May 16, 2025

First, I was just on a call with our National Council colleagues who are reporting that (while it is not a done deal yet) the CCBHC SAMHSA eGrant Program is still alive.  Earlier this week we told you we had heard that SAMHSA officials were desperately trying to save the Grant Program, and today we learned that there is a ‘Dear Colleague’ letter being circulated on The Hill urging the Administration to retain SAMHSA CCBHC eGrant appropriations in the line item budget that is due out shortly from the White House (SFY26 executive budget proposal).  Again, it’s not a done deal just yet and still subject to change, but the vibes are positive today.  
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House Republicans today postponed the Budget Committee vote on the bill that the House Energy and Commerce Committee passed out of markup earlier this week. Still, Speaker Mike Johnson and Republicans’ goal is to bring the bill to the House floor for a vote in the middle of next week. They hope to convene this weekend behind closed doors to try and hammer out details that will move this out of the Budget Committee and into the Rules Committee, where it will be one step away from a floor vote. Five Republicans expressed concerns that the bill did not go far enough to reduce spending and joined with Democrats in voting against it. House Republicans will now huddle over the weekend and attempt to make changes to the bill. If it passes the Budget Committee, the bill would head next to the Rules Committee and then to the House floor, where it would need to be voted on by the full House and the full Senate before being sent to the president’s desk to be signed. A vote on the House floor could come as soon as next week. Meanwhile, members of both chambers — and of both parties — expressed reservations about various pieces of the larger reconciliation package as it comes together, with Senate Majority Leader John Thune, R-S.D., indicating his chamber would make changes and Sen. Ron Johnson, R-Wisc., describing the pending bill as “the Titanic.”
Many rank and file moderates in the House are reluctant to cast a vote on the House floor in favor of draconian cuts that will take essential services and support away from their constituents.  None of them want to go on the record casting a vote for that, and so Johnson has a tiny needle to thread. I don’t think this is fatal, but it is clear Johnson is making concessions to move the process forward.
That means now is the time for all of us to dial up the pressure on members of Congress and demand they oppose this bill.

In addition to the quagmire (described above) we are hearing that moderate Republicans are vying heavily for a higher cap on the SALT deduction, while more conservative members are pushing for deeper health care cuts and acceleration of implementation of those cuts – all in an effort to find the savings necessary to deliver the tax cut for the Administration. 

What is the SALT – state and local tax deduction – issue?  It allows people who itemize when they pay taxes, generally wealthier people, to deduct their state and local taxes from their federal taxes. Most of the benefits from the SALT deduction go to the highest income taxpayers due to the deduction’s regressive design. It was capped in 2017 and Republican members are seeking to lift the cap. Lifting the cap would mean a reduction in federal tax revenues. In order to pay for this, the House bill would have to take money from somewhere.  And they would take it from health care.

The intel is that some House members – including the four (listed below) may trade deeper cuts to Medicaid and the Affordable Care Act provisions to pay for a higher SALT deduction cap.  This will prioritize very wealthy people over people with low income and people with disabilities, placing more of a burden on Medicaid and other entitlements.
All this to say we need calls into the offices of the following NYS representatives TODAY:  

Rep. Nick LaLota, NY-1: 202-225-3826

Rep. Andrew Garbarino, NY-2: 202-225-7896

Rep. Nicole Malliotakis, NY-11: 202-225-3371

Rep. Mike Lawler, NY-17: 202-225-6506

The hyperlinks above will take you to the Medicaid Matters fact sheets for each of these districts.  Use them as your guide if you want to include data and details when you make your calls.

The message is simple:  Do not trade deeper cuts to vulnerable New Yorkers, to include New Yorkers with mental health and substance use disorder conditions, for a higher SALT deduction cap.  Your constituents are watching and we are relying on you to do the right thing and preserve Medicaid and other critical entitlement programs that are essential for so many New Yorkers to maintain their community tenure and to prevent the need for more acute (and expensive services) further down the line.   

Thank you for all you are doing and for continuing this fight!  

——————In other news, some of you may be aware that NYS is currently defending itself against a class action lawsuit on behalf of children and youth here in New York who cannot access HCBS services as needed.  The litigation began several years ago and (based on a few conversations I’ve had recently with state officials) this is top of mind for government agencies at the present time).  
Here’s something from NHelp that describes a similar battle (and positive outcome) for kids and youth in Iowa: