The Centers for Medicare and Medicaid Services reduced funding to $10 million nationally for the 2026 Navigator Program for states using the federally facilitated marketplace, Healthcare.gov. A unanimous, bipartisan effort by the PA Legislature in 2019 moved Pennsylvania away from the federally facilitated marketplace, Healthcare.gov, to a state-based exchange, Pennie. This shields Pennsylvania from these cuts and from the ebbs and flows of federal funding fluctuations. It has allowed Pennsylvania to take control of operations and customer services at a significantly lower cost and use the financial savings to launch a reimbursement program to lower premiums. See the CMS Press Release.

Income, assets and household size determine eligibility for some Medicaid and Medicare programs. The Pennsylvania Health Law Project (PHLP) has a resource library with helpful guides to assist consumers with enrollment into the Medicare Savings Program, Part D Extra Help, Medical Assistance for Workers with Disabilities and other programs.

HHS recently released the HIPAA Security Rule to Strengthen Cybersecurity of Electronic Protected Health Information (PHI). The proposed rule attempts to address cybersecurity best practices, methodologies, and guidelines that would significantly impact Community Health Centers. Please view the recording and PowerPoint slides from NACHC’s February webinar on the proposed rule to learn more. We will circulate a comment letter template on Friday, Feb. 28, so FQHCs can tailor their feedback and ensure their voice is heard. The deadline for comments is Friday, March 7. To help us craft a strong comment letter, please send your thoughts and feedback on the proposed rule to regulatoryaffairs@nachc.org.

House Republicans released a budget blueprint that orders the primary healthcare committee to slash spending by $880 billion. The Budget Committee draft is the first step in an expedited process known as budget reconciliation that Republicans are using to extend tax cuts from Pres. Donald Trump’s first term, as well as to fund border security, energy and defense initiatives. The budget resolution does not spell out how the Energy and Commerce Committee must find $880 billion in spending cuts over the next decade. But Medicare and Medicaid are by far the largest programs under its jurisdiction, and Trump has repeatedly vowed not to touch Medicare as he seeks to renew tax cuts for corporations and wealthy households that are due to expire at the end of the year. Source: NBC News

Pennsylvania Govern Josh Shapiro filed a lawsuit challenging the Trump Administration’s unconstitutional freeze of federal funding. Even after multiple court orders to release the federal funds and Gov. Shapiro’s engagement with Pennsylvania’s federal representatives, state agencies still remain entirely unable to access $1.2 billion in federal funding, with an additional $900 million requiring an undefined review by federal agencies before it can be drawn down. To ensure the interests of the commonwealth and its residents are protected, Gov. Shapiro is taking legal action to restore access to this funding.

Click here to learn more.

The Centers for Medicare & Medicaid Services (CMS) released updated information on vaccine payment policies for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs). Effective January 1, 2025, CMS Hepatitis B vaccines are paid like other Part B preventive vaccines. New claim-based payments for Part B preventive vaccines and their administration are effective July 1, 2025. RHCs and FQHCs will need to annually reconcile payments with the facilities’ actual vaccine and vaccine administration costs on their cost reports. Get more information from CMS.gov.

The U.S. Department of Health & Human Services published the guidelines on household income that determine eligibility for Medicaid and a number of other Federal programs.

President Donald Trump’s executive orders have begun to disrupt patient care in the United States, as some providers cannot access essential federal funding, according to interviews with a dozen healthcare providers and policy advocates. Facilities in Virginia and West Virginia told Reuters they were forced to shutter primary care clinics or lay off staff. Other community health clinics in California and Virginia said they received notices of termination for federal grants that support HIV prevention care. Source-Reuters

With Medicaid and CHIP Enrollment at more than 79 million people nationally, data shows the wide range of services accessed by consumers ranging from preventative care to hospital stays and prescription drugs. Medicaid pays for half of all U.S. births and is the largest payer of long-term care and behavioral health services. Pennsylvania has over three million enrollees with more than 750,000 due to Medicaid expansion. Access the Department of Human Services Data Dashboard and Reports for more information.

The CDC issued a report last week showing that the maternal mortality rates decreased between 2022 -2023 for White, Hispanic, and Asian women. However, the rates increased for Black mothers – a group whose pregnancy-related death rate was already more than three times the rate for mothers of other racial and ethnic groups.