What the Budget Bill Means for Medicaid and our Network

July 17, 2025

On July 4, President Trump signed into law a sweeping budget reconciliation package that was passed in the Senate on July 1 and House on July 3 on party-line votes of 51–50 and 218–214, respectively. The law contains a number of provisions that will impact our network in several areas.

  • Healthcare:
    • Medicaid: The law imposes more stringent work reporting requirements for “able-bodied” adults between 19 and 64; lowers the allowable rate for state provider taxes for some provider types, with specific carve-outs for nursing homes and intermediate care facilities; grants states new authority to offer HCBS through standalone waivers that don’t require individuals to meet institutional-level of need.
    • SNF minimum staffing: Prohibits implementation of the SNF minimum staffing regulation for 10 years.
    • Rural hospitals: Includes a $50 billion rural hospital stabilization fund designed to support states with approved rural health transformation plans, allocating $10 billion annually from 2026 to 2030.
    • Medicare: The CBO projects that the law will trigger future cuts to Medicare totaling nearly $500 billion due to the Statutory Pay‑As‑You‑Go Act of 2010 (S-PAYGO). This law kicks in when legislation increases the deficit and would trigger an estimated $45 billion in Medicare cuts for fiscal year 2026.
  • Housing: Creates a permanent 12% allocation increase in low-income housing tax credits (LIHTC) starting in 2026, while also permanently reducing the 50% bond financing threshold test to 25% beginning in 2026, lowering a barrier to affordable housing production.
  • Refugees: It institutes a permanent ban on refugees and other humanitarian-status immigrants from getting Medicaid.
  • Nonprofit tax provisions:
    • Charitable deduction: It establishes a non-itemizer deduction for charitable contributions at $1000 for individuals and $2000 for joint filers;
    • Excludes two provisions we opposed: one putting nonprofit status in jeopardy if an organization was deemed to have ties to a “terrorist” group and a second levying UBIT on transportation and fringe-benefit related costs.

The focus now turns to implementation of the law, with much of the impact depending on which state is being discussed. For example, the Kaiser Family Foundation has prepared a state-by-state analysis of the impact of Medicaid spending reductions.

Looking ahead, we anticipate another budget reconciliation bill in the fall. In a recent interview, House Budget Committee Chair Jodey Arrington (R-TX) said that majority Republicans seek deeper cuts to Medicaid and spending reductions in Medicare that weren’t included in the first bill. They also plan to cut funding for states that fail to enforce existing laws against Medicaid benefits for undocumented immigrants and reimbursement rates for “healthy, able-bodied adults” added to Medicaid under President Barack Obama’s Affordable Care Act.

We will be tracking both implementation of the current law and further legislative efforts carefully and will update you as needed.

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

Lutheran Services in America Announces Partnership with NORC Walsh Center for Rural Health Analysis to Advance Rural Aging Solutions

July 7, 2025

Statement on the Passage of the Budget Reconciliation Bill

July 3, 2025

Voice. Evidence. Action.

May 23, 2025

Our strength as a trusted, community-centered national network comes not just from our size and scale, but from the intersections of our work where message, evidence, and action meet. Last week was a vivid example of that alignment as we launched the Here We Stand campaign, published a new issue brief, “Innovating Care Through Community Partnerships,” and hosted a Results Network convening with 50 leaders from across the country.

Together, these initiatives tell a story of collaboration, innovation, and a united, faith-based voice leading with purpose.

Medicaid is a cornerstone of our work and a lifeline for the people we serve in more than 1,400 communities nationwide. As policymakers at both the state and federal levels continue to debate the program’s future, Here We Stand gives voice to our shared values. It boldly affirms our unwavering commitment to the millions who rely on Medicaid and reflects our unique perspective as a network that works across the full spectrum of Medicaid stakeholders. This is more than messaging—it’s a public declaration of who we are and what we stand for.

That voice is rooted in real, on-the-ground innovation. Our new issue brief highlights how Lutheran Services in America members are transforming care by forging partnerships between Medicaid Managed Care and community-based organizations, showing how integration of behavioral health and non-medical services and supports are improving outcomes for children and families and strengthening communities. A future brief and forthcoming blueprint will spotlight similar innovation across the network including in aging services and the Disability Network.

These ideas don’t just live on paper. They come to life through our learning communities. From the Rural Aging Action Networks to the Disability Network and, just last week, the Results Network convening.

These aren’t parallel tracks—they are deeply connected. The message shapes the narrative. The evidence builds credibility. The convenings fuel collaboration, innovation, and momentum.

Together, they show what’s possible when we speak with one voice, ground our work in truth, and lead with courage and community. This is how change happens. This is how we light the way—united, unwavering, and filled with purpose.

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

How a Robot is Advancing Memory Care for Older Adults

April 21, 2025

Older adults who experience the loss of cognitive functioning are often more susceptible to social isolation. Loneliness can take an enormous toll on one’s physical, mental, and emotional health. It’s a reality that pushes our network to focus on finding person-centered solutions that embrace new and innovative approaches to improve social engagement—and thus the quality of life—for older adults in memory care.

Through a continuing partnership with the Consumer Technology Association (CTA) Foundation, Lutheran Services in America launched a pilot program with our member organization Lyngblomsten in Minnesota to explore how artificial intelligence-powered robots can meaningfully engage older adults with memory loss. This work is an example of how our network is catalyzing innovation and collaboration for impact—one of our core strategies to advance health and opportunity for all.

A Robot That Cares

Over the past year, two memory care campuses in Anoka and Ramsey Counties welcomed Temi, the newest team member at Lyngblomsten. Temi navigates independently, engages older adults individually, and interacts with residents based on each person’s interests, which are collected through family intake questionnaires. From playing a favorite card game to guiding gentle exercises or offering reminiscence therapy through music, Temi adapts to meet older adults where they are, literally and emotionally.

The response has been overwhelmingly positive. One resident calls Temi her go-to partner for a daily game of solitaire (no more shuffling required!). Another resident uses Temi as a walking companion who plays favorite hymns along the way and helps her stay physically active while bringing joy in her daily routine. Moreover, staff and family caregivers report seeing improved moods and stronger daily engagement.

“The robot has been embraced by staff, residents and family caregivers as part of the Lyngblomsten team in promoting person-centered care,” said Jeff Heinecke, president and CEO of Lyngblomsten.

What We’ve Learned

Originally intended for use across independent and assisted living settings, the pilot shifted focus exclusively to memory care residents after early results showed the greatest impact amongst this group. The robot’s ability to deliver consistent, individualized engagement, especially for those who may struggle to advocate for themselves, has become a valuable complement to staff-led activities.

Group sessions with Temi showed promise, with one-on-one interactions proving to be even more meaningful. With those results in mind, Lyngblomsten is now expanding implementation into community-based memory care programs, offering this powerful tool to older adults and families living outside of campus settings—people who might not otherwise have access to this opportunity.

“Our partnership with the CTA Foundation is a powerful force for good, uniting technology and innovation to expand support for older adults and family caregivers across the country,” said Alesia Frerichs, president and CEO of Lutheran Services in America.

Leading Together

We’re constantly evaluating how we can continue to innovate to better support older adults communities with quality care for underserved households. This pilot program allows us to collaborate with forward-thinking partners like the CTA Foundation and leverage new technologies like Temi the robot. Together with our member organizations, our network is reinventing what it means to redefine care.

In our past six years of partnership with the CTA Foundation, we have brought investment and visibility to the following projects:

  • Virtual reality devices to provide shared immersive experiences for homebound older adults and caregivers at Evertrue
  • Google Glasses for virtual caregiver education of loved ones with dementia at Samaritas
  • Technology stations within affordable housing at Graceworks
  • iPads, tablets, and hotspots for older adult and caregiver connections at LSS Minnesota

Reach out to me to learn more about how we’re evaluating outcomes and what implementation could look like in your setting.

Ashley Washington is Senior Director of Aging Initiatives & Member Experience at Lutheran Services in America.

Supporting
Our Neighbors,

TOGETHER.

Our shared Lutheran tradition of service to our neighbor is more vital than ever.

Join us as we work to ensure our network continues delivering essential services to all in need.