·Pulse issue · July 4, 2026

On H.R. 1's first anniversary, the CBO priced the coming Medicaid losses at 12.9 million mostly over paperwork, the workforce that staffs the remaining care thinned under the TPS ruling, and one state began paying the long-term-care benefit the federal government is cutting.

One year into H.R. 1, the CBO projects 12.9 million will lose Medicaid mostly over paperwork, the TPS ruling thins the care workforce, and WA Cares begins paying the first state-run long-term-care benefit.

5 briefs · 12 cited sources

What to watch next

How many of the projected 12.9 million Medicaid losses come from paperwork rather than work requirements?
Which states will feel the loss of Haitian TPS caregivers most acutely?
What does WA Cares actually cover, and who qualifies in its first year?
Will the narrowed 'medically frail' definition drop enrollees before work requirements begin?

Briefs in this issue

Analysis

One year of H.R. 1, and the coverage math comes due

On H.R. 1's first anniversary, the CBO projects 12.9 million losing Medicaid, most over paperwork, as one state begins paying a benefit the federal government is trimming.

PolicyElder CareDisabilityChild Care

Analysis

The TPS ruling reaches the care shift

NPR's account of the Haitian TPS termination syndicated across public radio this week, and FWD.us put a number on the aides at risk: about 21,000.

WorkforcePolicyElder CareChild CareDisability

Analysis

RFK Jr. calls family caregiving fraud, and families answer

The HHS secretary told a House hearing that Medicaid pay for relatives is rife with fraud; caregiver advocates said he mistook essential labor for errands.

PolicyWorkforceDisabilityElder CareChild Care

Brief

Home health gets a raise, and a warning

CMS's 2027 home-health proposal breaks two years of cuts with a rate increase, then stokes fresh fraud fears in the same rule.

PolicyBusinessElder Care

Brief

A caregiver's 'double duties' in Taiwan

Hired to tend a paralyzed man, an Indonesian live-in worker was also sent to the family lunchbox shop, in what advocates call possible forced labor.

PolicyBusinessElder Care

Reference paths

01GiveCare WikiEvergreen caregiver guides, source notes, and research synthesis.02GiveCare BenefitsSource-backed benefit records and program search.03GiveCare ScoreCaregiver load assessment and scoring context.04InvisibleBenchCare AI benchmark method and findings.05GiveCareProduct home and official GiveCare positioning.

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