HR 1 requires states to verify Medicaid beneficiary addresses by January 1, 2027, and submit cross-state data to CMS by October 1, 2029, to prevent duplicate enrollment. Marcella Maguire and Alison Barkoff warn populations experiencing homelessness, housing instability, child welfare involvement, or reentry from incarceration face particular risks of losing coverage. 

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The federal government shut down after lawmakers failed to approve spending by the start of the new fiscal year on October 1. Social Security and Supplemental Security Income benefits will continue, and IDEA funding will be disbursed on schedule. However, the Education Department's Office for Civil Rights will halt investigations, and CMS is unlikely to approve state plan amendments and waivers.

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Natalie Eilbert profiles Wisconsin's disability community facing threats from Trump administration policies. Cindy Bentley, 67, executive director of People First Wisconsin, lived in institutions from age 8 to 26 and now receives support through Wisconsin's IRIS Program (Include, Respect, I Self-Direct). "I go to bed crying because I'm terrified about them reopening institutions," Bentley said. Stacy Ellingen, an Oshkosh resident with cerebral palsy who hires caregivers through IRIS, struggled to fill 20 October shifts as caregivers earn $12-16/hour. Trump's $880 billion Medicaid cuts threaten services for 63,000 Wisconsin childless adults under new work requirements.

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The Wisconsin Board for People with Developmental Disabilities launched its Policy Internship.  It is an innovative paid experience to empower people with developmental disabilities and their family members to engage in policy advocacy and leadership. Applications due October 31st.

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Target recently announced that  the launch of a first-of-its-kind accessible self-checkout experience, designed with and for guests with disabilities, including those who are blind or have low vision. Beginning this holiday season and early into next year, these new checkouts will be installed in stores across the country.

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Howard Gleckman reports on recommendations from the Coalition to Transform Advanced Care and National Alliance for Caregiving to better support America's family caregivers through Medicare payment reforms. Proposals include expanding billing codes for caregiver training, integrating caregiver assessments into care planning, and requiring Medicare Advantage plans to offer supplemental benefits like respite care for families caring for enrollees with serious illness or dementia. The Trump Administration has stalled federal caregiver initiatives by firing program staff.

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PHI report shows home care workforce doubled from 1.4 million to 3.2 million workers over the past decade, with most employed as independent providers through Medicaid-funded consumer direction programs. Despite adding 681,000 new jobs by 2034, over 6.1 million total openings will result from turnover. Home care workers earn median wages of $16.77/hour and annual income of $22,429, with 60% receiving public assistance. Medicaid payments constitute 68% of the $312.9 billion spent on HCBS annually.

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Bipartisan legislation by Reps. Salud Carbajal and Don Bacon would repeal Medicaid's Institutions for Mental Diseases exclusion, allowing federal funds for mental health facilities with more than 16 beds. The Consortium for Constituents with Disabilities and 60+ disability groups oppose the bill, arguing it could direct tens of billions toward institutionalization while community-based services face cuts from the One Big Beautiful Bill Act. CBO estimates eliminating the IMD exclusion would cost $7.7-38.4 billion.

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