
Lutheran Services in America Issues Response to Disruptions from the Federal Funding Freeze
February 3, 2025
February 3, 2025
February 5, 2025
December 19, 2024
Early Administrative & Congressional Action Expected: Threats to Medicaid in 2025 and Broader Federal Policy Outlook
By Sue Polis
With the new year, we will welcome the new administration and Congress and prepare for the work ahead. As a $26 billion network largely funded through Medicaid and other federal programs, understanding the changing policy landscape is critical to our shared success. The following is meant to provide an overview of key issues we are tracking related to federal policy and member interests.
Potential Early Administrative Actions Specific to Medicaid and Long-Term Care
We may see some shifts early on through administrative action that would impact Medicaid, including:
Early Congressional Threats to Medicaid
With the Tax Cuts and Jobs Act (TCJA) of 2017 set to expire next year, cuts to Medicaid are possible as Republicans move to reauthorize the legislation. Through the TCJA, corporate tax cuts were largely made permanent, while the individual income and estate tax cuts were largely temporary and expire at the end of tax year 2025.
Based on Congressional Budget Office (CBO) estimates and Republican plans, which include efforts to make the expiring tax cuts permanent, the potential price tag could be as high as $4 trillion over the next 10 years. With President-elect Trump signaling that Medicare, Social Security and spending on defense are off the table to pay for permanent tax cuts, that leaves Medicaid and the Affordable Care Act to potentially make up the difference. We expect action early in the new year that could impact Medicaid, with Senate Majority Leader John Thune (R-SD) signaling Congress may make changes through a two-step budget reconciliation process that would start as soon as January 20. We will continue to monitor efforts and will ask you to send a letter to Congress to urge them to protect Medicaid in any budget negotiations next year.
There are a number of threats or ways Medicaid could be impacted, which include:
Non-Profit Charitable Tax Outlook
As noted above related to the expiring Tax Cuts and Jobs Act of 2017 (TCJA) and the need to find revenue to make the estate tax and personal income tax cuts permanent, a key area of focus is also the non-charitable tax deduction. As noted in the “Reining in America’s $3.3 Trillion Tax-Exempt Economy” report, which is being used to inform legislation on Capitol Hill, Lutheran Services in America is working with Leadership 18 to monitor and inform on-going discussions with a focus on restoring and making permanent the nonitemizer deduction and specifically to pass the bipartisan Charitable Act (H.R. 3435/S. 566). At present, across L18 supporting organizations, we are pulling together shared resources including materials for outreach to Senate Finance and House Ways and Means Committee members.
Non-profit organization status related to terrorism
Moreover, we are also monitoring a bill (H.R. 9495) that would essentially strip non-profit status from organizations deemed as supporting terrorism. We are working through a non-profit coalition of partners including the National Council of Nonprofits to voice opposition related to Section 4 of H.R. 9495 that would provide broad authority to the Secretary of the Treasury to revoke non-profit status without requiring the Secretary to share full evidence or reasoning with accused nonprofits.
More Managed Care
And while much remains uncertain, the continuing shift towards managed care and value-based payment is likely to pick up speed. With the nomination of Dr. Mehmet Oz to lead the Centers for Medicare and Medicaid Services (CMS), a lot of attention is being focused on his past statements related to Medicare Advantage. Specifically, a June 2020 op-ed authored by Dr. Oz and George Halvorson, the former CEO of Kaiser Permanente, called for expanding “Medicare Advantage for All.” We expect a lot of scrutiny through the confirmation process, especially from Democrats, in the coming weeks about Dr. Oz’s financial ties to Medicaid Advantage plans.
We will continue to monitor and share updates on all of these issues and efforts into the new year when we expect new legislation and action to commence.
For more information, contact:
Sue Polis at Spolis@lutheranservices.org or Sarah Dobson at Sdobson@lutheranservices.org or Bill Kallestad at Bkallestad@lutheranservices.org.
Sue Polis is Vice President of Public Relations and Government Affairs at Lutheran Services in America.
December 19, 2024
All House and Senate election results have been finalized and it is clear that Republicans will control the Senate and also lead with a slim majority in the House of Representatives. Party leaders have begun to finalize which lawmakers will lead key committees with jurisdiction over health and related workforce issues. Retirements, limits on length of service in leadership roles, and preference of party leaders will all result in changes to committee chairs and ranking members. The work of our policy team and our network with these committees will be crucial to advancing our advocacy priorities for the coming year during the 119th Congress.
Several committees in each chamber have jurisdiction over various elements of health care. The Senate Health, Education, Labor and Pensions (HELP) Committee plays a crucial role in shaping national policies related to healthcare and the workforce, while the Senate Finance Committee oversees health programs under the Social Security Act, including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP), along with their role in shaping tax policy, which will be key in 2025 with the expiring Tax Cuts and Jobs Act (TCJA) of 2017. Sen. Bill Cassidy (R-LA) is poised to lead the HELP Committee, with Sen. Bernie Sanders (I-VT) expected as lead Democratic caucus member. Sen. Mike Crapo (R-ID) is in line to lead the Finance Committee.
In the House, the Energy and Commerce (E&C) Committee has broad jurisdiction over healthcare and the regulations and laws that govern the sector, while the Ways and Means Committee has jurisdiction over revenue-related aspects of the Social Security system, Medicare, and social services programs, including foster care and adoption programs—and like Senate Finance, also has a key role in shaping tax policy, including an expected 2025 tax bill. Finally, the House Education and Workforce Committee has jurisdiction over education, workforce development, and workforce policy.
Here is where things stand with key House committees:
We look forward to leveraging the power of our network to strengthen relationships with these key members of Congress.
Sarah Dobson is Senior Director of Advocacy and Public Policy at Lutheran Services in America.
December 19, 2024
Across the Lutheran Services in America network, we are committed to addressing housing insecurity as an economic and health crisis, advocating for affordable housing not only as shelter but also to ensure that members of the community are healthy and connected to the supportive services—food, social connection, transportation and mental health care—that are necessary to thrive. Therefore, we are carefully tracking announcements on who will be moving into leadership roles in Congress and the new administration on these issues.
President-elect Donald Trump announced he will nominate former Texas state Rep. Scott Turner to lead the U.S. Department of Housing and Urban Development (HUD). Turner was twice elected to the Texas House of Representatives, serving from 2013 to 2017. In 2019, during his first term, Trump appointed Turner to lead a council tasked with turning around distressed communities, including directing private investment money toward “Opportunity Zones.” Turner now chairs the Center for Education Opportunity at the America First Policy Institute, a think tank set up by former staffers from Trump’s first presidency.
In Congress, Sen. Tim Scott (R-SC) has signaled his desire to chair the Senate Banking, Housing and Urban Affairs Committee, which holds jurisdiction over key housing policy. Former ranking member Sen. Sherrod Brown (D-OH) lost his bid for re-election, and as such, Sen. Elizabeth Warren (D-MA) is expected to take his place as top Democrat on the panel. Sen. Brown was the champion of S. 3910, the “Yes in God’s Backyard” (YIGBY) Act. The legislation seeks to break down regulatory and zoning barriers for churches and other faith-based institutions to use existing land and property to develop housing. Having endorsed the bill, we will be working to help identify a new lead senator to move this effort forward.
In the House of Representatives, the Financial Services Committee has jurisdiction on housing-related issues. The new ranking chair is Rep. French Hill (R-AR), while Rep. Maxine Waters (D-CA) will retain her role as the ranking members for Democrats.
Our staff is working across our network to strengthen and develop relationships with these key stakeholders to advance our key policy priorities:
If you are interested in engaging in advocacy with the network on housing and services issues, please contact Sarah Dobson.
Sarah Dobson is Senior Director of Advocacy and Public Policy at Lutheran Services in America.
November 19, 2024
With the 2024 presidential election decided, we know that Donald Trump will become President again in January, with clear victories in winning both the Electoral College and the popular vote. At the same time, we wait for final vote counts in races for the U.S. Congress – although it is clear that Republicans will control the Senate and also lead with a slim majority in the House of Representatives.
As we prepare for the new Congress and a new presidential administration, our public policy and advocacy team is tracking the key cabinet and agency nominations and Congressional committee positions that will have the most influence and impact on our collective work across service lines and for the people we work with in community. With many moving parts and decisions still unclear, we are seeing some high-level stakeholders and priorities beginning to come into focus, which we wanted to share with our network.
Congressional and Agency Leadership
In Congress, the committees with jurisdiction over health issues (and specifically Medicaid) will see new leadership: Rep. Cathy McMorris Rodgers (R-WA), current chair of the House Energy and Commerce Committee, is retiring from Congress, while Rep. Virginia Foxx (R-NC), current chair of the Education and Workforce Committee, will not be returning to that position. Their successors are not yet clear. In the Senate, with the majority flipping to the Republicans, Sen. Bill Cassidy (R-LA) is poised to lead the Health, Education, Labor, and Pensions Committee, with Sen. Mike Crapo (R-ID) in line to lead the Finance Committee.
President-elect Trump has announced his intention to nominate Robert F. Kennedy, Jr. to lead the Department of Health and Human Services (HHS) and Dr. Mehmet Oz as Administrator of the Centers for Medicare and Medicaid Services (CMS). We will continue to monitor additional nominations at HHS among other key departments including the U.S. Department of Housing and Urban Development (HUD).
Policy Priorities
Prior to the election, we created a summary of what was potentially at stake for health & social service organizations specific to Medicaid under Republican rule. While it now seems more likely that these proposals will be considered, with slim Republican majorities in each chamber it remains to be seen if they will reach consensus to pass legislation, including: eligibility restrictions via work requirements, spending caps, and premium payments; a reduction in provider administrative burdens; modification of current waiver processes; a rollback of Medicaid expansion; and while unclear, changes to the way Medicaid is financed by moving to block grant the program’s funding. The first test will come in early 2025 as the 2017 Tax Cuts and Jobs Act is set to expire. As part of those negotiations, we expect changes to Medicaid funding to be in the discussion. We will continue to monitor and advocate on this issue.
For more information, contact Sue Polis, VP of Government Affairs and Public Relations, at Spolis@lutheranservices.org, Sarah Dobson, Senior Director of Public Policy and Advocacy, at SDobson@lutheranservices.org, or Bill Kallestad, Disability Network Director of Public Policy and Advocacy, at BKallestad@lutheranservices.org.
November 19, 2024
Our network is uniquely positioned to unite around cross-cutting advocacy priorities that are of common interest across service lines, given our collective work with all Medicaid beneficiaries. To better leverage the knowledge and work across the network, Lutheran Services in America is launching a pilot policy committee to help support and inform our policy priorities. The overall aim is to guide our core organizational strategies through a policy and advocacy focus, including: growing our individual and collective capacity to lead and effect policy & systems change; catalyzing innovation and impact across our network; and amplifying our united, faith-based voice. To ensure the committee is structured for long-term success, we are beginning this work with a pilot committee launching later this year, with an initial focus on Medicaid policy levers.
We are pleased to share that committee members for this initial pilot period are as follows:
The committee will support aligned action across our network including through informing policy priorities drawing on relevant issue expertise based on social service practice and leadership; providing timely and relevant feedback on potential and pending federal legislation; identifying, exploring, and supporting consideration and discussion of future policy needs/areas related to ensuring social service sector innovation; supporting effective mobilization of broader LSA member network to advance key policy priorities; speaking and/or engaging in virtual and in-person meetings with policymakers, peers and other key stakeholders to share government relations and advocacy insights and expertise on behalf of the policy committee; and providing timely and relevant insights to connect and align across federal, state and local policy approaches.
We are excited about the launch of the Committee to amplify our united, faith-based voice and grow our collective capacity to lead and effect change.
Please contact Sue Polis, VP of Government Affairs and Public Relations at Spolis@LutheranServices.org or Sarah Dobson, Senior Director for Policy & Advocacy at Sdobson@lutheranservices.org or Bill Kallestad, Disability Network, Director of Policy and Advocacy at BKallestad@lutheranservices.org
November 14, 2024
Lutheran Services in America (LSA), in initial collaboration with UnitedHealthcare (UHC), is embarking on a multi-year initiative to reshape and foster alignment between health and social care systems through the “Strengthening Families Initiative.” We aim to improve outcomes for children, youth and families enrolled in Medicaid, with an initial focus on behavioral health conditions. Specifically, building upon LSA’s Results Innovation Lab and Family Stabilization Initiative, we seek to better leverage the capacity and leadership of the LSA member network, in alignment with key health and multi-sector stakeholders, to improve health outcomes.
Lutheran Services in America is one of the nation’s largest networks of health and human service providers with a mission to cultivate caring communities that advance health and opportunity for all. Together, we are 300 nonprofit organizations across 1,400 U.S. communities with more than $26 billion in combined annual services.
Lutheran social service organizations have been working by, in, with and for their communities for decades — and in some instances, for more than a century. This new initiative incorporates national and local efforts with the engagement of Lutheran Services in America member organizations, including Gemma Services in Philadelphia and enCircle in Roanoke, Virginia.
As faith-based, trusted and community-centered leaders our aim is to continue to develop and foster innovative national and local partnerships, including with Medicaid Managed Care Organizations (MCOs), to improve individual and community outcomes. We are pleased to announce our collaboration with UnitedHealthcare through a $1.5 million award as we seek to expand engagement with other MCOs along with philanthropic partners.
UnitedHealthcare (UHC) is a health care and well-being company with a mission to help people live healthier lives and make the health system work better for everyone. In the United States, UnitedHealthcare offers the full spectrum of health benefit programs for individuals, employers, and Medicare and Medicaid beneficiaries, and contracts directly with more than 1.7 million physicians and care professionals, and 7,000 hospitals and other care facilities nationwide.
As part of this effort, we will:
Through this initiative, our shared aim is to align data-informed, community-centered approaches that have sustainable reimbursement and financing mechanisms to better address social determinants of health (SDOH) and that improve equitable outcomes for children and families. Specifically, our work is guided through the following areas of focus:
The following principles and objectives will guide the overall effort:
Alesia Frerichs is President & CEO of Lutheran Services in America.
November 20, 2024
Through our Family Stabilization Initiative, we’ve committed ourselves to supporting families in crisis. Recently, Lutheran Services in America staff visited St. John’s United in Montana. The trip provided an important opportunity to reaffirm the importance of building community to support families. St. John’s United is leading significant community-building efforts that will strengthen resilience and resonate for years to come.
During our visit, St. John’s hosted a Family Night event that brought together over 60 families, a testament to the power of community. Families currently enrolled in St. John’s United’s high-fidelity wraparound program, as well as families who had successfully graduated from the program, came together for an evening of connection, games, and fun. It was heartwarming to see children laughing together, parents sharing their experiences, and families building bonds and memories that go far beyond the scope of any single program.
Many of the young people have formed friendships across families, learning the invaluable lesson of building community amongst themselves. These relationships help strengthen their sense of belonging and support, something that is vital for any child, especially those who have faced challenging circumstances.
Strategic Partnerships and Community Engagement
St. John’s United expands their work through key community partners, including one who recently opened a Family Resource Center through the local school system. The center is a direct result of their collaboration with St. John’s United. The partnership exemplifies the broader goal of our Family Stabilization Initiative—by connecting families with the right resources, we can create a network of support that extends far beyond any single organization.
A seminal moment of the visit was an event in honor of Missing and Murdered Indigenous People. It was a powerful reminder of the importance of supporting and standing with Indigenous communities. Through a moving drum presentation and the reading of the names of missing or murdered individuals, we took time to acknowledge the deep impact of these losses on the community. It was a humbling experience, reinforcing the need for accountability and the continued advocacy for equity and justice. St. John’s United exemplifies that broader commitment of our network as we extend our reach and support to improve health and opportunity for all.
Moving Forward Together
As we look ahead, it’s clear that the Family Stabilization Initiative is about much more than just addressing immediate crises. It’s about creating long-term, sustainable systems of care that empower families to stay together and avoid involvement in child welfare systems. It’s about fostering equitable outcomes for all, particularly for communities that have been historically marginalized.
The friendships formed among young people, the continuing collaboration with community partners, and the shared commitment to equity are essential as we come together to create change.
Together, as partners, advocates, and allies, we have the power to strengthen communities that uplift and support families in meaningful ways and ensure equity and justice to cultivate caring communities that advance health and opportunity for all.
Renada Johnson is Senior Director of Children, Youth and Family Initiatives. Liz Vetter is a Senior Program Associate.