You will find information here about impacts resulting from the recent change in administration and how resulting policy shifts affect and will affect state I/DD systems. Policy experts and colleagues will share information on congressional actions, federal rule changes, executive actions, administrative updates, state challenges, and other relevant topics in this environment. NASDDDS is working diligently to ensure our members are kept as up to date as possible in a rapidly evolving environment. All resources should be vetted to ensure you have the most recent version. Please reach out to NASDDDS at cmcgraw@nasddds.org with any questions or to receive clarification or confirmation on any posted items.
Resources:
- Summary Slides Joint Presentation of One Big Beautiful Bill Act
- Key Terms in I/DD Support Systems for State and National Leaders Brief
- HCBS Stories
- Medicaid Primer Infographic
- Medicaid Primer One Pager
- Budget Reconciliation Overview Infographic
- ADvancing States OAA and APS Infographics
Background Information:
- Study of Use of Presidential Powers (1957): https://www.nasddds.org/wp-content/uploads/2025/04/mdp-39015034716152-3-1744815076.pdf
Federal Information and Guidance:
- ENSURING LAWFUL GOVERNANCE AND IMPLEMENTING THE PRESIDENT’S “DEPARTMENT OF GOVERNMENT EFFICIENCY” DEREGULATORY INITIATIVE (posted 2/25/2025) https://www.whitehouse.gov/presidential-actions/2025/02/ensuring-lawful-governance-and-implementing-the-presidents-department-of-government-efficiency-regulatory-initiative/
- Fact Sheet-President Trump Reins in Waste (posted 2/27/2025): https://www.whitehouse.gov/fact-sheets/2025/02/fact-sheet-president-donald-j-trump-reins-in-government-waste/
- Guidance on Agency RIF and Reorganization Plans Requested by Implementing The President’s “Department of Government Efficiency” Workforce Optimization Initiative (posted 2/27/2025): https://chcoc.gov/content/guidance-agency-rif-and-reorganization-plans-requested-implementing-president%E2%80%99s-%E2%80%9Cdepartment
- New York Combined Decision Letter (posted 2/27/2025): https://acf.gov/sites/default/files/documents/ocse/NY-Combined-Decision-Letter_0.pdf
- Policy on Adhering to the Text of the Administrative Procedures Act (posted 2/28/2025): https://www.nasddds.org/wp-content/uploads/2025/02/2025-03300.pdf
- Nevada Response (posted 2/28/2025): https://www.leg.state.nv.us/App/NELIS/REL/83rd2025/Meeting/14313?p=3000000&p=6072209
- New Jersey Response (posted 2/28/2025): https://nj.gov/humanservices/news/publications/FEB%202025%20-%20Human%20Services%20Modeling%20Impact%20to%20NJ%20Medicaid%20of%20Congressional%20Budget%20Proposals.pdf
- NCSL Joins Others in Expressing Concerns Over Federal Medicaid Proposals (posted 3/4/2025): https://www.ncsl.org/resources/details/ncsl-joins-others-in-expressing-concerns-over-federal-medicaid-proposals
- Rescission of Guidance on HRSN: https://www.nasddds.org/wp-content/uploads/2025/03/cib03042025.pdf
- HR Full Year Budget Extension Act (posted 3/11/2025): https://www.nasddds.org/wp-content/uploads/2025/03/crfull_xml.pdf
- State lawsuit (posted 3/11/2025): https://www.nasddds.org/wp-content/uploads/2025/03/Lawsuit.pdf
- Continuing Resolution (posted 3/14/2025): https://appropriations.house.gov/sites/evo-subsites/republicans-appropriations.house.gov/files/evo-media-document/bill-text.pdf
- FY24 final budget (posted 3/14/2025): https://www.congress.gov/118/plaws/publ47/PLAW-118publ47.pdf
- Letter from Democrats to CMS (posted 3/14/2025): https://democrats-waysandmeans.house.gov/sites/evo-subsites/democrats-waysandmeans.house.gov/files/evo-media-document/w&m-enc-letter-to-cms-on-staff-cuts-final.pdf
- Dr Oz confirmation (posted 3/14/2025): https://www.finance.senate.gov/ranking-members-news/crapo-announces-cms-nomination-hearing
- Press Release: HHS Announces Transformation to Make America Healthy Again (3/27/2025): https://www.hhs.gov/about/news/hhs-restructuring-doge.html?eType=EmailBlastContent&eId=5d6bf64e-c34d-4427-82e2-22f9b1c3ac3e
- Fact Sheet: HHS’ Transformation to Make America Healthy Again (3/27/2025): https://www.hhs.gov/about/news/hhs-restructuring-doge-fact-sheet.html
- Letter to HHS-Reorganization and Staffing (4/2/2025): https://www.nasddds.org/wp-content/uploads/2025/04/letter_to_hhs_re_reorganization_and_staffing_reductions_3-31-25-1.pdf
- ACL move to ACF (posted 4/10/2025): https://www.ecfr.gov/current/title-45/subtitle-B/chapter-XIII/subchapter-C
- Rhode Island plaintiff state TRO (posted 4/10/2025): https://www.nasddds.org/wp-content/uploads/2025/04/TRO-Public-Health-Grants_Plaintiff-States-Only-Application-1.pdf
- NAMD Resource: Why Did They Do It That Way? Medicaid Financing (posted 4/30/2025): https://medicaiddirectors.org/resource/why-did-they-do-it-that-way-medicaid-financing/
- Unofficially released OMB Passback document (pre-decisional) (posted 5/6/2025): https://www.nasddds.org/wp-content/uploads/2025/05/Hhs_Reorganization_Proposal_Draft-1.pdf
Joint Association Webinar Series: Medicaid and Budget Reconciliation Procedural Basics
Joint Association Call: Federal Recap: May 8
Webinar Slides: https://www.nasddds.org/wp-content/uploads/2025/05/Federal-Check-in_Recap-Through-April-2025-050625-FINAL.pdf
Explaining the Budget Reconciliation Process: February 26
Webinar Slides: https://www.nasddds.org/wp-content/uploads/2025/02/Reconciliation-branded.pdf
Potential Medicaid Changes – Defining the Terms: February 27
Webinar Slides: https://www.nasddds.org/wp-content/uploads/2025/02/Joint-Association-Webinar-Possible-Medicaid-Changes-2-27-25_FINAL.pdf
Federal Information and Guidance (outdated):
- OMB Memo: Temporary Pause of Agency Grant, Loan, and Other Financial Assistance Programs (1/27/2025): https://www.nasddds.org/wp-content/uploads/2025/01/2025-0127-OMB-Memo-1.pdf
- Guidance Questions (1/27/2025): https://www.nasddds.org/wp-content/uploads/2025/01/OMB-QA-M-25-13.pdf
- Instructions for Federal Financial Assistance Program Analysis in Support of M-2513 (1/27/2025): https://www.nasddds.org/wp-content/uploads/2025/01/FILE_6108.pdf
- NOTE! Late in the day on January 27th, a federal judge temporarily blocked the funding pause. Please see the order below: https://www.nasddds.org/wp-content/uploads/2025/01/US_DIS_Judge-AliKhan-Order-1-28-25.pdf