Research, strategy, and hard-won lessons for the people reshaping health & human services.

A mid-2026 update on federal grantmaking: what has stabilized since the funding freezes, the new operational risks to watch, and concrete steps your organization should take now.

On Dec. 31, 2025, the enhanced Affordable Care Act (ACA) premium tax credits expired without congressional renewal — and the consequences are already showing up in revenue mix reports, emergency…

The Rural Health Transformation Program (RHTP) represents a $50 billion, five-year federal investment in rural health, the largest in a generation. Washington State, North Carolina, and Connecticut have received year-one…

The federal Rural Health Transformation Program (RHTP) is funded and moving fast. It was authorized under H.R 1*, or “The One Bill Beautiful Bill.” The program commits $50 billion over…

For sixty years, Medicaid had one job: provide health insurance to people with low incomes. That changed on July 4, 2025, when the One Big Beautiful Bill Act (H.R. 1)…

Once a reliable mainstay of programmatic and research support for health and human service nonprofits, federal grants have become a wild game of bureaucratic whack-a-mole. It’s a mind-bending, bewildering, maddening…

As we edge closer to a new year, two major federal policy flashpoints are aligning in ways that could profoundly affect millions of Americans: the scheduled expiration of enhanced Affordable…

Human services providers furnishing essential services — such as child protection, affordable housing assistance, job training, and support for people with disabilities — face an existential question: how to sustain…

More than 65,000 people in Washington State work in the human services sector, delivering child protection, affordable housing assistance, job training, and disability support to millions of residents. Yet many…