As the House of Representatives takes out the knife for public health care -- mostly Medicaid -- Maryland and other states brace for a major struggle. Maryland needs Medicaid, for sure, but some Red states in the South REALLY, REALLY need Medicaid, and that could split the already fractious GOP House majority further. How to fight back? Stories. Yep, stories; lots of folks have stories about how Medicaid helped them stave off financial and family collapse. See how you can help And there's lots more -- child care support freeze and big federal cuts, including at UM, here in Maryland; AI bills by (just barely) the thousands in 50 state legislatures this year, the fired chief of the Library of Congress is replaced by one of Trump's criminal lawyers, and more. It's News You Can Use.

HERE IN MARYLAND

Rulemaking at the state level: How to make your voice heard: Laws are not the only way that policies are set within a state. The agencies tasked with enacting the laws also have authority to iron out details that are not specified within the laws themselves. This is called the administrative rulemaking process, and it offers another opportunity for the public to help shape policies that impact the environmental health of their waterways, forests, air quality and communities. Bay Journal

UMD researchers left with uncertain future after NSF cuts 14 grants
Multiple professors at this university  lost their National Science Foundation research grants within the last month. At least 14 National Science Foundation grants funding researchers at this university have been terminated as of May 12, according to the Grant Watch database compiled by a team including a Harvard University researcher. The National Science Foundation grants make up a part of the 70 grants — totaling about $12 million — that have been cancelled or paused at this university since Trump returned to office in January, according to university president Darryll Pines. The Diamondback (UM student newspaper)

State news summaries from Maryland Reporter:

New Mosh Workplace Standards Target Heat Illness Prevention: State health and labor officials hope that new workplace regulations will help workers avoid overheating on the job, as Maryland enters the annual heat season following a deadly 2024 summer. The Maryland Occupational Safety and Health division of the Department of Labor finalized new heat illness prevention standards in September, at the tail end of a 2024 heat season that saw 27 fatalities and more than 1,200 emergency room visits related to high temperatures. Maryland Matters.

State Freezes Child Care Scholarship Program for Now: Faced with a sharp rise in children in the child care scholarship program — and costs for it — the state imposed a freeze on new enrollments May 1. New parents can still apply for a child care scholarship, but will be placed on a waiting list until enrollment declines. Officials hope to lift the freeze by September, when the number of recipients is expected to decrease to 40,000. Maryland Matters.

How Federal, State Action Mayh Impact Maryland EV Programs: Maryland joined a coalition of states and Washington, D.C., in a lawsuit Wednesday to overturn an executive order from President Donald Trump that blocks billions in funding for electric vehicle charging stations. It’s one measure the state has taken to push back against recent federal action against electric vehicle expansion, which could impact Maryland’s shift away from gas-powered cars in the last decade. Here’s a look at how electric vehicle infrastructure and ownership has changed in Maryland and the federal and state legislation that threatens its success.  Capital News Service/Maryland Reporter.

Supporters Of Reparations Study Urge Moore To Sign Bill: Supporters of a measure to create a commission to study potential reparations for slavery in Maryland rallied by the governor’s residence on Friday, calling on Gov. Wes Moore to sign the legislation. Speakers at the rally said they were optimistic Maryland’s first Black governor would sign the bill, but they wanted to underscore how significant the legislation is to them, days before Moore’s fourth bill signing ceremony and possibly the last of the year. Associated Press.

Alsobrooks Will File 'No Confidence' Resolution for RFK Jr.: Sen. Angela Alsobrooks is “sick of” Robert F. Kennedy Jr. On Saturday, Maryland’s freshman senator called for Kennedy, the nation’s Health and Human Services secretary, to resign as she announced a resolution of “no confidence” against him at a “Sick Of It” rally at the Medical Center Metro Station in Bethesda.  Baltimore Sun.

State Dems Angry Over Firing Of Librarian Of Congress Carla Hayden: Maryland Democrats reacted swiftly, and angrily, Friday to news that President Donald Trump had fired the librarian of Congress, Carla Hayden, a former director of the Enoch Pratt Free Library in Baltimore who drew raves for her work there. Maryland Matters. AND This morning The No. 2 official at the Trump Justice Department has also been declared temporarily put in charge of the Library of Congress – that’s Todd Blanche, once Trump’s defense attorney in his criminal trial and conviction for business fraud last year – the New York Times reported. [As a law school graduate, NUCU assumes he has read at least a few books, so there’s that… .]

THE OTHER 49

By the (round) numbers: Pluribus reports that 1,000 bills related to artificial intelligence and its regulation have been proposed in the 50 states in the 2025 legislative year, quoting Multistate

FAMILY HISTORY PRIVACY: Attorneys general from Alabama, Arizona, California, Kentucky, New Hampshire, North Carolina and Texas have issued calls for customers of the DNA testing company 23andMe to delete their data as the company seeks to sell itself and the genetic data it holds. HIPAA laws do not apply to DNA testing companies. Fourteen states have passed laws regulating direct-to-consumer genetic testing. (Stateline) via Pluribus

GREEN MOUNTAIN HOUSING: Vermont lawmakers are nearing final passage of omnibus housing legislation. The bill would increase financing for housing projects in smaller towns, raise thresholds for legal challenges to new housing projects and increase protections for undocumented immigrants. The state budget allocates $15 million for two pandemic-era development programs that have since run out of money. (VT Digger) via Pluribus

Children’s health services could see trims even under scaled-back Medicaid cuts
Any cuts would strain state budgets, according to a new analysis. Even as Republicans in Congress walk back their most aggressive proposal to slash federal Medicaid spending, they are weighing other options that could force states to cut services for children and other vulnerable populations. U.S. House Speaker Mike Johnson told reporters last week that his caucus won’t reduce the 90% federal funding match that states get to cover working-age adults who became eligible for Medicaid under the Affordable Care Act. However, the GOP is still considering capping federal spending by setting a fixed amount for how much states receive for every Medicaid enrollee. That move would fundamentally change the nature of the program, which has been an open-ended entitlement since its passage 60 years ago. Meanwhile, Florida has passed a bill putting Medicaid for disabled persons in a managed-care program – but it has been amended so much Gov. Ron DeSantis may veto it, according to the Florida Phoenix. The pilot is being closely watched by other states. Via Stateline Daily

See much more on Medicaid and other health care changes in the works in Congress below, in Megan E’s roundup from People’s Action.

As Trump slashes AmeriCorps, states lose a federal partner in community service
The federal agency dedicated to community service and volunteerism, which works in close partnership with states, is the latest target since President Donald Trump began his second term with an aggressive campaign to dismantle programs and slash the federal workforce. The agency abruptly cut $400 million, or 41% of its budget, and placed 85% of its staff on administrative leave last month, according to court records. AmeriCorps had provided $960 million to fund 3,100 projects across the United States each year, according to general undated figures available on the agency’s website. States News Service – the impact in Maryland is outlined in ‘My world is flipped on its head right now’: AmeriCorps workers devastated by firings -- Maryland Conservation Corps workers’ dismissal, right before busy summer season, also threatens housing, benefits --  from Maryland Matters last week.

 MAINE DAYS: A Maine legislator is pushing for the state to transition to a 4-day workweek: Maine Morning Star via Stateline Daily

HAWAII: GO, SCIENCE!: Gov. Josh Green (D) has launched Heal America PAC, a group dedicated to backing what he calls pro-science candidates for federal office. Observers said Green is setting himself up as the counterpoint to Health and Human Services Secretary Robert F. Kennedy Jr., whose nomination Green opposed. (Civil Beat) via Pluribus

GLOBAL, NATIONAL, CONGRESS AND THE EXECUMESS

Mexico has sued Google over its decision to label the Gulf of Mexico as the Gulf of America, President Claudia Sheinbaum said Friday. Mexico says the label should only apply to the part of the gulf that sits on the U.S. continental shelf. (Los Angeles Times) via Pluribus

>>>>>>>>>>>>>>Here is Megan E’s weekly blast on the misbehavior of the executive branch and subservient Congress. She is federal affairs director for Progressive Maryland’s national affiliate, People’s Action.

Hello People's Action!

Executive Branch
Trump seems to be having a good day, including a trade deal with China that has the stock market numbers up this morning. You can read about it here as this email will mostly focus on Congress.

From Politico: Trump is signing “an executive order Monday that could limit Medicare drug costs by tying them to the lower prices other nations pay. It comes after Hill Republicans balked at a similar proposal for Medicaid as an alternative to steep cuts to the program in their megabill. The pharmaceutical industry has slammed the proposals; the new executive order could cost companies billions of dollars.” [PM  blog editor sez cue the violins].

ICYMI Newark Mayor Ras Baraka was arrested by ICE protesting the city’s private-prison ICE facility on Friday. 

Congress/Budget Reconciliation

We expect the committees to pass portions of the budget reconciliation this week, including: cuts to Medicaid, SNAP, climate funding and the tax provisions of the bill. Republicans plan to put it all together and pass it out of the House budget committee on Friday and then move the bill to the House floor next week.  Note: “reconciliation” means it can be passed without a filibuster by the Senate GOP majority – IF the Senate Parliamentarian certifies it is really reconciliation and not dodgeball.

Notably, Senator Josh Hawley penned a NYTimes oped today calling on Republicans to stop efforts to cut Medicaid (he did not respond to the particular bill text):  “If Republicans want to be a working-class party — if we want to be a majority party — we must ignore calls to cut Medicaid and start delivering on America’s promise for America’s working people,” Hawley wrote. 

Overall, the House appears on track to pass the budget reconciliation bill next week. Though many things could still go wrong. 

Republicans on the Energy & Commerce committee released bill text last night (committee section by section available) on their proposed changes to Medicaid and funding for climate and the environment. (Note that changes to the ACA premium tax credits and changes to energy tax credits will come out in the Ways and Means bill text). 

Note that I have organized this document, House Budget Reconciliation Policies & Committee Markups, with hyperlinks to the different policies that I’ll populate as they come out. I’ve added the E&C policies and will add SNAP and tax policies as I receive them. I will also try to add resources from partners as I receive them. 

Medicaid

In response to frontline Republicans, there are no broad changes to FMAP and no per capita caps. Instead, Republicans are focused on work requirements, increased paperwork, adding cost sharing on to people and shifting some costs to states. 

Democrats are out with an unofficial estimate from CBO stating that the overall estimated deficit reduction will be $912 billion over the decade with the NYTimes reporting it will cause 8.6 million people to become uninsured and Punchbowl reporting that it will cause 13.7 million more Americans to be uninsured. I think one area of the discrepancy is that the NYTimes is reporting that some 2.3 million more people who are dual enrolled in Medicare and Medicaid will lose their Medicare but technically not be left uninsured though they may not be able to afford the cost sharing (copays & out of pocket expenses) that Medicare requires. Medicaid fills that gap for many poor seniors and people with disabilities. 

The nerd tour of proposed health care changes: From the NYTimes: 

• Adding “work requirements to Medicaid for poor, childless adults, mandating that they prove they are working 80 hours every month to stay enrolled. That is a less flexible version of a work requirement briefly imposed in Arkansas in 2018 that caused 18,000 people to rapidly lose coverage.”
• Paperwork “allowing states to check the income and residency of beneficiaries more often, and permitting them to terminate coverage for people who do not respond promptly. The use of such strategies had been curtailed under a regulation published during the Biden administration.”
• Cost sharing - “Medicaid beneficiaries who earn more than the federal poverty limit — around $15,650 for a single person — to pay higher co-payments for doctor visits.” $35 for many services. 
• State Budgets - “a change to longstanding rules that allow states to impose taxes on hospitals, nursing homes and other providers and to use various accounting maneuvers to use the taxes to obtain more federal funding. The bill would freeze all state taxes at their current rates, and prevent states from using special related payments to pay hospitals higher prices for Medicaid services than Medicare pays.”
• States Covering Undocumented Immigrants on Medicaid - “The bill also takes direct aim at a handful of states controlled by Democrats that fund health coverage for undocumented immigrants, who are barred under the law from enrolling in Medicaid. The legislation would reduce federal funding for all childless adults without disabilities to 80 percent from 90 percent if the state subsidized coverage for such people. The change would mean significant funding cuts to states including California, New York and Washington unless they eliminated their state programs that enroll undocumented people.”
• Provision to prevent owners of expensive homes from obtaining nursing home coverage
• Provision barring coverage of gender-affirming care for transgender minors  
• Several provisions intended to purge the program’s rolls of ineligible immigrants and people who have died.
• Prevent Medicaid from funding health providers that also offer abortion services

ACA Marketplace Changes

• shorten enrollment periods
• tighten income verification 
• restrict access for immigrants in the Deferred Action for Childhood Arrivals (DACA or “dreamers”) program
• make it harder for some people to automatically renew coverage at the end of the year.

Climate & Environment Reductions to reach House’s cuts goal

The remaining $197 billion in “savings” comes from the repeal of two Biden-era regulations that affect car pollution and auto efficiency.

• Increases gas taxes due to reduced fuel efficiency
• rescinds unspent money in a number of environmental programs that were created as part of the Inflation Reduction Act
• PLUS makes it easier to construct new energy pipelines, a change that generates fees to the government.

Maneuvers on taxes - a placeholder bill was circulated Friday; full bill text expected today

• It does not include raising the income tax rate on high earners, something Trump asked Speaker Johnson for last week and Johnson refused 
• I’ll list out the tax provisions here as I sort through them. 
• SALT deduction - Johnson has a meeting with blue state Democrats today to talk about the State and Local Tax deduction. Some of them are demanding a SALT cap lower than $30,000 and feel they need to deliver something to constituents on this issue to distract from the Medicaid cuts.

SNAP (Food Stamps)  - bill text expected today

Deadline to raise the debt limit

Treasury Secretary Scott Bessent says that the federal government could be unable to pay its bills as soon as August if Congress doesn't act, setting a goal of mid July to raise the debt limit. Republicans plan to add it to budget reconciliation. The federal government is already using “extraordinary measures” to pay its debts. Estimating the amount of revenue that the federal government will take in is difficult, especially if we head into recession and business earnings and therefore quarterly tax payments go down.  

Medicaid Stories for Committee markups 

Democrats on the Energy & Commerce Committee and Ways and Means Committee plan to read Medicaid stories from Republican committee members districts at the markups. Some of you have already sent us Medicaid stories and I’ll go through them to see if they match any of these districts. [And don't forget Freedom Caucus chair Andy Harris is the only GOP House member from Maryland, a Medicaid state. Stories read by Dem members about how Medicaid saved lives and families on the Eastern Shore could be nothing but embarrassing for him.] If you have stories to share please send them to me at [email protected]