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Category: Featured – News & Insights

Rural Voices Shaping Transformation (and Better Policy) for Older Adults

April 16, 2026

BY: Regan McManus

Rural older adults navigating both Medicare and Medicaid face some of the most complex challenges in our healthcare system, and Lutheran Services in America went directly to the source to understand why.

In July 2025, Lutheran Services in America launched Rural Voices 2025: Elevating the Resilience of Rural Older Adults Navigating Medicare-Medicaid, in partnership with The SCAN Foundation. This human-centered initiative reflects Lutheran Services in America’s longstanding leadership in rural aging, and its belief that the people closest to a problem hold the most important insights for solving it. Drawing on our network’s Rural Aging Action Network and in partnership with Lutheran Social Service of Minnesota and Lutheran Social Services of South Dakota, Lutheran Services in America engaged dual-eligible older adults across rural Minnesota, North Dakota, and South Dakota — communities that are too often invisible in national policy conversations yet disproportionately burdened by access barriers and system complexity.

Working with Public Policy Lab and The People Say, Lutheran Services in America conducted in-depth, human-centered interviews with 16 rural older adults whose stories now contribute to a growing national archive of firsthand insights. These are not data points. They are detailed, lived accounts of what it actually takes to age in place in rural America: navigating fragmented care, confusing benefits, workforce shortages, and policies that weren’t designed with them in mind.

The findings are now available, and urgently relevant. Lutheran Services in America’s newly released e-report, “Rural Voices Shaping Transformation,” translates these experiences into a clear roadmap for change: simplifying eligibility and enrollment, reducing administrative burden, improving benefit communication, and modernizing policies that inadvertently penalize rural older adults with farm-based assets. At a moment when federal policy affecting older adults is shifting rapidly, this report offers policymakers, providers, and advocates concrete, community-grounded direction.

To extend the reach of these findings, Lutheran Services in America hosted the webinar “From the Ground Up: Using Rural Voices to Build Better Policy for Aging Americans,” the recording of which is available. Together, the report and webinar equip anyone working in aging, rural health, or policy with the evidence and tools to act.

Lutheran Services in America is actively sharing these findings with policymakers, faith and aging partners, and advocates nationwide. The goal is clear: systems that honor the dignity and complexity of aging in place, wherever someone calls home.

Read the report. Watch the webinar. Join the effort. To learn more or explore partnership opportunities, contact Regan McManus.

Regan McManus, Director of Aging Initiatives at Lutheran Services in America.

GOP Push for Second Budget Reconciliation Accelerates Amid DHS Shutdown

April 16, 2026

BY: Sarah Dobson

Republicans are moving quickly toward a second budget reconciliation package as they seek to break the ongoing Department of Homeland Security (DHS) funding stalemate and advance the President’s priorities following release of his Fiscal Year 2027 budget request. Recent White House meetings with GOP leaders signal growing alignment around using reconciliation to fund immigration enforcement, with additional defense and security priorities potentially addressed in subsequent packages.

Senate Majority Leader John Thune (R‑SD), Senate Budget Chair Lindsey Graham (R‑SC), and House Budget Chair Jodey Arrington (R‑TX) are working to advance a budget resolution later this month—the procedural step required to unlock reconciliation. GOP leaders are aiming to pass an initial, narrowly scoped reconciliation bill by late May, potentially before Memorial Day recess.

The immediate focus is funding for Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP), as the DHS shutdown stretches beyond 60 days and continues to strain agency operations, including disaster response. Senate leaders have emphasized keeping the bill tightly focused to avoid procedural complications and limit intraparty conflict. However, pressure remains—particularly from House conservatives—to expand reconciliation to fund all of DHS rather than relying on bipartisan appropriations.

Offsets, “Waste and Fraud,” and Medicaid in the Crosshairs

As in prior reconciliation debates, disputes over offsets are re‑emerging. Fiscal conservatives are pressing for spending reductions to pay for new enforcement and defense funding, while Republican leaders increasingly point to “waste, fraud, and abuse” as a source of potential savings. Medicaid has again become central to those discussions.

Although the President’s FY 2027 budget does not explicitly propose Medicaid cuts, it calls for steep reductions in nondefense spending and shifts greater responsibility to states, raising concern among advocates. Arrington and other conservatives have publicly suggested revisiting Medicaid policies that failed Senate reconciliation rules last year, framing potential changes as antifraud or program‑integrity measures rather than benefit reductions.

Advocacy organizations warn that this framing obscures real risks to coverage and services—particularly home‑ and community‑based services—and note that recent polling shows voters prioritize protecting access to basic needs over preventing fraud. They argue that the resurgence of antifraud rhetoric is less about program integrity and more about creating political cover for cuts that would otherwise be difficult to advance.

Divisions Within the GOP Complicate the Path Forward

Despite White House pressure to move quickly, internal GOP divisions continue to complicate the path forward. Senate appropriators are uneasy about sidestepping the traditional funding process, while politically vulnerable Republicans remain wary of being forced into tough votes during reconciliation “vote‑a‑rama” sessions. In the House, razor‑thin margins amplify tension between leadership and hard‑line conservatives pushing for broader scope and deeper offsets.

Why it matters for Medicaid: By relying on reconciliation to fund homeland security and defense priorities, the administration has intensified pressure on Republicans to identify large offsets. Medicaid remains one of the few programs sizable enough to generate those savings, making it likely to stay in the crosshairs—particularly under the banner of antifraud reforms—even as leaders insist benefits will be protected.

Sarah Dobson is Senior Director of Advocacy and Public Policy at Lutheran Services in America.

The Dragonfly’s Journey: Reflections from the 2026 Disability Network Winter Meeting

March 12, 2026

BY: Bill Kallestad

Leaders from across the Lutheran Services in America Disability Network (LSA-DN) gathered for the 2026 Winter Meeting for two days of connection, reflection, and forward-looking conversation about the future of services for people with disabilities. The gathering opened with a reminder that our work is ultimately about people, dignity, and family. Participants reflected on the importance of sustaining themselves and one another in this work while continuing to pursue the shared mission of strengthening communities and expanding opportunity for those we serve.

Throughout the meeting, members engaged with national leaders, policy experts, and one another to explore the evolving landscape related to Medicaid, including long-term services and supports (LTSS) and home- and community-based services (HCBS). Conversations highlighted both the challenges and opportunities ahead, from workforce shortages and budget pressures to innovation in care models, technology, and value-based approaches that prioritize quality of life and independence. Members also celebrated the growing impact of Lutheran Services in America initiatives that are driving system changes across the country, reaching tens of thousands of children, youth, and families while elevating community voice and equity in policy and practice.

Above all, the meeting reaffirmed the strength of the Lutheran Services in America network. By sharing insights across states, learning from emerging models, and advocating together for strong community-based services, members continue to demonstrate the power of collaboration in advancing dignity, independence, and belonging for people with disabilities and their families.

We closed our time together with a devotion reflecting on the dragonfly’s journey from dark waters to flight, a reminder that even in uncertain times, leadership grounded in courage, faith, and care can help our communities rise toward light.

Bill Kallestad is Senior Director of Public Policy and Advocacy for the Lutheran Services in America Disability Network.

2026: Catalyzing Innovation and Collaboration, and Driving Impact

March 11, 2026

BY: Alesia Frerichs

We are in a time when change, challenge, and opportunity are all converging across our network. The unique strength of Lutheran Services in America comes from aligning around purpose, partnership, and shared action. As we look ahead, we are putting this mission into action by growing leadership, catalyzing collaboration and innovation, and amplifying a united faith-based voice that shares solutions.

Catalyzing Collaboration and Innovation
Together, we are responding to this moment in meaningful ways. As we celebrate ten years of the Results Innovation Lab, we’re leaning into innovation, partnership, and new ways of working to meet today’s challenges and tomorrow’s needs.

Our Health Through Housing work continues to help members grow their mission by accessing capital, building partnerships, and expanding housing with services at a time when too many people still don’t have a place to call home. In February, we announced an innovative partnership with California Lutheran Homes to provide flexible funding for early-stage development projects. At the same time, new collaborations with SCAN, the RRF Foundation for Aging, and others are helping elevate and deepen our rural aging work.

Growing Leadership Across the Network
We recently hosted our first Leadership and Growth Forum, bringing members together to explore the role of private equity in social service organizations. Peer networks like the Lutheran Information Technology Network (LITN), Lutheran Financial Managers Association (LFMA), and the Mission Leaders community amplify this work, offering trusted spaces for learning, collaboration, and innovation throughout the year. Our monthly “Capitol Conversations” also provide timely insights on federal and state policy.

Amplifying Our Voice, Sharing Solutions
Together, we are advancing practice-informed policy through our ongoing Here We Stand campaign and our broader policy priorities.

Partnering for Impact in a Shifting Medicaid Landscape
Through a two-year partnership with The George Washington University and Health Management Associates, we have surfaced innovations from across our network and translated those insights into a practical guide to help strengthen partnerships and navigate a rapidly changing Medicaid landscape. We will share the guide and key insights from this work during a webinar on March 26.

This network exists for moments like this, to align our leadership, strengthen how we act together, and help shape what comes next.

Alesia Frerichs is the President & CEO of Lutheran Services in America.

Lutheran Services in America Announces 2026 Leadership Award Winners

February 9, 2026

Turning Policy into Practice: What We’re Learning from our Local Demonstration Sites

December 22, 2025

BY: Renada Johnson

Across Lutheran Services in America, we often talk about the need to bridge policy and practice. The Results Innovation Lab (RIL), in partnership with the Strengthening Families Initiative (SFI), is doing exactly that by turning national policy priorities into real-world learning through local demonstration sites.

At a time when Medicaid policy, child welfare systems, and community-based organizations are all under pressure, these sites are helping us answer a critical question: What does prevention actually look like on the ground—and what does it take to make it work?

Our demonstration sites are showing that prevention is not a single program or service, but a way of working across systems. It shows up in addressing basic needs early, coordinating care more effectively, and reducing the likelihood of crisis before families reach child welfare or emergency systems. Making prevention work requires strong cross-sector collaboration, clear shared populations, and the ability to test small changes, learn quickly, and adapt.

From Policy Signals to Practice Experiments

RIL’s focus on outcomes, equity, and leadership development is now directly shaping how we design and support local demonstration sites alongside health care. Rather than starting with abstract policy ideas or top-down models, we are using small, practical tests of change to learn what collaboration actually looks like on the ground, under real-world conditions.

This approach allows us to:

  • Focus on clear outcomes at the intersection of Medicaid and child welfare
  • Build cross-sector “muscle memory” for collaboration
  • Document prevention strategies that align with federal priorities and are feasible for overburdened local systems

This matters in the current policy environment. The White House’s 2025 Executive Order emphasizes family stability, timeliness, upstream investment, and cross-system coordination. Through RIL and SFI, Lutheran Services in America is effectively operating a living lab for what that policy vision looks like in practice.

What We’re Learning from the Demonstration Sites

In Pennsylvania and Virginia, the demonstration sites are surfacing several consistent lessons with clear policy implications.

Identifying shared populations is harder than expected—but essential.
Even when organizations serve the same families, health plans, schools, and child welfare systems often define populations differently. The work of aligning around a shared group of children or families takes time, trust, and data—but it is foundational to any meaningful partnership.

Small tests of change are the right scale for this moment.
Rather than launching large pilots, sites are using Plan-Do-Study-Act (PDSA) cycles to test ideas quickly. These small tests help partners stay engaged, surface barriers early, reduce risk, and generate evidence that can inform future investment. This is exactly the kind of learning federal and state leaders look for when identifying promising prevention approaches.

Basic needs are the gateway to deeper engagement.
Across sites, food access, transportation, hygiene supplies, and mental health supports consistently emerge as high-impact entry points. Addressing these needs improves appointment attendance, engagement in services, and trust with families—outcomes that matter to both child welfare and Medicaid systems.

Workforce capacity matters as much as program design.
Burnout and turnover can undermine even the strongest ideas. RIL’s emphasis on resilience, listening, and curiosity is helping organizations adapt while protecting staff capacity, an often overlooked but critical component of prevention.

Why Medicaid Matters for Children, Youth, and Families

Medicaid has become one of the largest funders of prevention. Families interact with health systems far more frequently than they do with formal child welfare systems, making Medicaid a powerful lever for upstream support.

Our demonstration work with UnitedHealthcare highlights several truths:

  • Many organizations involved in children, youth and family work already do Medicaid-relevant work, even if they do not bill Medicaid directly
  • Prevention lives in the gaps between health care, social care, and child welfare systems
  • Managed care organizations are still expected to address social needs and improve outcomes, even amid federal policy shifts

Lutheran Services in America members are uniquely positioned to bridge these gaps by stabilizing families, improving care coordination, reducing avoidable involvement, and delivering trusted, community-rooted support. In many ways, this is exactly what policymakers are asking systems to do. The demonstration sites are helping show the “how.”

Building Toward Scale and Sustainability

The learning from these sites is already shaping how Lutheran Services in America will strengthen practice across the network. Key areas of focus include:

  • Organizational readiness for Medicaid-aligned partnerships
  • Clearer demonstration of value through outcomes and data
  • Stronger cross-sector relationships with health plans and states
  • Meaningful integration of lived experience leadership
  • Framing prevention in terms of cost containment and avoided crises

Together, this work helps Lutheran Services in America members meet the current policy moment while staying rooted in mission. By grounding policy aspirations in practical learning, the demonstration sites are not just testing ideas, they are helping build a roadmap for prevention that can scale.

Renada Johnson is Senior Director of Children, Youth & Family Initiatives at Lutheran Services in America.

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