid patients’ access to and choice of affordable, quality family-planning care.
Supreme Court Agrees to Hear a Lawsuit Surrounding Religious Exemptions for Unemployment Systems
The Supreme Court agreed to hear a lawsuit filed by the Wisconsin chapter of Catholic Charities after the organization was disqualified from Wisconsin’s religious exemption.
Wisconsin’s unemployment tax system reserves religious exemption for organizations “operated primarily for religious purposes.” The Wisconsin Supreme Court maintained Catholic Charities did not meet that requirement because it serves and employs individuals outside of the Catholic faith and provides services that secular organizations could offer.
The Supreme Court decision is expected to broadly impact state unemployment systems, as 47 states have similar laws. It will also likely shape how organizations are determined to have a religious purpose, potentially affecting First Amendment religious protections.
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Congressional Budget Office Discusses Extending Premium Tax Credits for Individuals Without Insurance
The Congressional Budget Office recently wrote a letter to Congress about the effects of extending the expanded premium tax credit structure provided in the American Rescue Plan Act of 2021 (ARPA).
The expanded credits lowered the amount individuals needed to pay for insurance, including for those with incomes above 400% of the federal poverty level. They significantly increased access to health care; however, the provisions will expire at the end of the 2025 calendar year.
Congressional Budget Office (CBO) Director Phillip Swagel warned of the significant harm associated with failing to extend the credits. CBO estimates that it would leave a staggering number of individuals unable to afford insurance:
- 2.2 million individuals in 2026
- 3.7 million individuals in 2027
- 3.8 million each year from 2026 to 2034
The CBO also predicts that ending the credits could lead to healthier individuals, without the incentive, to leave the marketplaces. This would lead to higher premiums for the remaining enrollees. Premiums could rise by 4.3% in 2026, by 7.7% in 2027, and by about 7.9% annually through 2034.
New Rule Requires State Title IV-E Agencies to Collect and Report ICWA Data
The Administration for Children and Families (ACF) has released a final rule amending the AFCARS regulations, mandating that state Title IV-E agencies collect and report key data elements related to the procedural requirements of the Indian Child Welfare Act (ICWA) of 1978. This rule aims to enhance transparency and accountability in child welfare practices affecting Native American children and families.
State Title IV-E agencies will now be required to gather and report the following information:
- Inquiry into ICWA Status: Whether the state asked certain individuals if the child qualifies as an Indian child under ICWA and when the agency first identified the child as potentially meeting this definition.
- ICWA Notice: Whether the child’s parent or Indian custodian was notified as required under ICWA.
- Court Determination of ICWA Applicability: Whether and when a court ruled that ICWA applies to the child’s case.
- Tribal Court Transfer Requests: Information on requests to transfer cases to Tribal court, including whether such requests were denied and the reasons for denial.
- Parental Rights Termination and Child Removals: Data on voluntary and involuntary terminations of parental rights and removals under ICWA.
- ICWA Placement Preferences: Information on whether the agency met the placement preferences specified by ICWA.
- Efforts to Prevent Family Separation: Whether the state Title IV-E agency made active efforts to prevent the separation of the Indian family.
State Title IV-E agencies will have three federal fiscal years to comply with the new requirements while continuing to report data already mandated by current regulations.
This updated rule highlights the importance of ICWA in protecting the welfare and cultural heritage of Native American children and families, ensuring that child welfare practices align with federal requirements.
Updates from the Judiciary
Supreme Court Considers Constitutionality of Ban on Gender-affirming Medical Treatments for Transgender Adolescents
The U.S. Supreme Court heard oral arguments in early December to determine the constitutionality of a Tennessee law banning puberty blockers, hormone therapy, and surgery for those under the age of 18. The law also criminalizes doctors and providers who seek to support transgender youth seeking gender-affirming affirming care. This ruling is expected to significantly shape transgender youth’s access to gender-affirming care, as 26 states have enacted similar laws or policies.
The Biden administration and three transgender youths and their families challenged the Tennessee law, contending it violates the Constitution’s equal protection clause. They highlighted the discrepancy in prohibiting the use of treatments for gender dysphoria, while retaining their legal use for other purposes, including congenital disorders or physical injuries.
However, Tennessee Solicitor General J. Matthew Rice argued that certain gender-affirming treatments may pose health risks and that gender exploration is sometimes temporary.
Conservative justices appeared to favor Tennessee’s position, with Chief Justice John Roberts asserting that the medical decisions should be determined by the people’s elected representatives, such as state legislatures rather than the judiciary. In contrast, liberal justices expressed concern over granting state legislatures significant authority to regulate medical decisions.
The Supreme Court is not expected to release its decision for several months, although its verdict will likely have significant implications for gender-affirming care for minors, as nearly 40% of transgender youth ages 13 to 17 currently live in states with restrictions.
Idaho Law Restricting Minors’ Ability to Access Out-of-State Abortions Partially Upheld
A federal appeals court will allow an Idaho law that will impose criminal penalties on those who help a minor obtain an out-of-state abortion without parental consent. Often referred to as an abortion trafficking ban, the first-of-its-kind law is intended to prevent minors from seeking abortions in neighboring states where the procedure is legal.
Idaho only allows abortions in medical emergencies and cases of rape or incest that are reported to police. While this is one of the strictest abortion bans in the country, neighboring states, Oregon, Washington, and Montana, have significantly fewer restrictions.
Adults who help a minor access a medical or surgical abortion by “recruiting, harboring, or transporting” them without parent or guardian’s permission are subject to a felony charge, punishable by two to five years in prison. The appellate panel permitted Idaho to enforce the law’s criminalization of “harboring or transporting” a minor, but the court maintained the state cannot prosecute individuals who simply provide information about where to obtain an abortion, or who provide other types of financial or logistical assistance to receive an abortion in a state that has legalized abortions.
The federal appeals court determined encouragement, counseling, and emotional support; education about available medical services and reproductive health care; and public advocacy promoting abortion care and abortion access were protected speech. Advocates agree and maintain it is a critical protection to ensure minors receive accurate information in Idaho, a state with severely restricted access to abortions.
Court Decision Raises the Bar for 501(c)(4) Nonprofits but Advocacy Remains Strong
A recent Fifth Circuit Court of Appeals ruling has introduced stricter standards for 501(c)(4) organizations seeking tax-exempt status. In the case, Memorial Hermann Accountable Care Organization v. Commissioner, the court applied a “substantial nonexempt purpose test,” which disqualifies organizations if any significant nonexempt activities exist. This replaces the more lenient “primary purpose test” previously used by the IRS.
This decision, which was influenced by the Supreme Court’s Loper Bright Enterprises v. Raimondo ruling, underscores the increasing need for nonprofits to demonstrate that their activities benefit the public good. However, this does not signal a need for organizations to scale back lobbying or advocacy efforts. Under the Internal Revenue Code, 501(c)(4) organizations can engage in unlimited lobbying and advocacy if political campaign activity remains a secondary purpose, far below 50% of total spending.
While the ruling directly impacts 501(c)(4) nonprofits, it has broader implications for 501(c)(3) organizations. Increased scrutiny of tax-exempt organizations may lead to more rigorous oversight of 501(c)(3) activities, especially those related to related to advocacy and lobbying. Although 501(c)(3) organizations face stricter lobbying limits than 501(c)(4)s, they must carefully document their compliance with IRS regulations to ensure their advocacy activities are within permissible bounds. This includes tracking expenditures and maintaining clear distinctions between advocacy and political campaign activities.
Although the ruling raises concerns about compliance, it’s important to avoid undue fear. Advocacy and lobbying remain essential for 501(c)(4) organizations to influence policy and serve their missions. To mitigate risks, organizations can take proactive steps, such as ensuring diverse funding sources, including outside representation on governing boards, and thoroughly vetting activities to emphasize their social welfare impact. By focusing on transparency and aligning programs with their public mission, nonprofits can confidently continue their vital work while adhering to evolving regulatory standards.
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On Nov. 15, the Departments of Education and Health and Human Services released updated guidance to enhance educational stability and success for children in foster care. This new guidance builds on and strengthens the 2016 guidance, offering clearer recommendations for state and local education agencies and child welfare agencies working with foster children. The guidance addresses frequently asked questions about crucial topics such as Title I educational stability provisions as well as data collection to support students in foster care.
While the updated guidance does not change the existing policy, it aims to improve the implementation of foster care stability provisions by clarifying how they intersect with other educational programs. The goal is to provide more comprehensive support for foster care students through a stronger, more collaborative approach. The guidance also recognizes the unique intersectional identities of foster children, highlighting additional support programs available through the Departments of Education and Health and Human Services. Overall, this initiative seeks to ensure children in foster care receive the stability and support they need to succeed academically, underlining the importance of educational stability for foster children under Title I.
House Subcommittee Examines Safety and Vetting Policies for Unaccompanied Migrant Children
On Nov. 20, the House Judiciary Subcommittee on Immigration Integrity, Security, and Enforcement held a hearing to examine the processing of unaccompanied alien children by the Department of Homeland Security (DHS) and the Department of Health and Human Services (HHS) Office of Refugee Resettlement. The focus of the hearing was on policies related to unaccompanied minors, including the vetting of sponsors and guardians, and safeguarding children from potential threats such as human traffickers. The committee also addressed concerns regarding reports of missing migrant children in HHS custody and the efforts to locate them.
Chairmen Clay Higgins (R-La.) and Dan Bishop (R-N.C.) opened the hearing, emphasizing the government’s responsibility to protect vulnerable children. HHS Secretary Xavier Becerra later testified, outlining the safety protocols in place for children after being released to vetted sponsors. While acknowledging the agency’s limited authority to monitor children once they are discharged, Becerra highlighted the agency’s efforts, such as follow-up phone calls and post-release services, to ensure the children’s safety and wellbeing. He reaffirmed HHS’s commitment to adhering to child welfare best practices, prioritizing the best interests of the children in their care.
HHS Removes Barriers for HIV-Positive Patients, Expanding Access to Life-Saving Kidney and Liver Transplants
On Nov. 26, the Department of Health and Human Services (HHS) announced a new final rule that removes clinical research requirements for kidney and liver transplants between donors and recipients with HIV. This rule is part of the ongoing implementation of the HIV Organ Policy Equity (HOPE) Act, which aims to increase the availability of organs for transplant and reduce stigma for people with HIV. By eliminating the need for institutional review board approvals and clinical research for these transplants, the rule reflects robust research showing the safety and effectiveness of kidney and liver transplants in HIV-positive individuals.
This policy change is expected to streamline the transplantation process, reduce wait times for individuals in need of organs, and lower healthcare costs. It will also significantly increase the availability of life-saving organs for all patients, regardless of their HIV status. Admiral Rachel L. Levine, M.D., Assistant Secretary for Health, emphasized that the move aligns with the latest evidence and reflects the commitment to improving healthcare access for people with HIV. Along with the final rule, the National Institutes of Health (NIH) is seeking public input on revising research criteria for other organ transplants under the HOPE Act, aiming to expand the program further and continue building evidence on transplant outcomes for individuals with HIV.
Updates from the Judiciary
Federal Appeals Court Upholds Indiana’s Ban on Gender Affirming Care
On Nov. 26, the 7th U.S. Circuit Court of Appeals upheld an Indiana law banning the use of puberty blockers and hormones for transgender minors under 18. The court ruled the law does not discriminate based on sex because it prohibits gender transition procedures for all minors, regardless of their sex assigned at birth. They also concluded the law does not violate the constitutional rights of transgender children, their parents, or medical providers. This ruling comes as more states have passed similar laws, with over 20 states enacting restrictions on gender-affirming care since 2021.
The Indiana law mirrors a similar law in Tennessee, which is set to be reviewed by the U.S. Supreme Court in the case United States v. Skrmetti. The main issues in the case include whether banning gender-affirming care violates the 14th Amendment, whether it infringes on parents’ rights to make medical decisions for their children, and whether these laws should undergo heightened scrutiny. The 7th Circuit’s ruling could serve as an important legal precedent for the Supreme Court as it decides on the national availability of gender-affirming care for minors.
Wyoming Court Blocks Statewide Abortion Ban, Protects Access to Medication Abortion
On Nov. 26, Judge Melissa Owens of Wyoming’s Ninth District Court blocked the state’s total abortion ban, including the nation’s first explicit prohibition on the use of medication for abortion. Judge Owens ruled that the ban would interfere with the integrity of the medical profession by limiting doctors’ ability to provide evidence-based care. She also determined that Wyoming’s abortion laws violate the state’s constitution, which guarantees individuals the right to personal autonomy in medical decisions. The judge emphasized that the decision to have an abortion should be made by the pregnant individual, not by any other party.
The ruling has significant implications for abortion access in Wyoming, as it temporarily prevents the enforcement of the restrictive laws. Governor Mark Gordon said the state plans to appeal the decision to the Wyoming Supreme Court, indicating an ongoing legal battle over abortion rights in the state.
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We recognize organizations and communities may be experiencing unease and uncertainty following the results of the 2024 election.
To assist in navigating changing political landscapes, Social Current invites you to a free webinar designed to empower nonprofits with the knowledge and tools for effective advocacy and policy engagement. The webinar offers an opportunity to grow your organization’s expertise in policy and advocacy through strategies to channel concerns into actionable advocacy plans. Interactive sessions will detail key tactics to advance organizations’ missions and strengthen the communities served.
The webinar is scheduled for Wednesday, Dec. 4, from 1-2:30 p.m. ET. Participants will gain a comprehensive understanding of building policy literacy, crafting compelling narratives, engaging in coalition building, and developing disciplined messaging strategies.
State Ballot Measures
Abortion Access
Ballot measures to enshrine the right to abortion into states’ constitutions passed in seven states: Arizona, Colorado, Maryland, Missouri, Montana, New York, and Nevada. Ballot measures to expand abortion access failed in Florida, Nebraska, and South Dakota. Access to abortion impacts maternal health.
Minimum Wage
Voters in Missouri and Alaska approved measures to raise the states’ minimum wage and require employers to provide earned paid sick time. Alaska’s minimum wage will increase to $15 per hour by 2025 and Missouri’s to $13.75 per hour by 2026.
Online School Meal Fees are Terminated for Low-Income Families
The U.S. Department of Agriculture announced processing fees will not be charged to students eligible for free or reduced-price school meals, effective during the 2027-2028 school year.
School districts often partner with processing companies to offer families online, cashless payment systems. While the fees and rates can be negotiated, the concentration of just three leading companies limits competition and complicates contract negotiations.
These processing fees present critical challenges to families, especially those with lower incomes who rely on weekly transactions. On average, companies charge approximately $2.37, or 4.4% of the total transaction, each time money is added to a child’s account. The U.S. Department of Agriculture estimates families who qualify for free or reduced-price lunch pay nearly sixty cents per dollar in fees when paying electronically.
The rule is expected to generate significant cost savings for families, as school lunch fees collectively cost upwards of $100 million each year.
Centers for Medicare & Medicaid Services Improve Access and Care Standards
The Centers for Medicare & Medicaid Services (CMS) have finalized several key healthcare policies to improve access and care standards. For example, Medicaid and the Children’s Health Insurance Program (CHIP) have mandated continuous 12-month eligibility for children under 19 (with restrictions on disenrollment for nonpayment during that period). Additionally, new obstetrical care standards require facilities to be prepared for emergencies as well as staffed by trained professionals. Expanded preventive care now includes coverage for follow-up colorectal cancer screenings and HIV pre-exposure prophylaxis (PrEP). Medicaid clinic services will also be more flexible, with exceptions for Indian Health Service and Tribal clinics, behavioral health clinics, and rural clinics to deliver care outside traditional settings.
CMS is emphasizing health equity through new quality reporting requirements for surgical centers, rural hospitals, and outpatient facilities, including screenings for social drivers of health and patient understanding of recovery. Telehealth policies have also been expanded, making audio-only telehealth permanent and exploring coverage for remote diabetes, nutrition, and mental health services under Medicare. These changes aim to increase healthcare access, enhance quality, and address social and health disparities across populations.
Updates from the Judiciary
Texas Court Considers Overtime Rule
On Nov. 8, the Eastern District Court of Texas held oral arguments on the legality of an overtime rule issued by the Biden Administration’s Department of Labor. The rule aims to expand overtime pay eligibility to salaried workers earning less than $58,656 annually, potentially affecting four million employees. Texas and several business groups have sued, claiming the rule exceeds the Department of Labor’s authority under the Fair Labor Standards Act (FLSA), additionally violating the Administrative Procedure Act. They have requested a preliminary injunction, which currently applies only to Texas employers, be expanded nationwide.
While parts of the rule are already in effect, the salary threshold increase to $58,656 for overtime exemptions is set to take effect on Jan. 1, 2025. U.S. District Judge Sean Jordan previously granted the preliminary injunction to block the rule in Texas while litigation continues. The U.S. Court of Appeals for the Fifth Circuit has also weighed in, affirming the Department of Labor has the authority to use salary as a factor for determining overtime eligibility, but warned the agency’s power is not unlimited. The case currently remains unresolved as further legal proceedings unfold.
Court Upholds Emergency Health Care to Undocumented Immigrants
On Nov. 8, the Florida First District Court of Appeal ruled that the state cannot require hospitals to return Medicaid payments made retroactively for emergency care provided to undocumented immigrants. While undocumented citizens are generally ineligible for Medicaid, federal law mandates that states offer limited Medicaid coverage for emergency medical situations involving migrants, such as dialysis, childbirth, or trauma.
The court’s decision reinforces a key ruling from 2019, which found that Florida cannot pursue Medicaid fraud cases related to these payments, including actions by the state’s Bureau of Medicaid Program Integrity (MPI), a fraud detection unit. The court clarified that the recent changes to the Medicaid laws do not override the 2019 ruling.
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The Administration for Children and Families (ACF) released its inaugural data strategy to promote equity, enhance support for grant recipients, and invest in improved disaster preparation. ACF envisions 12 initiatives to responsibly exchange data across the human services landscapes. These initiatives are split among four categories to better inform policy and safely deliver services and benefits more quickly.
- Sustaining Initiatives will develop the foundational infrastructure to support the data strategy, including by creating a long-term funding and investment plan and establishing a data governance council.
- One Stop Shop Initiatives will create centralized resources to support program offices in building their data capacity, including by creating a data talent center to support hiring and team development.
- Delivery Initiatives will advance ACF’s use of data, including through centralized resources that support program offices in building their data capacity and by releasing community-centered data tools and stories.
- Technology Initiatives will provide the technology platforms and tools needed to streamline data reliability and enhance collaboration, including the launch of a customer relationship management system to coordinate across ACF.
Download a comprehensive overview of their data strategy to learn more about each of the initiatives and how they will support and strengthen data sharing throughout the sector.
Biden Administration Proposes New Rule to Increase Coverage of Contraception for Private Health Insurance Holders
The Departments of Health and Human Services, Labor, and Treasury recently released a proposed rule to significantly increase contraception coverage under the Affordable Care Act. The rule would enable women to obtain over the counter (OTC) contraception without a prescription at no additional cost such as emergency contraception and Opill, the first oral contraceptive approved by the Food and Drug Administration (FDA) for use without a prescription.
Additionally, the rule is expected to increase choice by mandating that plans and issuers expand the coverage of oral contraceptives and drug-led combination products, including intrauterine devices (IUDs). It reinforces plans and issuers’ responsibility to cover FDA-approved, cleared, and granted birth control methods at no cost to recipients.
The rule would require most private health plans to disclose OTC contraception is available without cost sharing or a prescription as well as to assist women in learning about their contraception coverage. Under the rule, plans and issuers would also be required to add a disclosure to the results of any online Transparency in Coverage self-service tool search for covered contraceptives explaining OTC contraceptives’ coverage.
Alongside the proposed rule, the Biden Administration issued guidance to ensure patients can access other preventative services, including cancer screenings, without cost. Comments may be submitted until Friday, Dec. 27.
IRS Releases Benefit Plan Notices
The IRS has issued guidance to expand the preventive care items and services High-Deductible Health Plans (HDHPs) may cover before plan deductibles are met.
Two notices released by the agency, which outline both expenses treated as paid medical care as well as preventive care for purposes of qualifying as a HDHP, include over-the-counter oral contraceptives, including OTC birth control pills, male condoms, and emergency contraceptives, regardless of whether they are purchased with a prescription. Non-mammogram breast cancer screenings, continuous glucose monitors, and selected insulin products were also named in the preventative care coverage.
Updates from the Judiciary
FTC Appeals Fifth Circuit Court’s Noncompete Ban
The Federal Trade Commission (FTC) requested the 5th U.S. Circuit Court of Appeals to review a Texas district court’s ruling which set aside the FTC’s ban on noncompete agreements in employment contracts. The Northern District of Texas issued its ruling in August, maintaining the FTC’s ban violated the Administrative Procedure Act by exceeding the commission’s statutory authority. The lower court argued that the Federal Trade Commission does not have the authority to create substantive rules regarding unfair methods of competition. The ruling stopped the Non-Compete Rule from nationwide enforcement.
The FTC’s non-compete rule would have prohibited employers from entering and enforcing new non-competes with all workers including, but not limited to: employees, independent contractors, externs, interns, volunteers, apprentices, and sole proprietors who provide a service to a client. It would require employers to notify current and former workers, excluding senior executives, that their non-competes are no longer enforceable. The rule would also render existing non-competes unenforceable, excluding senior executives.
A federal court in Florida similarly rejected the non-compete rule, but alternatively grounded their decision in the major questions doctrine. The major questions doctrine refers to the Supreme Court declaration that if an agency seeks to decide an issue of major national significance, its action must have clear congressional authorization. Considering the economic significance of non-competes, Florida’s federal judges ruled against their implementation. The FTC has since appealed its decision, although the rule remains paused.
A federal court in Pennsylvania upheld the rule, however, the company which brought the suit has since withdrawn the case. The judges rejected the company’s claims it would suffer irreparable harm to its contractual rights and investments in specialized training if the rule were to go into effect. The judges also affirmed the FTC acted within its authority to designate all non-compete clauses as unfair methods of competition.
As the FTC’s appeals are considered, employers can continue utilizing non-competes. The judges’ decisions, however, will likely have significant implications for the future of non-competes in employment contracts nationwide and will play a key role in defining the scope of the FTC’s regulatory authority.
Pharmaceutical Companies Appeal Medicare Drug Price Negotiation Program
AstraZeneca, Bristol Myers Squibb, and Janssen requested the Third Circuit Court of Appeals to revive their previously dismissed lawsuits challenging the government’s authority to negotiate Medicare drug prices.
Through the first round of negotiations, the prices of AstraZeneca’s diabetes medication, Farxiga, Bristol Myers’ blood thinner, Eliquis, and Janssen’s blood thinner, Xarelto, were each reduced between 56% and 68%. The negotiated prices will go into effect in 2026 and, projected, will save Medicare approximately six billion in the first year.
The pharmaceutical companies raised numerous concerns, such as the severe consequences of refusing to accept negotiated prices. Either by accepting steep penalties or withdrawing from Medicare, Bristol Myers Squibb argued the negotiation process amounts to an unconstitutional taking of property without just compensation.
Meanwhile, Janssen’s attorney grounded their argument in First Amendment concerns, maintaining that requiring companies to agree to a “maximum fair price” compels speech which violates their constitutional rights.
The pharmaceutical industry has filed eight lawsuits against the Biden Administration, challenging the validity of Medicare’s negotiation authority. Federal courts have continued to uphold the constitutionality of the drug price negotiation program, enforcing the importance of the Third Circuit’s ruling. A ruling in favor of Medicare would fortify the precedent needed to discourage future challenges. A ruling in favor of the pharmaceutical companies, however, is expected to impact access to life-saving medications significantly.
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The White House recently held a convening on child care to discuss state actions to improve the affordability of child care for working families, increase the number of child care providers, and improve child care workers’ job quality.
Lawmakers and organizations from 34 states across the country reflected on key strides, pathways for growth, and challenges faced within child care and early childhood education throughout the past year. State leaders discussed potential legislation to serve a greater number of working families, lower costs, and support providers. Key issues that were discussed included early childhood education teacher compensation and benefits, supply-building strategies, access and affordability of child care, and quality care assurance.
White House officials thanked state legislators for their leadership and expressed the Biden administration’s support for continued federal and state action to improve access to affordable, high-quality child care and support child care providers.
New Report on Maternal Health Care Access in Medicaid Managed Care
The U.S. Department of Health and Human Services’ Office of Inspector General (OIG) recently issued a report surrounding Medicaid managed care enrollees’ access to maternal health care. The review was conducted because of the country’s maternal health crisis, which is marked by significant racial and geographic disparities in maternal deaths and complications. The report emphasized the importance of Medicaid as the nation’s largest maternal health care payor.
States use provider coverage rules and network adequacy standards to ensure that Medicaid managed care enrollees retain adequate access to care. However, the OIG found states are not leveraging managed care provider coverage requirements and network adequacy standards to promote access to maternal health care services that can support improved maternal and infant health.
Specifically, many states do not cover mental health providers and professionals outside of OB-GYN physicians and hospital births, including midwives, maternal-fetal medicine specialists, doulas, and community health workers, some of whose services are federally required.
Other states were found to not utilize network adequacy standards, including time and distance requirements, which limit the distance enrollees should have to travel to visit their provider. Additional standards included appointment wait times to reduce how long patients wait for a visit and provider to enrollee ratio standards, which dictate the number of providers that networks must have in proportion to number of enrollees.
Vitally, some states lack data on how the standards impact enrollees’ access to maternal health care. The OIG accordingly recommends the Centers for Medicare & Medicaid Services (CMS) confirm all states cover required services from maternal health care providers for Medicaid managed care enrollees. They additionally recommend clarifying the requirement that States have a provider-specific OB-GYN network adequacy standard and supporting states in tailoring their network adequacy standards to better address maternal health care needs.
CMS agrees with each of OIG’s recommendations and is expected to respond with a plan of action within six months. CMS is planning outreach with states to ensure managed care enrollees have access to all required maternal health services. The agency will also assist states in adjusting network adequacy standards to meet the needs of residents in their states.
Final Guidance for Second Cycle of the Medicare Drug Price Negotiation Program
The Department of Health and Human Services recently released guidance outlining the process for the second cycle of negotiations under the Medicare Drug Price Negotiation Program.
The guidance centers how Centers for Medicare & Medicaid Services (CMS) will assist Medicare beneficiaries in accessing needed medications once negotiated prices become effective in 2026 and 2027, respectively. It discusses the requirements and parameters for how participating entities, including pharmacies and mail order services, will ensure designated Medicare Part D beneficiaries will have access to the negotiated prices.
The guidance also contains a key safeguard to ensure access to the maximum fair prices by allowing CMS to engage with a Medicare Transaction Facilitator to ease data sharing. Drug companies will also have access to the Facilitator for optional, voluntary payments between eligible individuals with Medicare and the pharmacies that serve them.
The next 15 medications covered by Part D for the second cycle of negotiations will be announced by February 1, 2025, while the negotiated prices will be effective beginning January 1, 2027. Fifteen patient-focused roundtables and one town hall meeting will also be held through spring 2025.
For additional information, CMS issued a fact sheet.
Additional Steps to Lower Prescription Drug Costs
HHS additionally released a request for information and a sample list of prescription drugs that the agency preliminarily intends to include under the proposed Medicare $2 Drug List Model, a key strategy within President Biden’s broader efforts to increase healthcare affordability and accessibility.
The Model provides a fixed copayment of no more than $2 for a month’s supply per drug for eligible Medicare Part D beneficiaries. The medications are intended to treat common conditions, such as high cholesterol and high blood pressure.
The Center for Medicare and Medicaid Innovation has released the plan with the intent of determining whether a simplified approach to offering low-cost, clinically important generic drugs can improve medication adherence, lead to better health outcomes, and improve satisfaction with the Part D prescription drug benefit among people with Medicare and prescribers.
Participation in the model is voluntary for Part D sponsors and, pending further development, is estimated to start as early as January 2027. Comments may be submitted until Dec. 9.
Updates from the Judiciary
Growing Concern of Social Media’s Impact on Adolescent Mental Health
Fourteen attorneys general, led by officials in New York and California, individually filed lawsuits against TikTok, claiming the social media platform damages young users’ mental health and collects the data of users younger than 13 without parental consent.
The bipartisan coalition alleged TikTok violates safety laws by claiming the platform is safe for youth, despite addictive features like 24/7 notifications and video autoplay. The filings also highlight dangerous TikTok challenges.
The legal coalition includes the attorneys general of California; Illinois; Kentucky; Louisiana; Massachusetts; Mississippi; New Jersey; New York; North Carolina; Oregon; South Carolina; Vermont; Washington; and Washington, D.C.
The lawsuit follows the passage of the Kids Online Safety Act (KOSA) through the House Energy and Commerce Committee and the Senate, which expressed overwhelming support as 91 Senators voted in favor. KOSA is intended to boost online privacy and safety for children, regulating the features offered and reducing the addictive nature of the platform. Nevertheless, bipartisan concerns have been raised of censorship and the suppression of free speech.
Federal Judge Removed from a Thirteen-Year Lawsuit Against Texas’ Child Protective Services
The Fifth Circuit Court of Appeals unanimously voted to remove Judge Janis Jack, a federal judge for the U.S. District Court for the Southern District of Texas. The Fifth Circuit detailed several instances in which Judge Jack was disrespectful and antagonistic toward Texas state employees and their lawyers. The Fifth Circuit judges maintained she inappropriately urged and instigated lawyers representing foster care children to provide evidence that Texas is willfully disregarding her orders for systemic improvements.
Judge Jack’s removal primarily follows the expansive reforms she mandated after determining Texas’ foster care system violated children’s constitutional rights. She levied heavy fines when state officials failed to meet compliance standards and found the state in contempt three times for failing to address unsafe conditions.
In April, Judge Jack issued a ruling that found Texas Department of Health and Human Services Commissioner Cecile E. Young, in contempt of her court orders to fix the way the state investigates complaints by children in its care. Her ruling carried a daily fine of $100,000 until the state could demonstrate an attempt to address its routine neglect of investigations into allegations of abuse and neglect of children in foster care.
The Fifth Circuit blocked that fine two days after Jack’s ruling and recently reversed it, maintaining it violates the court’s constitutional limits of power over individual states. The Fifth Circuit further affirmed federal judges do not have the power to become de facto superintendents, permanently overseeing major state agencies. Moreover, federal courts are not allowed to thwart the state’s self-management as they work to address identified abuses.
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