Adam Searing
@adamsearing.bsky.social
Attorney, Research Professor, Georgetown University, McCourt School of Public Policy, Center for Children and Families. Hiker (with Bear), kayaker, sailor, mountain biker, member Chapel Hill Town Council in my spare time.
Trump Administration Severely Limits Funding for Rural Hospitals and Clinics from Rural Health Transformation Fund – Capped at 15%
ccf.georgetown.edu/2025/10/21/t...
ccf.georgetown.edu/2025/10/21/t...
Trump Administration Severely Limits Rural Health Transformation Funds for Rural Hospitals and Clinics – Capped at 15%
Passage of the budget reconciliation law signed into law by President Trump (HR1) will result in a gross reduction of $990 billion in federal Medicaid and CHIP spending over 10 years and an increas…
ccf.georgetown.edu
October 21, 2025 at 5:14 PM
Trump Administration Severely Limits Funding for Rural Hospitals and Clinics from Rural Health Transformation Fund – Capped at 15%
ccf.georgetown.edu/2025/10/21/t...
ccf.georgetown.edu/2025/10/21/t...
Reposted by Adam Searing
From @adamsearing.bsky.social the latest on the budget reconciliation law rural health fund. Trump Admin is telling states they can’t use more than 15% of $ for provider payments including to rural hospitals & wants states to expand enrollment in short term plans. ccf.georgetown.edu/2025/09/19/u...
Unpacking the Rural Health Transformation Fund Created by Congress to Soften Impact of Medicaid Cuts on Rural Hospitals
I grew up in North Carolina and often split my time between the urban center of the state and some of its most beautiful and rural areas on the back sounds “Down East.” This part of NC is so rural …
ccf.georgetown.edu
September 20, 2025 at 12:10 AM
From @adamsearing.bsky.social the latest on the budget reconciliation law rural health fund. Trump Admin is telling states they can’t use more than 15% of $ for provider payments including to rural hospitals & wants states to expand enrollment in short term plans. ccf.georgetown.edu/2025/09/19/u...
Reposted by Adam Searing
Georgia's Medicaid work requirement program spends more on administrative costs than on providing care and has enrolled less than 3% of the eligible population. Thanks to HR 1, we'll be rolling it out to the whole country. Senseless. @apnews.com apnews.com/article/geor...
Federal watchdog report on Georgia's Medicaid program raises concerns about administrative costs
A government watchdog has raised concerns about high administrative costs in Georgia's Medicaid program. The U.S.
apnews.com
September 19, 2025 at 5:39 PM
Georgia's Medicaid work requirement program spends more on administrative costs than on providing care and has enrolled less than 3% of the eligible population. Thanks to HR 1, we'll be rolling it out to the whole country. Senseless. @apnews.com apnews.com/article/geor...
I‘m thinking today about Saint Ignatius, the Budget Reconciliation Bill’s “Rural Health Transformation Fund” and Down East North Carolina:
Will the Trump Administration use the Rural Health Fund to try and improve rural health or is it all politics?
ccf.georgetown.edu/2025/09/19/u...
Will the Trump Administration use the Rural Health Fund to try and improve rural health or is it all politics?
ccf.georgetown.edu/2025/09/19/u...
Unpacking the Rural Health Transformation Fund Created by Congress to Soften Impact of Medicaid Cuts on Rural Hospitals
I grew up in North Carolina and often split my time between the urban center of the state and some of its most beautiful and rural areas on the back sounds “Down East.” This part of NC is so rural …
ccf.georgetown.edu
September 19, 2025 at 8:13 PM
I‘m thinking today about Saint Ignatius, the Budget Reconciliation Bill’s “Rural Health Transformation Fund” and Down East North Carolina:
Will the Trump Administration use the Rural Health Fund to try and improve rural health or is it all politics?
ccf.georgetown.edu/2025/09/19/u...
Will the Trump Administration use the Rural Health Fund to try and improve rural health or is it all politics?
ccf.georgetown.edu/2025/09/19/u...
Reposted by Adam Searing
ICYMI: from Georgetown CCF and CHIR our comprehensive analysis of the budget reconciliation law's draconian #Medicaid, CHIP, ACA Marketplace cuts as well as other health provisions. We now have an easier-to-print PDF version. ccf.georgetown.edu/2025/07/22/m...
Medicaid, CHIP, and Affordable Care Act Marketplace Cuts and Other Health Provisions in the Budget Reconciliation Law, Explained
Editor’s Note: this brief was updated on August 13, 2025 to reflect additional Congressional Budget Office coverage estimates of the reconciliation law issued on August 11, 2025 In partnership with…
ccf.georgetown.edu
September 19, 2025 at 5:37 PM
ICYMI: from Georgetown CCF and CHIR our comprehensive analysis of the budget reconciliation law's draconian #Medicaid, CHIP, ACA Marketplace cuts as well as other health provisions. We now have an easier-to-print PDF version. ccf.georgetown.edu/2025/07/22/m...
Buried in grant docs for HR1 Rural Health Fund:
States more likely to get $ by passing GOP priorities like getting rid of CON laws, expanding skimpy health plans, limiting SNAP and changing scope of practice. Plus Govs rqd to agree in writing - by 11/5
www.grants.gov/search-resul...
States more likely to get $ by passing GOP priorities like getting rid of CON laws, expanding skimpy health plans, limiting SNAP and changing scope of practice. Plus Govs rqd to agree in writing - by 11/5
www.grants.gov/search-resul...
Lock
www.grants.gov
September 15, 2025 at 9:26 PM
Buried in grant docs for HR1 Rural Health Fund:
States more likely to get $ by passing GOP priorities like getting rid of CON laws, expanding skimpy health plans, limiting SNAP and changing scope of practice. Plus Govs rqd to agree in writing - by 11/5
www.grants.gov/search-resul...
States more likely to get $ by passing GOP priorities like getting rid of CON laws, expanding skimpy health plans, limiting SNAP and changing scope of practice. Plus Govs rqd to agree in writing - by 11/5
www.grants.gov/search-resul...
Messaging spin v. actual wording of the law that passed Congress:
Coming federal Medicaid cuts hitting state budgets will not be negated by the newly-created but misnamed Rural Health Transformation Program.
ccf.georgetown.edu/2025/09/02/u...
Coming federal Medicaid cuts hitting state budgets will not be negated by the newly-created but misnamed Rural Health Transformation Program.
ccf.georgetown.edu/2025/09/02/u...
Untangling the Current Debate Around Federal Medicaid Cuts, the “Rural Health Transformation Program” and State Medicaid Budgets
The Congressional Budget Office estimates that the budget reconciliation law signed into law by President Trump (HR1) will result in a gross reduction of $990 billion in federal Medicaid/CHIP spend…
ccf.georgetown.edu
September 2, 2025 at 7:27 PM
Messaging spin v. actual wording of the law that passed Congress:
Coming federal Medicaid cuts hitting state budgets will not be negated by the newly-created but misnamed Rural Health Transformation Program.
ccf.georgetown.edu/2025/09/02/u...
Coming federal Medicaid cuts hitting state budgets will not be negated by the newly-created but misnamed Rural Health Transformation Program.
ccf.georgetown.edu/2025/09/02/u...
Reposted by Adam Searing
Senate passed billion reduces federal #Medicaid spending by $1 trillion over 10 years and will have major implications for millions of people who rely on Medicaid coverage, states and providers.
The Senate has just passed what amounts to the biggest health reform plan since the ACA, rolling back many of the health insurance coverage increases achieved by the ACA.
July 1, 2025 at 4:29 PM
Senate passed billion reduces federal #Medicaid spending by $1 trillion over 10 years and will have major implications for millions of people who rely on Medicaid coverage, states and providers.
My home state GOP Senator Thom Tillis dug up the facts and said it best this week on $1 trillion in cuts to Medicaid. @JoanAlker1, Andy Schneider, and I let his words speak for themselves in our new blog. ccf.georgetown.edu/2025/07/01/t...
Truth to Power: A Republican Senator Stands Up for Medicaid and His Constituents; Then Announces Retirement
With Vice President breaking the tie, the U.S. Senate just voted 50-50 “One Big Beautiful Bill Act”, the crown jewel of President Trump’s legislative agenda. With final text not even availabl…
ccf.georgetown.edu
July 1, 2025 at 5:28 PM
My home state GOP Senator Thom Tillis dug up the facts and said it best this week on $1 trillion in cuts to Medicaid. @JoanAlker1, Andy Schneider, and I let his words speak for themselves in our new blog. ccf.georgetown.edu/2025/07/01/t...
Reposted by Adam Searing
@adamsearing.bsky.social and I wrote a blog about the "One Big Beautiful Bill" -- its an attack on the vision of universal coverage of the Affordable Care Act - President Obama's legacy.
ccf.georgetown.edu/2025/06/11/t...
ccf.georgetown.edu/2025/06/11/t...
The “One Big Beautiful Bill” is an Attack on the Affordable Care Act’s Vision of Health System that Works for Everyone
For over 100 years, the unfinished business of creating a health care system that covers all Americans has raged on. With President Obama making this a top priority, in 2010 this effort took an unp…
ccf.georgetown.edu
June 13, 2025 at 3:39 PM
@adamsearing.bsky.social and I wrote a blog about the "One Big Beautiful Bill" -- its an attack on the vision of universal coverage of the Affordable Care Act - President Obama's legacy.
ccf.georgetown.edu/2025/06/11/t...
ccf.georgetown.edu/2025/06/11/t...
Reposted by Adam Searing
Rural fund is thus a "fig leaf" to placate R Senators concerned about #Medicaid cuts. It's small/capped, temporary while the cuts are permanent, poorly targeted, gives discretion to Trump Admin to send $ to favored states, and may not even go to help rural hospitals actually hurt by the cuts (8/x)
June 28, 2025 at 3:37 PM
Rural fund is thus a "fig leaf" to placate R Senators concerned about #Medicaid cuts. It's small/capped, temporary while the cuts are permanent, poorly targeted, gives discretion to Trump Admin to send $ to favored states, and may not even go to help rural hospitals actually hurt by the cuts (8/x)
Reposted by Adam Searing
The Senate version of the Medicaid work requirement in the "OBBB" doubles down and worsens a bad policy advanced by the House.
It also gives the Trump Administration enormous leverage to protect their Governor friends and punish their enemies.
🧵
It also gives the Trump Administration enormous leverage to protect their Governor friends and punish their enemies.
🧵
June 28, 2025 at 4:25 PM
The Senate version of the Medicaid work requirement in the "OBBB" doubles down and worsens a bad policy advanced by the House.
It also gives the Trump Administration enormous leverage to protect their Governor friends and punish their enemies.
🧵
It also gives the Trump Administration enormous leverage to protect their Governor friends and punish their enemies.
🧵
Reposted by Adam Searing
One more thread on a new provision in Senate reconciliation bill that Senate GOP will misleadingly tout as expanding access to home- and community-based services for seniors and people with disabilities (section 71123) but in context of the bill, it won't be meaningful (1/x)
June 28, 2025 at 5:24 PM
One more thread on a new provision in Senate reconciliation bill that Senate GOP will misleadingly tout as expanding access to home- and community-based services for seniors and people with disabilities (section 71123) but in context of the bill, it won't be meaningful (1/x)
Reposted by Adam Searing
Want to know what Congress did to Medicaid in the middle of the night?
🔥 off the presses our georgetownccf.bsky.com explains.
ccf.georgetown.edu/2025/05/27/m...
🔥 off the presses our georgetownccf.bsky.com explains.
ccf.georgetown.edu/2025/05/27/m...
georgetownccf.bsky.com
May 28, 2025 at 6:32 PM
Want to know what Congress did to Medicaid in the middle of the night?
🔥 off the presses our georgetownccf.bsky.com explains.
ccf.georgetown.edu/2025/05/27/m...
🔥 off the presses our georgetownccf.bsky.com explains.
ccf.georgetown.edu/2025/05/27/m...
Reposted by Adam Searing
Our new report on the role of Medicaid for women of child-bearing age in rural areas w/ state by state data is here
Medicaid covers 47% births in rural areas
Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.
Medicaid covers 47% births in rural areas
Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.
May 16, 2025 at 4:53 PM
Our new report on the role of Medicaid for women of child-bearing age in rural areas w/ state by state data is here
Medicaid covers 47% births in rural areas
Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.
Medicaid covers 47% births in rural areas
Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.
Reposted by Adam Searing
New blog from @joanalker1.bsky.social & me on the latest developments with the draconian #Medicaid cuts in the House GOP reconciliation bill including new CBO estimates and Rules Committee changes making the cuts even harsher: ccf.georgetown.edu/2025/05/20/m...
Medicaid Cuts Grow Harsher as GOP Attempts to Ram Trump Agenda Through House Before Memorial Day
The full court press is on to pass the “One Big Beautiful Bill” with President Trump visiting the House Republican Caucus this morning to pressure competing factions to just say “yes” and pass the …
ccf.georgetown.edu
May 20, 2025 at 10:07 PM
New blog from @joanalker1.bsky.social & me on the latest developments with the draconian #Medicaid cuts in the House GOP reconciliation bill including new CBO estimates and Rules Committee changes making the cuts even harsher: ccf.georgetown.edu/2025/05/20/m...
CNN: "House Republicans are pushing to slash nearly $1 trillion from two of the nation’s bedrock safety net programs, Medicaid and food stamps....millions of Americans could lose access to these benefits as a result of a historic pullback in federal support."
www.cnn.com/2025/05/21/p...
www.cnn.com/2025/05/21/p...
House GOP lawmakers are proposing $1 trillion in cuts to Medicaid and food stamps. Here’s who could be impacted | CNN Politics
House Republicans are pushing to slash at least $1 trillion from two of the nation’s bedrock safety net programs, Medicaid and food stamps, as part of their sweeping package aimed at enacting Presiden...
www.cnn.com
May 21, 2025 at 5:25 PM
CNN: "House Republicans are pushing to slash nearly $1 trillion from two of the nation’s bedrock safety net programs, Medicaid and food stamps....millions of Americans could lose access to these benefits as a result of a historic pullback in federal support."
www.cnn.com/2025/05/21/p...
www.cnn.com/2025/05/21/p...
My @georgetownccf.bsky.social colleague Leo Cuello's detailed overview of Medicaid and immigrant health coverage - and how kids and pregnant women who are legal immigrants are now being targeted for health coverage cuts by the House "big beautiful bill" ccf.georgetown.edu/2025/05/21/t...
The Truth About Medicaid Coverage for Immigrants – and the Looming Threats
There has been a lot of information and misinformation about Medicaid coverage for immigrants circulating in the news, including wildly inaccurate reporting that undocumented immigrants are driving…
ccf.georgetown.edu
May 21, 2025 at 4:57 PM
My @georgetownccf.bsky.social colleague Leo Cuello's detailed overview of Medicaid and immigrant health coverage - and how kids and pregnant women who are legal immigrants are now being targeted for health coverage cuts by the House "big beautiful bill" ccf.georgetown.edu/2025/05/21/t...
Reposted by Adam Searing
Our new report on the role of Medicaid for women of child-bearing age in rural areas w/ state by state data is here
Medicaid covers 47% births in rural areas
Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.
Medicaid covers 47% births in rural areas
Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.
May 15, 2025 at 3:58 PM
Our new report on the role of Medicaid for women of child-bearing age in rural areas w/ state by state data is here
Medicaid covers 47% births in rural areas
Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.
Medicaid covers 47% births in rural areas
Rural areas have been losing labor + delivery units. Medicaid cuts will make this scary situation even worse for moms and babies.
Reposted by Adam Searing
An under-appreciated aspect of a Medicaid work requirement is the enormous administrative expense involved in managing reporting by enrollees of their work hours or eligibility for an exemption.
As Congressional Republicans push for Medicaid work requirements, here’s how it’s going in Georgia:
Deloitte Consulting is taking in tens of millions in tax dollars to manage the country’s only Medicaid work requirement program — and sell it to the public.
Only 3% of those eligible have enrolled.
Deloitte Consulting is taking in tens of millions in tax dollars to manage the country’s only Medicaid work requirement program — and sell it to the public.
Only 3% of those eligible have enrolled.
The Firm Running Georgia’s Struggling Medicaid Experiment Was Also Paid Millions to Sell It to the Public
Deloitte Consulting is taking in tens of millions in tax dollars to build, manage and market Georgia’s Medicaid work requirement program. Yet only 3% of eligible residents have enrolled.
www.propublica.org
May 15, 2025 at 3:53 PM
An under-appreciated aspect of a Medicaid work requirement is the enormous administrative expense involved in managing reporting by enrollees of their work hours or eligibility for an exemption.
Reposted by Adam Searing
Thursday May 15th at9:45 ET we release a new report on Medicaid's role for women of child-bearing age in rural America. Open to all.
We have some great speakers including @katybkoz.bsky.social
@edwincpark.bsky.social will share the latest from the House markup
georgetown.zoom.us/webinar/regi...
We have some great speakers including @katybkoz.bsky.social
@edwincpark.bsky.social will share the latest from the House markup
georgetown.zoom.us/webinar/regi...
Welcome! You are invited to join a webinar: Webinar and Report Release: Medicaid Key to Maternal and Infant Health in Rural America. After registering, you will receive a confirmation email about join...
Georgetown University CCF will share a new report with state-by-state data on Medicaid coverage of women of reproductive age and how cuts could impact their access to obstetric care in small towns and...
georgetown.zoom.us
May 14, 2025 at 7:23 PM
Thursday May 15th at9:45 ET we release a new report on Medicaid's role for women of child-bearing age in rural America. Open to all.
We have some great speakers including @katybkoz.bsky.social
@edwincpark.bsky.social will share the latest from the House markup
georgetown.zoom.us/webinar/regi...
We have some great speakers including @katybkoz.bsky.social
@edwincpark.bsky.social will share the latest from the House markup
georgetown.zoom.us/webinar/regi...
Reposted by Adam Searing
My Georgetown CCF colleague Leo Cuello examines the harsh #Medicaid work requirement provision being considered in the House Energy and Commerce Committee as we speak: ccf.georgetown.edu/2025/05/13/h...
How Do We Know Congress’s Work Requirements in Medicaid Will Fail? They Already Have.
As expected, the House’s rushed attempt to finance the Trump Administration’s immigration and tax agenda by cutting Medicaid includes a “work requirement.” Proponents claim that it is intended to s…
ccf.georgetown.edu
May 13, 2025 at 10:54 PM
My Georgetown CCF colleague Leo Cuello examines the harsh #Medicaid work requirement provision being considered in the House Energy and Commerce Committee as we speak: ccf.georgetown.edu/2025/05/13/h...
Reposted by Adam Searing
My new Georgetown CCF blog on harmful impact of the House Energy and Commerce Committee reconciliation bill’s restrictions on state use of #Medicaid provider taxes which will make it much harder for states to finance their share of Medicaid costs: ccf.georgetown.edu/2025/05/13/h...
House Energy and Commerce Committee Reconciliation Bill Would Restrict State Use of Provider Taxes and Undermine State Financing of Medicaid
The House Energy and Commerce Committee is completing its markup of its section of the House Republican budget reconciliation bill. The bill includes draconian Medicaid cuts, as well as…
ccf.georgetown.edu
May 13, 2025 at 10:58 PM
My new Georgetown CCF blog on harmful impact of the House Energy and Commerce Committee reconciliation bill’s restrictions on state use of #Medicaid provider taxes which will make it much harder for states to finance their share of Medicaid costs: ccf.georgetown.edu/2025/05/13/h...
My new @georgetownccf.bsky.social blog on some of the cuts (and an attempt to change state policy toward immigrants) targeting Medicaid expansion in the House’s budget reconciliation bill ccf.georgetown.edu/2025/05/13/c...
Cuts to Medicaid Expansion in the Proposed Budget Reconciliation Bill being Considered by Congress
FMAP Cuts Tied to State Decisions to Expand Comprehensive Health Coverage with State-Only Funds to Children Regardless of Immigration Status Section 44111 of the proposed budget reconciliation bill…
ccf.georgetown.edu
May 13, 2025 at 11:04 PM
My new @georgetownccf.bsky.social blog on some of the cuts (and an attempt to change state policy toward immigrants) targeting Medicaid expansion in the House’s budget reconciliation bill ccf.georgetown.edu/2025/05/13/c...