The Geiger Gibson Program and our partners continue to examine and analyze how ongoing federal policy changes to Medicaid, immigration and health care are affecting communities and health center organizations. Recent work examines the Medicaid community engagement requirements and a ruling on the Personal Responsibility and Work Opportunity Act (PRWORA).
Community Engagement Requirements
In response to implementing rules on Medicaid community engagement requirements published by the Centers for Medicare and Medicaid Services (CMS), thousands of stakeholders including health care professionals, public health and health care providers, and policy experts provided extensive comments highlighting the impact of the rules on their patients and communities.
Geiger Gibson Research Associate Maddie Krips conducted a review of more than 120 public comments submitted to CMS by community-based health care providers and public health advocates. Her data note Medicaid, Community Engagement, and Medically Frail Adults: Voices From the Front Line summarizes their broad range of concerns and the consequences of the Medicaid community engagement requirements, which threaten patient access and coverage as well as safety-net operations and care.
PRWORA
Last week, U.S. District Judge Mary McElroy of the District of Rhode Island issued a favorable ruling on behalf of the plaintiffs in, State of New York v. U.S. Department of Justice. The lawsuit, brought by the attorneys general representing a coalition of 20 states and Washington, DC, challenged the federal government’s 2025 policies on immigrant access to certain public health, education, and social welfare programs under the Personal Responsibility and Work Opportunity Act (PRWORA).
In a new “Notes from Washington” blog, Sara Rosenbaum, Emerita Professor of Health Law and Policy and President, Liberty Health Alliance, explains the underlying law, discusses the ruling and examines its implications for community health centers and those they serve. Read, New York v United States Department of Justice: Implications for Community Health Centers and Immigrant Patient Population.2, 2026.