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New Policy & Advocacy Subcommittee Structure

September 15, 2026

BY: Bill Kallestad

Lutheran Services in America is launching a new subcommittee structure to expand upon our current Policy & Advocacy Committee to further develop our federal policy and advocacy priorities to ensure they are grounded in the experiences and expertise of our network.

The new structure will include three issue-focused subcommittees:

NOTE: AI, technology, and data will be explored as a cross-cutting issue across all three areas.

The subcommittees will create a regular forum for Lutheran Services in America members to share what they are seeing in their communities, identify emerging policy challenges and opportunities, and help shape Lutheran Services in America’s policy priorities and advocacy strategies. Members will also have opportunities to highlight innovative approaches and bring state and local experiences into our federal policy conversations.

Each subcommittee will be co-chaired by members of the Policy & Advocacy Committee and supported by Lutheran Services in America policy staff. The groups will meet between full Policy & Advocacy Committee meetings, with key recommendations and issues brought forward for broader discussion and alignment.

This is an important step toward a more member-driven policy and advocacy model—connecting the expertise of our members directly to the work of the Lutheran Services in America Policy & Advocacy team and strengthening our collective voice in Washington and across the network.

If you have questions, please contact Sarah Dobson at SDobson@lutheranservices.org or Bill Kallestad at BKallestad@lutheranservices.org.

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

Midterm Elections: What We’re Watching

September 14, 2026

BY: Kylie Bowlds

With midterm Election Day quickly approaching, political analysts view both chambers as genuinely in play. The Cook Political Report currently gives Democrats the advantage in the fight for the House majority, and over the summer, they moved several Republican-held Senate seats to ‘competitive’ leaving more uncertainty. 

Spotlight on the Senate:  

Control of the Senate remains one of the central questions of the 2026 midterm elections. Although Republicans currently hold the majority, the outcome may hinge on a small number of races in competitive states. Democrats would need a net gain of four seats to take control in January 2027 — meaning they must retain every seat they currently have and flip four Republican-held seats. Throughout much of the cycle, analysts have viewed nine Senate races as the seats most likely to change party hands: six Republican-held seats in Maine, North Carolina, Ohio, Texas, Iowa, and Alaska, and three Democratic-held seats in Georgia, Michigan, and New Hampshire.

More recently, two additional GOP-held seats, in Kansas and Nebraska, have emerged as potentially competitive. Democrats face an uphill climb, targeting several Republican-held seats in states that strongly backed Trump. Several other states—Montana, South Carolina, Florida, Mississippi, and South Dakota—offer potential pickup opportunities for Democrats, but those races are widely viewed as longer-shot opportunities that would require notable upsets to flip.

From Solid Republican to Likely Republican? 

Kansas and Nebraska each present unusual circumstances that have drawn national attention to races that have not recently been contested.  

Kansas: Incumbent Republican Sen. Roger Marshall faces Democratic nominee Adam Hamilton, a United Methodist pastor who explored an independent bid before running as a Democrat. Hamilton won a crowded August primary and set a state record for Senate campaign fundraising. Kansas has not elected a Democrat to the Senate since 1932.  

Nebraska: Independent Dan Osborn is challenging Republican incumbent Pete Ricketts. Previously, Osborn lost to Sen. Deb Fischer (R) by fewer than seven points in 2024 in a state President Trump carried by twenty. Osborn has said he would not caucus with either party, meaning a win here would complicate the majority math rather than settle it. 

Why does this matter? 

Unlike the House, where a national shift can move dozens of races at once, the Senate turns on a handful of states. Of course, the ‘majority party’ in each chamber essentially sets the agenda including the federal funding for key programs supported across the Lutheran Services in America network, including — Medicaid, SNAP, aging and disability services, and child welfare among them. Engagement is essential as November approaches, and as we look ahead to 2027. 

Key Toss Ups in House:  

Republican:  

  • MI-10 OPEN (James) 
  • OH-07 Miller  
  • WI-03 Van Orden  

Democrat:   

  • FL-14 Castor 

Key Toss Ups in Senate:   

Republican  

  • AK Sullivan 
  • IA OPEN (Ernst)  
  • ME Collins 
  • OH Husted  
  • TX OPEN (Cornyn) 

Democrat  

Note that “toss-up” is a narrower category than “battleground” — several of the nine battleground races, including North Carolina and Georgia, are currently rated Lean rather than Toss Up. 

What can you do now?   

With the midterms approaching and many competitive toss– up races, we encourage our members to take the following steps to stay engaged and prepared:  

  • Monitor emerging candidates in toss-up Congressional and gubernatorial races, and track redistricting in your state to identify newly competitive seats as maps evolve.  
  • Strengthen voter outreach by making sure the people you serve understand any documentation requirements and changes to voter registration processes in your state.

Kylie Bowlds is an Issue Education & External Relations Associate at Lutheran Services in America.

Medicaid: Where Things Stand

July 16, 2026

BY: Sarah Dobson

Given the continuing challenges related to Medicaid, including further cuts in a potential third reconciliation bill and H.R. 1’s ongoing impacts, Lutheran Services in America recently held a series of meetings with key House and Senate offices, including the Senate Finance, Senate HELP, House Energy and Commerce, and House Ways and Means, along with Montana, Nebraska, and Iowa offices.

What Did We Learn?

Initial implementation of work requirements is causing confusion. Staff noted that Nebraska’s rollout is underway, with Iowa, Montana, and Arkansas beginning soon. Given the challenges already arising in Nebraska, members of Congress and their staff are eager to stay informed, especially to understand ongoing impacts. Lutheran Family Services was featured, and Chris Tonniges was quoted, in the recent NBC News Story “New Medicaid Work Requirements Prompt ‘Extreme Mass Confusion’ in Nebraska,” which illustrates the current confusion.

A third reconciliation bill?  Some staff believe a package is coming — likely to pass the House but face hurdles in the Senate — while others noted only early-stage discussion centered on tax policy. Committee jurisdiction and timing remain open questions.

The DOJ Olmstead statement is drawing concern. Multiple offices raised alarm about the statement’s implications for home- and community-based services (HCBS) and encouraged strong advocacy on the issue, including the use of strong evidence related to HCBS services.

Congress wants to hear from you. Nearly every office asked for the same things: personal stories, data — including estimates of coverage loss — and local news coverage showing district-level impact.

Take Action: Below are ways to leverage Here We Stand resources to defend Medicaid, including through the August recess:

→ Take action in two minutes. Use our turn-key advocacy tool to send a message to your lawmakers urging them not to make further cuts to Medicaid funding as part of any future budget reconciliation bill.

→ Schedule an in-district meeting. Members of Congress are home during the August recess. Our Action Guide walks you through the ask.

→ Share your impact story. How are Medicaid changes affecting your organization and the people you serve? Share your insights with us.

→ Explore the full toolkit. Messaging materials to lead the conversation in your community.

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

Midterm Elections: What to Watch Ahead of November

June 17, 2026

BY: Kylie Bowlds

The Current Landscape

As the Midterm elections approach, key primaries are beginning to shed light on potential outcomes of the November elections. Republicans are defending narrow majorities in both chambers, with a 5-seat margin in the House and a 3-seat margin in the Senate, while contending with historical headwinds. Republicans are less unified in their messaging, with leadership touting actions stemming from passage of H.R. 1, while other candidates in tight races are distancing themselves from the cuts made to Medicaid.

Meanwhile, Democrats seek to strengthen their chances of retaking House and potentially Senate majorities centered around cost-of-living concerns and opposition to recent health care cuts.

What’s at Stake?

A Democratic majority would likely result in efforts to reverse recent health care cuts, while continued Republican control of both chambers would likely mean a sustained emphasis on oversight and continued implementation of H.R. 1 provisions.

Race to Redistrict: The debate over the Voting Rights Act has brought redistricting into focus ahead of the upcoming elections. After the Supreme Court ruling in April in Louisiana v. Callais – which narrowed Section Two of the Voting Rights Act – states are allowed to redraw Congressional maps ahead of the 2026 midterms, potentially shifting control of a meaningful number of House seats.

Recent states who have passed new maps include Alabama and Florida, which will likely result in a total gain of 4-5 GOP seats. Other efforts remain undecided: Virginia’s redraw was blocked by the state supreme court, Louisiana is still drawing its replacement map, and additional states in both parties’ control are weighing action — meaning the competitive map will continue to evolve through the summer.

SAVE Act: White House demands to include the SAVE Act in a planned third reconciliation bill continue, but the Senate Parliamentarian has previously ruled the act did not quality for inclusion in the prior immigration reconciliation package. The SAVE Act would require documentary proof of U.S. Citizenship, such as a passport or birth certificate, for individuals registering to vote in federal elections. Because reconciliation is limited to predominantly budgetary matters, attempts to attach the SAVE Act again would likely face the same procedural objection.

Key Toss Ups in the House:

Republican:

Democrats:

Key Toss Ups in the Senate:

Republican

Democrat

What you can do now? 

With the midterms approaching and many competitive toss ups, we encourage our members to take the following steps to stay engaged and prepared:

  • Utilize our to advocate at the state level around the issues you want candidates to prioritize around health care issues
  • Monitor emerging candidates in toss-up congressional and gubernatorial races, and track redistricting in your state to identify newly competitive seats as maps evolve.
  • Strengthen Voter Outreach by ensuring your communities understand potential documentation requirements and any changes to voter registration processes.

Kylie Bowlds is an Issue Education & External Relations Associate at Lutheran Services in America.

Here We Stand: Coming Together with New Resources

May 14, 2026

BY: Sarah Dobson

On April 23, Lutheran Services in America network members from our Policy and Advocacy Committee, the Disability Network, and the board of directors convened in Washington, D.C., for a day of meetings with Congressional offices. Nineteen member organizations were represented, and over 40 meetings were conducted in total.

Our Asks? No more cuts to Medicaid. Support for Workforce and Housing.

As part of our recent re-launch of our Here We Stand campaign to protect Medicaid, network members went to the Hill with three primary asks:

What can you do?

This is a pivotal moment as we work on two fronts:

  • Federal: Congress is considering a third budget reconciliation bill that may mean even deeper cuts to Medicaid. Learn more and take action.
  • State-level efforts: Whether your state is already working on implementation of H.R. 1 provisions including work reporting requirements and limitations from provider tax constraints, state budgets are tightening and most will be trying to do more with less.

Also consider the following:

  • 5/21: Join our May Capitol Conversations webinar to learn more about future budget reconciliation efforts.
  • Sign-up for one-on-one consultation to review updated Here We Stand. Resources and options for action. to review updated Here We Stand. Resources and options for action.
  • Use our new Here We Stand resources to engage with lawmakers and the media. Materials include:
    • Medicaid Brief: Backgrounder on state fiscal challenges, Medicaid program integrity and waste, fraud and abuse.
    • Action Guide: Suggested ways you can engage policymakers at the state or federal levels.
    • Medicaid FAQs: Frequently asked questions and answers about the importance of Medicaid, policy impacts, and the Here We Stand campaign.
    • Messaging for Federal Lawmakers: Suggested messaging for meetings with members of Congress (House and Senate).
    • Messaging for State Lawmakers: Suggested talking points for your meetings/engagements with state lawmakers and officials.

Please contact the Lutheran Services in America government relations and public policy team:

Sue Polis
Sarah Dobson
Bill Kallestad
Kylie Bowlds

Support with communications efforts:

Christopher Findlay

 

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

Congress Watch: Redistricting and the Road to the 2026 Midterms

December 19, 2025

BY: Kylie Bowlds

The outlook of the 2026 midterm elections continues to evolve as both parties focus on key House districts that will determine the balance of power in Congress. Key toss-up races continue to take shape as various states seek to redraw maps ahead of the 2026 midterms – aiming to flip or add additional seats. However, in many blue and purple states with independent redistricting commissions, it is too late for legislatures to amend their states’ constitutions to do so.  

For Republicans, redistricting could yield a net gain of four to five House seats. Alternatively, Democrats could net two to four House seats as well, depending on how new maps are implemented across key states. Various factors – pending court rulings, ballot initiatives, etc. – will heavily impact these outcomes.    

Toss-Ups to Watch

Senate: Several Senate races are expected to be highly competitive. These include:  

  • Sen. Susan Collins (R-ME)  
  • Sen. Jon Ossoff (D-GA)  
  • Open seats in Michigan and North Carolina  

House:  On the Democratic side, toss seats include:  

  • AZ-13 (Gray)  
  • NM-02 (Vasquez)  
  • NY-04 (Gillen)  
  • OH-01 (Landsman)  
  • WA-03 (Perez)  

Republican-held seats that are expected to be competitive include:  

  • AZ-01 (Ciscomani)  
  • CA-22 (Valadao)  
  • CA-48 (Issa)  
  • CO-08 (Evans)  
  • IA-01 (Miller-Meeks)  
  • MI-07 (Barrett)  
  • NJ-07 (Kean Jr.)  
  • PA-07 (Mackenzie)  
  • PA-10 (Perry)  
  • VA-02 (Kiggans)  
  • WI-03 (Van Orden)  
  • An open seat in Arizona 

What You Can Do Now

With the midterms approaching and many competitive toss ups, we encourage our members to:  

  • Stay connected and monitor emerging candidates in toss-up states and districts — including congressional and gubernatorial races.  
  • Utilize the Congressional calendar to check as to when your elected officials are on recess and available for meetings and site visits.  

For your organizational advocacy efforts, engagement at both the federal and state levels is increasingly important. Elected officials on all levels of government play a role in shaping critical policies. Continued engagement and relationship building ensure that your voice and the voice of those in your communities are represented. 

Kylie Bowlds is an Issue Education & External Relations Associate at Lutheran Services in America.

Lawmakers Face Government Shutdown as CMS Launches Workforce and Rural Health Initiatives

September 25, 2025

BY: Sarah Dobson

As of today, with just days left before fiscal year 2025 funding expires, Congress is racing to avoid a government shutdown. Late last week, the House passed a continuing resolution, mostly along party lines, to fund the government through November 21. However, the Senate has not yet acted on it and seems unlikely to do so, making a government shutdown more likely when current funding expires on October 1.

While Republicans indicate general support for a short-term funding patch without any additional provisions to allow more time for broader negotiations, this is at odds as Democrats advocate that any temporary funding bill must include a permanent extension of expiring health insurance premium tax credits. The President canceled a planned meeting (that was set to take place today, Sept. 25) with Democratic leaders and signaled he would use a shutdown to shrink federal agencies by designating fewer workers as “essential.” His administration also directed agencies to consider firing employees working on unfunded programs that don’t align with his priorities to support additional downsizing once funding resumes.

Meanwhile, lawmakers have yet to reach consensus on a second budget reconciliation package, which could bring damaging cuts to Medicaid and other critical human services. Lutheran Services in America urges advocates to contact their lawmakers now to protect these essential programs.

Amid these debates, the Centers for Medicare & Medicaid Services has announced two major initiatives. First, a $75 million investment in workforce training for skilled nursing facilities, aimed at addressing shortages of nurses and certified nursing assistants. The program will support tuition reimbursement, stipends, and training programs in collaboration with states. Second, CMS has launched the $50 billion Rural Health Transformation Fund, giving states the opportunity to address pressing rural health challenges over the next five years.

Congress is also taking steps to address workforce shortages through new legislation. The bipartisan Healthcare Workforce Resilience Act and the Dignity Act of 2025 seek to expand the pool of authorized healthcare workers through immigration reforms. In addition, new research highlights the role of telehealth and artificial intelligence in expanding healthcare capacity—though neither alone can solve the workforce crisis.

Stay engaged with these fast-moving developments: Join our next Capitol Conversations webinar on Thursday, October 16 at 1 p.m. ET.

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

Congress Watch: Midterm Elections that Could Sway the Balance of Power in the House

September 24, 2025

BY: Sue Polis

With so much change happening in Washington, D.C. with Republicans in control of the executive, legislative and judicial branches, many are starting to look to the 2026 midterm elections to see what the future might hold. We will continue to see Republican control of all branches? Will Democrats win control of the House of Representatives and change the balance of power in Congress?

The races to watch are starting to emerge and we are tracking toss-ups elections in 2026 in both the House and the Senate. The best way to make your voices heard is to engage early and often in cultivating relationships with current and future elected officials.

What can you do now? Congress will recess the week of November 10 for the Veterans Day holiday. This is a good time to request in-district and in-state meetings with your elected officials and/or invite them for a site visit to tour and see the work of your organization up close.

For more information, please contact Lutheran Services in America advocacy staff: Sarah Dobson at SDobson@lutheranservices.org, Bill Kallestad at BKallestad@lutheranservices.org, and Kylie Bowlds at KBowlds@lutheranservices.org.

Sue Polis is Vice President of Public Relations and Government Affairs at Lutheran Services in America.

Policy Shifts at CMS & HHS and What it Means for Social Service Providers 

September 24, 2025

BY: Sue Polis

The U.S. Department of Health and Human Services (HHS) and agencies under it, including the Centers for Medicare and Medicaid Services (CMS), have recently offered insights into policy priorities that further signal significant policy shifts. Below is a synopsis of key changes, including potential opportunities and challenges for social service providers.

In May, CMS, through their Innovation Center (CMMI), recently released their new strategic direction, which focuses on evidence-based prevention, data access, and choice and competition. Given CMS’s recent withdrawal of federal Medicaid guidance that impacts the ability of states to use waivers and other funds to address health-related social needs, CMMI’s new strategic direction points to the following areas of interest: 

  • Evidence-Based Prevention: Includes great focus and emphasis on meeting nutrition needs, including food access, healthy food access and food as medicine; accountable care and accountable care organizations (ACOs) that assume global risk/downside risk; caregiver support; chronic disease management and disease prevention
  •  Data Access: Priorities include global risk/total cost of care models and waivers for predictable cost sharing for certain services.  
  •  Drive Choice and Competition: With a focus on rural providers, ACOs, community health centers; site neutral payments across settings; changing certificate of need requirements; and prioritizing high value care and services and incentivize unnecessary utilization

HHS also recently released their Make America Healthy Again key strategies report with a broad prevention-based agenda across several areas, including some more specifics important for social service providers including: executive actions, process reform and deregulation, public awareness and education, and private sector collaboration. Some more specific areas that Lutheran Services in America will continue to monitor include:

  • USDA Nutrition Programs: USDA will use its authorities to prioritize utilization and promotion of whole, healthy foods across its 16 nutrition programs.
  • Supplemental Nutrition Assistance Program (SNAP): USDA will provide states with technical assistance in SNAP waiver development and implementation to restrict the purchase of junk food and reorient the program towards better nutrition. 
  • MAHA Boxes: USDA will develop options to get whole, healthy food to SNAP participants. 
  • Head Start Nutrition: ACF and USDA will implement the new Dietary Guidelines for Americans (DGAs) through supporting access to USDA’s Child and Adult Care Food Program (CACFP) and the National School Breakfast and Lunch programs in Head Start providers, and will provide supplemental funding opportunities to support the provision of whole, healthy foods in Head Start programs. 
  • Medicaid Quality: CMS will collaborate with states to establish quality metrics for Medicaid managed care organizations that promote measurable health improvements through nutrition coaching and other fitness indicators (e.g., predicted VO₂ Max). 
  • Quality Measurement: HHS and CMS will develop quality measures that promote children’s health outcomes rather than just healthcare utilization. 
  • Pediatric Mental Health: HHS will ensure the Pediatric Mental Health Care Access Program at Health Resources and Services Administration (HRSA) is effective at providing access to pediatric mental health professionals, especially as youth anxiety and depression are increasing and are linked to factors such as screen time, vaping, poor nutrition and lack of physical fitness.  

For more information, please contact Sue Polis.

Sue Polis is Vice President of Public Relations and Government Affairs at Lutheran Services in America.

What the Budget Bill Means for Medicaid and our Network

July 17, 2025

BY: Sarah Dobson

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.

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