Inside the Beltway is a member-only benefit developed by NAPNAP’s Health Policy Team to keep members up to date on key policy issues at the federal level.
From Policy to Practice: Responding to MAHA Initiatives with Evidence-based Care
Contributed by Health Policy Committee Member Allison Clark Young, DNP, APRN-FPA, CPNP-PC, IBCLC
Child health policy has never been louder or more contested. Parents today are inundated with health information from all directions, from the Make America Healthy Again (MAHA) Commission’s reports to social media influencers whose motives aren’t always transparent. Pediatric-focused nurse practitioners are well-positioned to translate that noise into action, advocating for policies and practices that genuinely advance the health and well-being of all children. We face the important task of dismantling misinformation and redirecting action towards evidence-based practices and policies that advance access and equity.
The MAHA report identifies problems that are very real for the families we serve, including mental health, safe food and water supply, nutrition, chronic disease, and environmental concerns. The problem lies in the report’s failing to examine the root causes of disease and combat inequities in outcomes using validated, unbiased information.
In many ways, we need to reframe the MAHA movement and bolster our efforts to provide children with their best possible health outcomes and future well-being. While issues like vaccine hesitancy and demonizing medical management for mental health diagnoses can be deeply exhausting, we can use this opportunity to return to the idea of treating the whole person, family and community as a core tenet of our work as nurses.
The Administration’s policies rolling back environmental protections and regulations contradict the report’s aim of improving access to nutritious foods. This past February, an executive order granting protections to the production of glyphosate, a potent herbicide that is potentially carcinogenic and at the center of much debate in food safety, was brought to light as a concrete example of policy that did not back the MAHA report’s aims and brought discord among its supporters.
Similarly, the MAHA report connects the importance of oral health, the microbiome and the need for chronic disease prevention. At the same time, many states have eliminated adding fluoride to the water supply, an important preventative tool against childhood dental caries, and proceed to dismantle protections in food safety and surveillance of food suppliers.
As the child health policy landscape continues to evolve, we have a unique position to maintain real-world connection and relevance in the lives of our patients, our own networks, communities and broader systems. It is imperative that we continue to provide sound guidance and advocacy through our work and lives to maintain a voice of credibility, stability and evidence-backed actions and advocacy.
Key NAPNAP Advocacy Activities
- NAPNAP submitted comments to the Department of Education calling for the agency to recognize post-baccalaureate nursing as a “professional degree” qualifying for higher annual and aggregate amounts of federal financial aid under the Notice of Proposed Rulemaking, “Reimagining and Improving Student Education” (Docket ID ED-2025-OPE-0944).
- NAPNAP sent a letter to bipartisan House leaders urging Congress to protect children from trauma and toxic stress in federal immigration policies as part of any final agreement on fiscal 2026 appropriations for the Department of Homeland Security, including preventing separation and minimizing detention of children and families; maintaining child welfare standards; protecting pregnant, postpartum and nursing individuals from arrest and detention; and protecting sensitive locations, including health care practices.
- NAPNAP submitted comments to the Centers for Medicare and Medicaid Services, urging the agency to revise provisions of its proposed rule, “Patient Protection and Affordable Care Act, HHS Notice of Benefit and Payment Parameters for 2027” (CMS-9883-P), to strengthen standards for provider network adequacy and essential community providers and to reconsider the elimination of standardized health plan options and the expansion of multi-year catastrophic health plans.
- NAPNAP joined members of the Nursing Community Coalition in urging House and Senate appropriators to provide $610 million in fiscal 2027 for nursing workforce development programs under Title VIII of the Public Health Service Act, doubling the programs’ current funding and $215 million for nurse-led scientific studies through the National Institute of Nursing Research.
- NAPNAP joined the American Academy of Pediatrics and other children’s health groups in an amicus brief in American Water Works Association v. EPA, supporting the 2024 regulations strengthening the Lead and Copper Rule for drinking water.
Apply to Serve on a NAPNAP Committee
NAPNAP is currently recruiting for several national committees, including the Health Policy Committee. Visit our committee webpage to learn more and apply by May 19. Selected members will begin their terms on July 1, 2026.
Kennedy Moves to Reshape CDC Vaccine Advisory Panel
In an apparent effort to circumvent a federal judge’s ruling blocking previous changes to vaccine policies, HHS Sec. Robert F. Kennedy, Jr. signed an updated charter for the CDC’s Advisory Committee on Immunization Practices this month that gives the panel responsibility for investigating vaccine injuries, broadens the criteria for voting members and invites groups with ties to the anti-vaccine movement to participate as liaisons. The new charter includes language about vaccine risks and specifies that the committee should advise the CDC director on “gaps in vaccine safety research, including adverse effects following vaccination.” The revisions also expand the description of qualifications for members to serve on the committee to include “toxicology,” “pediatric neurodevelopment,” and “recovery from serious vaccine injuries.”
The revisions also add several non-mainstream medical groups to the roster of liaison members who participate in ACIP meetings as observers and specialist commentators. Several of those groups have either directly challenged the medical consensus on vaccine safety or have ties to the anti-vaccine movement. Kennedy has also added members of organizations that promote unproven treatments for autism to a separate advisory panel on autism research.
President’s Budget Seeks to Eliminate Nursing Programs
President Trump sent a $2.2 trillion budget to Congress earlier this month that calls for an unprecedented $1.5 trillion in national security spending while cutting funding for the Department of Health and Human Services by $15.8 billion and eliminating nearly 70 percent of federal funding for nursing workforce development. Similar to the president’s fiscal 2026 budget, which congressional appropriators largely rejected, the blueprint for 2027 would do away with all of the current nursing programs under Title VIII of the Public Health Service Act except for the Nurse Corps, cutting nearly $213 million in funding. NAPNAP has joined nursing organizations in calling for doubling current Title VIII funding to $610 million for all existing programs.
As the administration’s fiscal 2026 budget did, the 2027 proposal calls for merging the Health Resources and Services Administration, the Substance Abuse and Mental Health Services Administration, and functions of the Centers for Disease Control and Prevention into a proposed “Administration for a Healthy America.” The budget calls for a $50 million increase for the CDC’s Immunization and Respiratory Diseases, which includes the Section 317 vaccine program, but it also eliminates the Prevention and Public Health Fund, which currently supplements the Section 317 program. Unlike the fiscal 2026 budget, the administration’s new plan retains the National Institute of Nursing Research as an independent entity, but proposes cutting its funding by $60 million, more than 30 percent of its budget.
Republican Plan Budget Bill to Fund Immigration Enforcement
Congressional Republicans returned from a two-week Easter and Passover break, nearing agreement on a solution to end the two-month partial shutdown of the Department of Homeland Security and fund immigration enforcement efforts. After initially dismissing the plan as a “joke,” House leaders reversed course and agreed with Senate Republicans on a two-part plan to approve funding for the rest of fiscal 2026 for all of the department’s programs except for Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP). Those programs would be funded separately through a second budget reconciliation bill, similar to last year’s One Big Beautiful Bill Act, that could pass with only Republican votes, avoiding a filibuster by Senate Democrats. The reconciliation process could block efforts to reform immigration policies or protect sensitive locations from enforcement actions.
With President Donald Trump’s approval, Senate leaders plan to draft a narrowly focused budget resolution that proposes immigration enforcement funding without offsetting spending cuts to pay for it. However, many Republicans in the House want to draft a broader reconciliation bill that could include cuts to Medicaid funding for services thought to be high risks for fraud and abuse, as well as supplemental defense funding and voter ID requirements.
In Other News
Supreme Court Strikes Down Conversion Therapy Law
The Supreme Court last month found that a Colorado law banning “conversion therapy” for gay and transgender minors probably violates free speech rights, the latest in a string of decisions by the high court rolling back protections for LGBTQ+ people and expanding the rights of the religious. In an 8-1 ruling, an ideologically diverse majority ruled for an evangelical therapist who argued the state prohibition infringed on her First Amendment rights. Colorado argued it was not regulating free speech but outlawing substandard medical care – something courts have long allowed. The decision casts doubt on similar statutes in nearly 30 states that prohibit attempts to change the expressed sexual orientation or gender identity of youths. Many states passed the laws over the last decade as evidence grew that the treatment was harmful.
Guidance Limits Medicaid Funding for Non-Citizens
The Centers for Medicare and Medicaid Services issued initial guidance to states this month on how to implement provisions in last year’s budget reconciliation law that limit states’ ability to claim federal matching funds for non-citizens. In its letter to state health officials, CMS explained that, starting Oct. 1, the funding will be limited to U.S. citizens and nationals, legal permanent residents (“green card holders”), Cuban/Haitian entrants, and migrants eligible under the Compact of Free Association (COFA). The agency clarified that federal matching dollars remain available for the treatment of emergency conditions, and that states can continue to receive matching funds for coverage of lawfully residing children and pregnant women in Medicaid, as well as for Health Services Initiatives in CHIP.
Separately, Minnesota officials said the Centers for Medicare and Medicaid Services has yet to release $243 million in deferred Medicaid payments to the state, despite its having honored its promise to enact a plan to tackle government fraud. CMS Administrator Mehmet Oz promised to release the deferred Medicaid payments if Minnesota acted on a plan to fight fraud, and the agency approved the state’s fraud action plan last month. Minnesota sued CMS, arguing that the $243 million deferral was politically motivated.
