If Congress cuts Medicaid funding to states to help extend tax cuts, dental care for adults could be one of the first casualties as legislators and governors re-sort priorities and try to make do with less. All states cover some level of dental services for people over 21, but the generosity of benefits varies, and states already tend to cut or eliminate adult dental benefits when budgets are tight. Comprehensive Medicaid dental coverage is associated with better oral health, and better oral health, in turn, is connected to decreased risk of cardiovascular disease, pregnancy complications and other physical health concerns. The lack of dental insurance also pushes people to the hospital for treatment, where it’s more expensive to provide care. Read more.
Potential Medicaid Cuts Loom Over Pennsylvania Human Services Budget
House lawmakers delved into the complex issue of potential massive cuts in federal Medicaid spending amid increased use of that program during a budget hearing Tuesday, March 4, for the Department of Human Services (DHS). “We must acknowledge uncertainty in federal funding for a number of programs that help create stability and bridges to success for millions of Pennsylvanians,” said DHS Secretary Dr. Val Arkoosh in budget testimony before the Appropriations Committee. “Loss of funding or substantial programmatic changes will have significant ramifications for partners in local government, our provider community, and our fellow Pennsylvanians. Today nearly 3 million Pennsylvanians, 23 percent of our population, access health care through Medicaid, including 750,000 who are covered through Medicaid expansion.” The Republican-controlled U.S. House adopted a federal budget resolution last week that instructs the House Energy and Commerce Committee, which has jurisdiction over Medicaid, to identify at least $800 billion in mandatory spending cuts during the next 10 years. Medicaid is seen as a prime target for cuts since it’s one of the largest federal programs costing more than $600 billion a year. This resolution went to the GOP-controlled U.S. Senate. Any cuts are likely to affect the federal Affordable Care Act providing health insurance to people with low incomes, including seniors, those with disabilities and pregnant women. Click here to read more. Click here to watch the House hearing. Click here to watch the Senate hearings.
RFK Jr.’s “Radical Transparency” Means Ending a 54-Year-Old Transparency Policy
Robert F. Kennedy Jr., the Department of Health and Human Services secretary who promised “radical transparency” shortly after his Senate confirmation, 10 days later announced that he was ending a 54-year-old department transparency commitment. On Friday morning, Feb. 28, Kennedy filed a bureaucratic notice headlined as, “Policy on Adhering to the Text of the Administrative Procedure Act.” The notice was first reported by Isabella Cueto at Stat News. As the notice summarizes the action: SUMMARY: The Department of Health and Human Services’ (the Department) Immediate Office of the Secretary is rescinding the policy on Public Participation in Rule Making (Richardson Waiver) and re-aligning the Department’s rule-making procedures with the Administrative Procedure Act. The Administrative Procedure Act — which sets forth the procedures for agency rulemaking, including notice and comment — exempts regulations relating to “public property, loans, grants, benefits, or contracts” from notice and comment. Learn more.
ERS: Aging and Wildfire Risk to Communities Report Released
A new report from the Economic Research Service (ERS) at the U.S. Department of Agriculture found that most (87 percent) of the recent population growth in places with wildfire risk has been among persons age 60 and older. Already, the proportion of older people living in places with more wildfire risk is higher than in the population at large. In rural areas with the greatest wildfire risk, 35 percent of people living in those areas are age 60 and older. The report examines population aging and wildfire risk for States, counties, and fire management areas.
HRSA Announces Tom Engels’ Return as Administrator
Mr. Engels previously led HRSA from 2019 to 2021 and brings a wealth of experience, including his work on the White House’s COVID-19 task force and implementing the Provider Relief Fund. He returns to HRSA from his recent role as Sergeant at Arms at the Wisconsin Senate.
Drug Overdose Deaths Fall Released
Data from the National Center for Health Statistics show that the age-adjusted rate of drug overdose deaths in the United States decreased by 4.0 percent from 2022 to 2023. The report includes a table with state-by-state numbers for overdose deaths for any opioid, synthetic opioids other than methadone, psychostimulants with abuse potential, and cocaine. HRSA’s Federal Office of Rural Health Policy funds a variety of grant programs each year through the Rural Communities Opioid Response Program, including three Rural Centers of Excellence focused on rural-specific prevention, treatment, and recovery. See Approaching Deadlines below for new funding opportunities under this program
New Report: Oral Health Spending in the United States
A study recently published in the Journal of the American Medical Association (JAMA) explores health care spending and utilization in the United States from 2010-2019. The investigators founds that spending for oral disease was $93 million, which was higher than spending for heart disease.
Click here for the oral health summary of the article.
Click here to read the full article.
New Rural Health Value Resource Published: Introduction to Rural Clinically Integrated Networks
The Rural Health Value team is pleased to share a new resource, entitled Introduction to Rural Clinically Integrated Networks (CINs). The purpose of this Rural Health Value topic brief is to define CINs, describe common CIN characteristics, and explore the unique value-based care advantages a rural CIN may bring to its members. The conclusion is that a collaboration of independent rural HCOs, incorporated as a CIN, can achieve the scale and develop the infrastructure necessary to successfully participate in value-based care and payment opportunities. Furthermore, CINs can be a powerful vehicle to deliver better rural health care, healthier rural people, and smarter spending.
Related resources on the Rural Health Value website:
- A Rural Accountable Care Organization’s Journey. For more than a decade, South East Rural Physicians Alliance Accountable Care Organization (SERPA-ACO) – a physician-led ACO that includes 16 physician-owned clinics in Nebraska – has been leveraging health care payment and delivery models to provide high quality, comprehensive, coordinated, and patient-centered care at a lower cost.
- Rural Value-Based Care – The Payer Perspective, Rural Health Value Summit Report. The Rural Health Value team convened professionals and executives from national and regional health care payer organizations to share and explore insights, innovations, successes, and challenges in rural health value-based care (VBC) contracting. This report summarizes challenges and solutions followed by suggestions for rural health care organization leaders from the Summit participants.
Rural Health Value facilitates the transition of rural healthcare organizations, payers, and communities from volume-based to value-based health care and payment models. Visit www.ruralhealthvalue.org
Contact information: Clint MacKinney, MD, MS, Co-Principal Investigator, clint-mackinney@uiowa.edu
Medicaid Cuts Would Cost Hospitals Billions, Spike Uncompensated Care Costs: Report
From Becker’s Financial Management
Hospitals and health systems could face severe financial consequences if Congress moves forward with proposed Medicaid funding cuts, with new research projecting an $80 billion revenue loss for providers in 2026 and a sharp rise in uncompensated care costs.
This month, the Senate is expected to vote on a budget resolution passed by House Republicans on Feb. 25. The legislation directs the Energy and Commerce Committee, which oversees Medicare and Medicaid, to identify $880 billion in savings over the next 10 years.
The resolution does not specify how the committee must achieve these savings, but Medicare and Medicaid account for the largest share of its oversight. The Congressional Budget Office has said that reaching the $880 billion healthcare savings target over the next decade would likely require significant cuts to Medicaid or the Children’s Health Insurance Program.
A March 11 report from the Urban Institute and the Robert Wood Johnson Foundation analyzed the impact of potential federal funding reductions for Medicaid expansion programs. The findings suggest that if all 41 states that expanded Medicaid eligibility over the past decade were to drop the program in response to federal cuts, nearly 11 million people would lose coverage, leading to widespread financial strain on healthcare providers.
The analysis projects hospitals would bear the brunt of revenue cuts, facing a $31.9 billion decline in 2026 alone. At the same time, the cost of uncompensated care would rise by $6.3 billion. The study also forecasts:
- $20.9 billion less spent on prescription drugs
- $20.7 billion less on other healthcare services, including dental care, home healthcare and services from non-hospital providers
- $6.4 billion less on office-based physician services
The financial hit would not be evenly distributed, with some states — Arizona, Indiana, New Mexico, New York, North Carolina, North Dakota, Oklahoma and Oregon — facing healthcare spending cuts exceeding 6%. Researchers warn such reductions could be particularly devastating for rural hospitals, where Medicaid expansion has played a critical role in maintaining financial viability.
Medicaid expansion, introduced under the ACA, covers millions of working Americans who earn modest incomes but do not receive employer-sponsored insurance. The federal government currently funds 90% of the costs for states that opt into the expansion. If funding is cut, states may be forced to reconsider their participation, which could have far-reaching consequences beyond coverage loss, according to the report.
“As Republicans in Congress consider significant cuts to the Medicaid program, it is important that federal, state, and local policymakers and stakeholders consider potential adverse effects on healthcare coverage, access and affordability, and health providers,” Fredric Blavin, senior fellow at the Urban Institute, said in a news release.
Beyond the direct impact on hospitals and patients, the study underscores potential ripple effects across local economies. Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, noted that hospitals are often the largest employers in their communities.
“A funding reduction of this magnitude would not only cause a massive coverage loss but would also be financially devastating for hospitals and other healthcare providers,” Hempstead said. “Hospitals are major employers and are often the economic bedrock of their communities. These cuts would have major ripple effects on local economies, especially in rural areas.”
Click here for more details on the report.
Pennsylvania Child Care Fact Sheets and Online Mapping Tool Released for 2025
Every child deserves an equal opportunity for quality early care and education in their earliest years to ensure they are well prepared to learn, grow, and succeed. While the child care sector has been facing a workforce shortage impacting access to high-quality child care for families in recent years and particularly since the pandemic, we are hopeful the Governor’s proposed $55 million recruitment and retention effort will be included in final budget negotiations. Our 2025 interactive maps and corresponding fact sheets for the Start Strong PA campaign are now available and show data about the workforce, high-quality access, and quality. Fact sheets are available by county, school district, and legislative district.
Key data points include:
- The average annual salary of child care workers in 2023 was $29,480, which is over $39,000 less than the average annual salary of kindergarten teachers.
- Of the 177,710 eligible children under 5 years living in Pennsylvania, only 28% access the Child Care Works subsidized child care program. Of these 49,225 children, only 53% are enrolled in high-quality child care.
- Of Pennsylvania’s 104,470 eligible infants and toddlers, only 23% access the Child Care Works subsidized child care program. Of these 24,292 children, only 50% are enrolled in high-quality child care.
- Support the proposed investment of $55 million in a new and recurring Child Care Recruitment and Retention line item to grant licensed child care providers participating in the child care subsidy program an additional $1,000 per educator.
- To more fully address the child care staffing crisis and its impact on working families, businesses, and the economy, consider an investment above the proposed $55 million.
As part of the 2025-26 final state budget, Pennsylvania policymakers should:
- Support the proposed investment of $55 million in a new and recurring Child Care Recruitment and Retention line item to grant licensed child care providers participating in the child care subsidy program an additional $1,000 per educator.
- To more fully address the child care staffing crisis and its impact on working families, businesses, and the economy, consider an investment above the proposed $55 million.
Click here to access the fact sheets and online maps.