The Federal Freeze, Medicaid, and the Direct Care Workforce

PHI is closely monitoring concerning developments over the past 24 hours, which have seen President Trump attempt to place a temporary freeze on federal grants, loans, and other financial assistance programs.

Slated to go into effect on 5 p.m. Tuesday, the freeze was temporarily halted by a federal judge late Tuesday afternoon.  This came in response to multiple legal actions—including a challenge from a multi-state coalition of attorney generals and a lawsuit from National Council on Nonprofits, the American Public Health Association, the Main Street Alliance, and SAGE.

PHI strongly condemns the Trump Administration’s targeted freeze of federal resources, given the grave challenges that it will bring to millions of Americans.

It is of particular concern that this federal freeze brought disruption to Medicaid portals in every state, and generated uncertainty about whether the freeze intended to target Medicaid reimbursement. When initially asked at a press briefing about whether the freeze would impact Medicaid reimbursement, White House Press Secretary Karoline Leavitt told reporters, “I’ll have to get back to you.”

A White House memo later confirmed that individual-supporting programs like Medicaid would not be effected by the targeted freeze. However, the day’s uncertainty brought into sharp focus that the GOP is targeting permanent reductions in Medicaid spending that would be far more harmful to Americans than a temporary freeze.

In a recent letter to President Trump, PHI noted how cuts to Medicaid “will bring significant disruption to care in the United States, and have a profound negative impact on older adults, people with disabilities, and direct care workers.”

Actions like yesterday’s appear intended to sow confusion and chaos for the many Americans who deliver and rely on public programs.  We should not let these actions have their intended effect.

It is a time for us to stand together—as nonprofits, as healthcare providers, as advocates—to ensure that direct care workers hold quality jobs, that family caregivers have the support and partnership they need, and—critically—that older adults and people with disabilities benefit from high-quality care and support in the settings they choose.

We will need partnership from policymakers who truly care about the impact of policies on the lives of their constituents. We as Americans need leadership that will bring out the best in us—allies and champions helping to ensure that the most vulnerable among us see better lives. And, together, we need to hold firm to—and fight for—a vision of a care economy that fairly supports us all.