From DC: Advocates Push SSA & CMS on Medicare Rules, CMS Launches Rural Health Fund Application and more

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.

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