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:

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 several webinars and trainings. Register now to participate:

“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:

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: 

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 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: 

President Biden Signs Key Legislation 

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.  

Subscribe to the Policy and Advocacy Radar to receive our biweekly policy roundup, which includes commentary on issues in Social Current’s federal policy agenda, opportunities to take action, and curated news and opportunities.

Social Current’s grassroots advocacy network offers an opportunity to work collaboratively with other human service organizations to create positive social change. The grassroots advocacy network is a rapid response team that will take collective action to drive timely, impactful solutions. Participants will receive opportunities to grow your advocacy skills, connect with like-minded advocates, and amplify their organizations’ work. 

By joining, advocates will: 

Share your information to join. 

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: 

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:

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.


Subscribe to the Policy and Advocacy Radar to receive our biweekly policy roundup, which includes commentary on issues in Social Current’s federal policy agenda, opportunities to take action, and curated news and opportunities.

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.

Subscribe to the Policy and Advocacy Radar to receive our biweekly policy roundup, which includes commentary on issues in Social Current’s federal policy agenda, opportunities to take action, and curated news and opportunities.

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.

Subscribe to the Policy and Advocacy Radar to receive our biweekly policy roundup, which includes commentary on issues in Social Current’s federal policy agenda, opportunities to take action, and curated news and opportunities.

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.

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.

Subscribe to the Policy and Advocacy Radar to receive our biweekly policy roundup, which includes commentary on issues in Social Current’s federal policy agenda, opportunities to take action, and curated news and opportunities.

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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The Office of Management and Budget (OMB) recently released guidance, effective Oct. 1, to reduce the barriers organizations face in accessing government grants. The revisions are intended to offer clarity and improve the readability of funding opportunities through plain, concise, consistent language. They are also expected to address longstanding challenges to recovering actual costs and reduce the burdens and costs of seeking, performing, and reporting on federal grants.

A few key provisions are highlighted below:

Notice of Funding Opportunity: Funding details, an executive summary, and key dates will be required to be listed at the top of the notice before the announcement’s full text.

Reimbursement for Indirect Costs: Passthrough entities, often states and local governments and occasionally larger nonprofits, that use federal funds and all federal departments and agencies are required to reimburse a nonprofit for the reasonable indirect costs incurred performing services on behalf of governments.

15% Minimum Rate: Federal grants are now required to provide the guaranteed minimum (de minimis) rate for indirect costs of 15% of modified total direct costs. Federal agencies cannot compel recipients and subrecipients to use an indirect rate lower than the 15% de minimis rate unless required by statute. While organizations may choose not to utilize the 15% minimum, they cannot be forced to.

Mandated Application: Nonprofits are allowed to negotiate a higher rate through a negotiated indirect cost rate agreement (NICRA). Passthrough entities are then required to accept a grantee’s NICRA, although it remains subject to statutory and a few other limitations. Nonprofits with negotiated rates with one federal agency must be paid that same rate by all other federal, state, and local government agencies.

Right of Appeal: Receipts and subrecipients are now empowered to notify OMB of any disputes over how a federal agency applies or accepts their federally negotiated indirect cost rates or fails to pay the minimum indirect cost rate. For the first time, nonprofits can turn to OMB for help when federal agencies are not following the law.

Upfront Payments: Once financial and written procedures are met, the recipient or subrecipient of federal grants must be paid in advance. Meanwhile, reimbursable grants are preferred only when those requirements cannot be met. The guidance offers key flexibility as governments can be encouraged to make advance payments to nonprofits, rather than assuming that reimbursable grants are their only option or default.

Reporting Requirements: Federal agencies are instructed to eliminate reports that are not necessary to effectively monitor the grant. By encouraging agencies to only measure things that matter, nonprofits are able to redirect their efforts from burdensome, needlessly complex reporting requirements toward serving their communities.

Continuing Resolution Approved, Preventing a Government Shutdown

The U.S. House of Representatives and Senate negotiated a bipartisan continuing resolution to continue funding the government until Dec. 20. President Biden signed the bill shortly afterward. Congress has since adjourned and will return to session Nov. 12 to negotiate spending agreements on FY2025 spending bills funding key services, including housing and transportation.

A few of the programs and services that will continue to receive funding are included below:

Executive Order to Address Emerging Firearms Threats and Improve School-Based Active-Shooter Drills

President Biden recently issued an executive order to address emerging firearms threats, including by preventing unauthorized access to firearms for youth and individuals in crisis. The order strives to address the mental health needs of students, particularly those impacted by gun violence. It also intends to support schools that are implementing evidence-based safety and gun violence prevention and intervention solutions.

The executive order additionally created an Interagency Emerging Firearms Threats Task Force to develop a risk assessment and strategy to stop the proliferation of machine gun conversion devices and address the emerging threat related to 3D printed firearms. Additionally, it directs key government agencies to develop and publish information about school-based active shooter drills for schools, including the appropriate frequency of such drills and the effects of such drills on students and educators.

Throughout, President Biden enforced the importance of an integrated approach to promoting the safety of students and educators, uniting the Department of Justice, the Department of Health and Human Services, the Department of Education, and the Department of Homeland Security.

House Ways and Means Committee Holds Hearing on Reforming Temporary Assistance for Needy Families

Chairman Jason Smith (R-Mo.) highlighted the House Ways and Means Committee’s efforts to promote stable, prosperous lives for families, including by reforming direct cash assistance. He stressed the importance of restoring integrity and accountability to Temporary Assistance for Needy Families (TANF) as he lamented waste, fraud, and abuse. Chairman Smith discussed the importance of guardrails to ensure funds are directed to those in need, including through data collection.

Ranking Member Richard Neal (D-Mass.) echoed the profound impact TANF funds can have on the well-being of families and the importance of ensuring families receive the assistance they deserve. He affirmed the importance of a multifaceted approach, including through an expanded Child Tax Credit, guaranteed child care, and paid family and medical leave.

Sam Adolphsen, policy director of the Foundation for Government Accountability, and Brett Favre, a former professional football player, spoke of the positive impacts of TANF through economic growth and falling rates of childhood poverty. They also discussed egregious instances of fraud, waste, and abuse associated with TANF funds and emphasized the importance of addressing loopholes that allow the misuse of funds. They recommended rebalancing program spending on work-related activities to combat fraud alongside increased accountability, oversight, and stronger guardrails.

Jarvis Dortch, executive director of the American Civil Liberties Union (ACLU) of Mississippi, echoed the presence of widespread abuse and fraud of TANF funds in Mississippi. He recommended policies that verify families in need are receiving assistance and stressed the importance of directing funds toward programs that meet the spirit of TANF, including quality child care and access to transportation. He warned of the harm of redundant verification systems while encouraging innovative programs to advance employment and assist low-income families. Dortch also urged the committee to pass legislation creating a TANF ombudsman program, which would be able to ensure compliance, monitor misspending, and gather data.

Representatives discussed potential reforms to ensure TANF-funded programs help those most in need while safeguarding against fraud and abuse. Representatives and witnesses also discussed the importance of work, underscoring the lack of requirements, incentives, and minimum standards for state spending on work, education, and training activities among TANF’s non-assistance funds. The hearing follows a report issued by the Government Accountability Office outlining preliminary observations on state budget decisions, single audit filings, and fraud risks within TANF.

Sector Updates from the Judiciary

Salary Tests Upheld for Overtime Pay
A Texas businessman recently challenged a rule issued by the Department of Labor in 2019. The rule raised the required minimum weekly salary to qualify for the exemptions for executives, administrators, and professionals (EAP) by more than 50%, from $455 to $684 per week.

On Sept. 11, 2024, the U.S. Court of Appeals for the Fifth Circuit ruled in favor of the U.S. Department of Labor. They affirmed the department’s authority to use a salary basis to define its white-collar overtime exemptions and to define the professions classified within the EAP exemptions.

The ruling establishes key precedent to defend the recently published April 2024 rule to further increase the minimum salary requirement for the EAP exemptions in similar legal challenges. Nevertheless, potential challenges to the 2024 rule remain, including from a Texas district court that has temporarily prevented the rule from taking effect for the state government’s employees.

The 2024 DOL rule raised the minimum weekly salary to qualify for the EAP exemption from $684 per week to $844 per week, or the equivalent salary of $43,888 per year, on July 1, 2024. Salaries are set to rise again on Jan. 1, 2025, when the minimum salary will increase to $1,128 per week, the equivalent of a $58,656 annual salary. Under the rule, the salary threshold would increase every three years based on up-to-date wage data.

For more information on the rule and employee classifications, view the Department of Labor’s fact sheet.

Student Loan Forgiveness Remains on Pause
Judge Hall, a judge for the District Court for the Southern District of Georgia, recently moved a challenge to President Biden’s student loan forgiveness plan from Georgia to Missouri. The challenge was brought by a coalition of seven Republican-led states, including Alabama, Arkansas, Florida, Georgia, Missouri, North Dakota, and Ohio.

Biden’s plan to ease student loan debt would erase up to $20,000 in interest for those who have seen their original balances increase. It would also provide relief to individuals who have been repaying their loans for 20 to 25 years.

Judge Hall ruled that Georgia failed to demonstrate it would experience harm following student loan relief. The Judge allowed the suit to be moved to Missouri, which stands to lose millions directly through the Missouri Higher Education Loan Authority, the nonprofit student loan servicer the state operates.

Judge Matthew Schelp, a district judge based in St. Louis, has since issued a preliminary injunction against President Biden’s student loan relief plan. Borrowers are not expected to witness any changes as student loan relief remains paused.

Texas Sues to Stop Biden Administration Rule Requiring Affirming Placements for Youth in Foster Care
Texas Attorney General Ken Paxton recently filed a lawsuit against the federal government claiming the requirement that states provide LGBTQ+ affirming placement for foster care youth would exacerbate the shortage of foster families.

The rule requires that child welfare agencies ensure that a foster parent is supportive of the child’s LGBTQI+ status, is knowledgeable and skilled to address the child’s needs, and is willing to provide access to appropriate resources to support the child’s well-being. Agencies are required to implement the rule by Oct. 1, 2026 as non-compliance jeopardizes Title IV-E and Title IV-B funding.

Paxton alleged the U.S. Department of Health and Human Services does not have the statutory authority to implement the rule and that it further violates the U.S. Constitution’s Spending Clause without fair notice. He additionally maintained the rule violates the Administrative Procedure Act as Title IV does not include any requirement for special accommodations for sexual orientation or gender identity.

Texas has asserted that the Texas Department of Family and Protective Services will implement the rule, but remains concerned of the potential harm to the state’s financial security and sovereignty. The suit asks the court to declare the rule unlawful, postpone its effective date, and grant a permanent injunction against its enforcement.

New Jersey Sues Hospitals Over ‘Discriminatory’ Pregnancy Drug Screens
New Jersey Attorney General Matthew J. Platkin and Director of the New Jersey Division on Civil Rights Sundeep Iyer filed a lawsuit against three Virtua hospitals in Southern New Jersey. The suit follows an investigation into complaints filed with the Division of Civil Rights by several pregnant women who gave birth at Virtua Voorhees Hospital. The patients were drug tested without informed consent after being admitted to the labor and delivery and high-risk obstetrics units.

The lawsuit claims the hospital’s mandatory drug testing policy violates the New Jersey Law Against Discrimination and the state’s right to privacy. Iyer underscored the potential trauma of the policy, as several families faced lengthy investigations for child abuse following screenings that incorrectly indicated drug use. Once the results were shared with New Jersey’s child welfare agencies, several individuals experienced unannounced home visits and some patients were not allowed to be discharged with their babies.

The lawsuit asks for an injunction to stop Virtua’s universal drug testing policy for pregnant patients and civil penalties against the South Jersey hospital system, including compensatory damages.

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On Sept. 9, President Joe Biden and Vice President Kamala Harris announced a rule that is expected to significantly advance parity for mental health care coverage. The protections will ensure mental health care coverage for 175 million Americans is on par with their physical health care coverage.

As President Biden stated, “Mental health care is health care. But for far too many Americans, critical care and treatments are out of reach. Today, my Administration is taking action to address our nation’s mental health crisis by ensuring mental health coverage will be covered at the same level as other health care for Americans. There is no reason that breaking your arm should be treated differently than having a mental health condition.”

The rule builds on the bipartisan Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA). MHPAEA fortified key protections to ensure group health plans and health insurance issuers that provide mental health or substance use disorder benefits do not enact less favorable benefit limitations compared to their medical/surgical benefits. 

The rule requires health plans to evaluate their mental health care access, including assessing provider networks, payment rates for out-of-network providers, as well as using prior authorizations. It must then act accordingly to provide needed changes, potentially by expanding its network of mental health professionals or reducing bureaucratic hurdles. Health plans are also required to use similar factors in setting out-of-network payment rates for mental health and substance use disorder providers as they would for medical providers.

The above protections, and the inclusion of non-federal governmental health plans, are critical steps to increasing the accessibility and affordability of mental health care. For additional information, please see the U.S. Department of Labor’s general fact sheet as well as explanations for participants/beneficiaries, providers, and plans and issuers. The White House has also made a fact sheet available.

Addressing Food Distribution Shortages in Tribal Communities

On Sept. 11, the House Committee on Appropriations held a Joint Oversight Hearing titled “Severe Food Distribution Shortages in Tribal and Elderly Communities.” Representatives discussed the shortage crisis caused by the U.S. Department of Agriculture (USDA)’s consolidation of warehouses supporting the Food Distribution Program on Indian Reservations (FDPIR) and the Commodity Supplemental Food Program. The programs collectively serve approximately 800,000 individuals, ensuring dietary staples are received monthly.

Witnesses detailed how the consolidation, and resulting food shortages, jeopardized the welfare of their communities through extended delivery delays, missing items, and receipt of damaged and expired food. The USDA offered temporary solutions, but most were inaccessible to tribes. While temporary funding provides short-term relief, it does not address the inherent problems that stem from relying on a singular warehouse and distribution center.

Recommendations included a permanent expansion of the FDPIR pilot program, including by expanding the program to the Commodity Supplemental Food Program. The Honorable Darrell G. Seki Sr., chairman of the Red Lake Band of Chippewa Indians, additionally recommended moving to a regional sourcing model as well as establishing an automatic tracking system for deliveries.

USDA Secretary Tom Vilsack affirmed the USDA’s commitment to ensuring access to safe and nutritious foods as well as better partnering with tribal nations to empower tribal food sovereignty. Secretary Vilsack acknowledged past failures and discussed efforts to resume and improve programs immediately as well as in the short and long-term future. He further echoed the importance of consistent communication and outreach through consultations and feedback, especially in developing a more resilient, reliable distribution system capable of meeting their partners’ needs.

Committee members stressed the importance of accountability considering the harm tribal communities faced and the failure to fulfill responsibilities to tribes. They collectively expressed the unacceptability of inadequate access to nutrition and the need for corrective action.

The Inflation Reduction Act and Reduced Health Care Costs for Americans

Sen. Wyden (D-Ore.) detailed the key protections the Inflation Reduction Act (IRA) has offered in increasing the affordability of health care, including price gouging penalties, the out-of-pocket cap on prescriptions through Medicare Part D, and lower premiums through enhanced tax credits. He stressed the importance of further protecting and strengthening its terms.

Ranking Member Crapo (R-Idaho) spoke of the potential consequences of the IRA, including its impact on research and development, citing the 21 medicines and 36 research programs that have been discontinued since the law’s enactment. While he affirmed the importance of capping out-of-pocket costs for seniors’ prescriptions, he stressed hidden costs, warning how tax credits would grow the deficit. Crapo affirmed his commitment to bipartisan solutions that improve health care choice, affordability, and reliability.

Theo Merkel, Director of the Private Health Reform Initiative, also highlighted concerns about the financial implications of permanently extending the premium tax credit, estimating it would add $415 billion to ACA spending over a decade. He warned that enhanced coverage could lead to reduced employer-provided insurance and suggested improving risk adjustment and direct cost-sharing reduction payments for eligible enrollees.

Kirsten Axelsen, a Nonresident Fellow at the American Enterprise Institute, echoed these concerns, cautioning that reduced revenue could hinder investments in drug development for critical areas like rare diseases and senior medications. She advocated for greater transparency in drug selection for the Medicare Drug Negotiation Program, emphasizing the need for oversight of Medicare Part D formularies to ensure beneficiary access to affordable options.

Rena Conti, Ph.D., an Associate Professor at Boston University, highlighted that provisions in the Inflation Reduction Act (IRA), including negotiation, inflation rebates, and redesign of Medicare Part D, are actually projected by the Congressional Budget Office to save the federal government $58 billion by fiscal year 2031 without harming pharmaceutical innovation. She noted that the growth in sales of COVID-19 therapeutics and vaccines could further stimulate innovation, while also increasing coverage and profits for pharmaceutical companies.

Jeanne M. Lambrew, Ph.D., Director of Health Care Reform at the Century Foundation, supported Conti’s findings, citing nonpartisan research that demonstrates how the IRA’s health tax credit provisions enhance coverage and lower costs for consumers. Lambrew urged for the extension and expansion of the IRA, emphasizing the financial burdens Americans would face without healthcare coverage and the negative impact on healthcare providers.

Judy Aiken, a 70-year-old retired nurse, affirmed the challenge to afford the medication needed to manage chronic conditions she experiences. The costs significantly impacted her quality of life, straining her family’s budget until home repairs became unaffordable. Aiken shared the reduction in price and cap on out-of-pocket expenses signify she no longer needs to choose between her health and financial stability.

Committee members discussed the potential impact of the IRA on Medicare beneficiaries, emphasizing the need to end price gouging and increase access to care. They also expressed concern of the potential for premiums to rise while centralizing the experiences of their constituents.

Key Legislation Considered in the U.S. House of Representatives

House Committees held hearings to markup pending legislation. A few of the bills heard last week are discussed below.

U.S. House Committee on Ways and Means
U.S. House Committee on Education and the Workforce
Energy and Commerce

The U.S. House of Representatives also considered the Supporting America’s Children and Families Act, which reauthorizes and amends Part B of Title IV of the Social Security Act. The bill increases the availability of community-based resources for families, including through family resource centers. The bill further centers lived experience, family preservation, and continuous improvement. The legislation was passed by a voice vote, and all representatives who spoke were strongly in favor. The Senate has since read the bill and referred it to the Committee on Finance.

Sector Updates from the Judiciary

Revisiting the Denial of Benefits for Wilderness Therapy

The US District Court for the District of Utah recently returned a lawsuit regarding the coverage of wilderness therapy to a lower court for reevaluation. United Healthcare denied coverage for wilderness therapy because of its status as an unproven treatment. However, the Court maintained their denial of benefits was arbitrary because United Healthcare didn’t provide a sufficient explanation and analysis.

The decision upholds a key provision of the Employee Retirement Income Security Act, which requires United Healthcare to provide adequate notice with specific reasons for the denial in plain language for participants. By ruling in favor of the family, the court fortified precedent mandating insurance companies include explanations of the scientific or clinical judgment used to deny the benefits.

Extended Statute of Limitations

A home health care company’s lawsuit was previously dismissed because it was filed after the six-year statute of limitations set by the Administrative Procedure Act (APA). It was reinstated, however, after the Supreme Court issued a landmark ruling in Corner Post, Inc. v. Board of Governors of the Federal Reserve System. The verdict maintains the statute of limitations does not begin until an organization is harmed by a final agency action. One of the judges dissented in part, arguing the statute limitations do not begin until the business is created.

The health care company’s lawsuit surrounds a regulation issued by the Department of Labor in 2013, which clarifies which home care workers meet the law’s minimum wage and overtime pay requirements under the Fair Labor Standards Act. Previously, the lawsuit was dismissed as the court agreed with the Department of Labor that the six-year statute of limitations began when the final rule was issued in 2013.

By returning the lawsuit to a lower court, the 3rd U.S. Circuit Court of Appeals demonstrated a key potential of Corner Post to allow organizations to challenge harmful regulations beyond the APA’s statute of limitations for civil actions.

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