From DC is Justice in Aging's weekly roundup of national news and resources about issues impacting older adults. To receive From DC in your inbox as soon as its published, sign up for our mailing list.
Here’s what we’re watching in Washington:
Advocates Ask SSA and CMS for HR 1 Medicare Eligibility Restrictions Implementation Records
Justice in Aging joined the Center for Medicare Advocacy, the National Immigration Law Center, and Refugee Council USA on a Freedom of Information Act (FOIA) request to the Social Security Administration (SSA) and the Centers for Medicare and Medicaid Services (CMS) seeking records related to implementation of Medicare eligibility restrictions for noncitizens enacted under H.R. 1.
An estimated 100,000 lawfully present immigrants will have their Medicare eligibility taken away under the new law, which restricts noncitizen eligibility for Medicare to legal permanent residents (green card holders), certain Cuban and Haitian immigrants, and people residing in the U.S. under a Compact of Free Association (COFA migrants). People with Temporary Protected Status (TPS) and other lawfully present immigrants are no longer eligible despite having lived and worked in the U.S. for decades.
Although these restrictions for new Medicare enrollees took effect immediately on July 4, 2025, SSA and CMS have not updated guidance or issued information about how the law will be implemented. The FOIA request seeks expedited production of records to provide transparency and to avoid confusion, fear, and unnecessary loss of health care.
Learn more about the changes to Medicare in Justice in Aging’s Older Immigrants and Medicare issue brief. Advocates can also learn about other provisions of H.R. 1 that impact older adults’ access to health and long-term care in our explainer and timeline.
CMS Opens Application for Rural Health Transformation Fund
On Monday, CMS released information on how states can apply to receive funding from the Rural Health Transformation Program (RHT) authorized under H.R. 1. RHT provides $50 billion for state grants, with funding to be distributed in $10 billion increments beginning in fiscal year 2026 through 2030.
The law specifies half of the funding will be distributed equally among all states with an approved application. (DC and the U.S. territories are not eligible.) CMS has discretion on how to allocate the remaining half of funding to states. The deadline for states to apply is November 5, 2025, and CMS plans to announce approvals by December 31, 2025.
States are engaging with stakeholders now to gather feedback on grant applications and how states should invest any future funding. As much of the focus on RHT has been on rural hospitals, it is important for advocates to urge their states to include funding for home-and community-based services and other programs that older adults rely on in their applications and spending plans.
New Justice in Aging Resources
- Issue Brief: Supporting LGBTQ+ Older Adults’ Basic Needs (9/18)
- FAQ: Access to Medicare for People Leaving Incarceration (9/18)
- Issue Brief: Advocacy with Public Housing Authorities: Expanding Affordable Housing Access for Formerly Incarcerated Older Adults (9/16)
- Comment Letter: Justice in Aging Comments on Changes to Medicare Current Beneficiary Survey (9/16)
- Comment Letter: Justice in Aging Comments on the Physician Fee Schedule CY 2026 (9/10)
- Issue Brief: Older Immigrants and Medicare (9/9)
- Resource: Communicating the Harm of Medicaid Estate Recovery (8/28)
- Fact Sheet: Collecting Medicaid Costs from Heirs: How Missouri Compares to Other States (8/28)
- Fact Sheet: Collecting Medicaid Costs from Heirs: How New Jersey Compares to Other States (8/28)
- Comment Letter: Justice in Aging Comments on the Application of the Fair Labor Standards to Domestic Services (8/21)
- Toolkit: Care Coordination for D-SNP State Medicaid Agency Contracts (8/19)
