CMS Launches $275 Million Nursing Home Workforce Initiative

CMS has committed $100M, with participating states contributing at least an additional $175M, to recruit and retain nurses in nursing homes. Funded through civil monetary penalties collected from nursing homes, the Nurses for Nursing Homes initiative focuses on improving staffing in rural communities and areas facing workforce shortages. The program is expected to support more than 4,000 nurses and nursing students across all 50 states and Washington, D.C.

Eligible participants can receive up to $40K in student loan repayment and/or a $10K stipend in exchange for working at least 30 hours per week for three years at a qualifying nursing home. Applicants must meet licensing and other eligibility requirements, including generally not having worked in a nursing home within 60 days of applying. However, a temporary exception through January 24, 2027, allows nurses who began working at eligible facilities between July 28 and October 25, 2026, to apply (CMS, October 23; Fierce Healthcare, October 23).

CMS Proposes Pre-Eligibility Verification Process for Exchange

On October 23, in alignment with the Trump Administration’s goal to prevent fraud, waste, and abuse (FWA), CMS announced the Exchange Pre-Eligibility Verification Proposed Rule (CMS 9873-P). Under requirements specified under H.R.1, the proposed rule would establish verification of certain criteria before the provision of financial assistance, including household income and family size, eligibility for or current enrollment in other qualifying coverage, place of residence, and status as a citizen, US national, or eligible non-citizen. Key provisions of the proposed rule include:

• Program integrity: Exchanges would be prohibited from providing financial assistance during inconsistency periods, when eligibility criteria cannot be verified electronically. Enrollees would also have to return annually to re-verify eligibility.
• Exchange consumer supports: Exchanges would offer an annual pre-open enrollment (OE) verification period and let consumers select contingent plans that take effect once financial assistance eligibility is verified.
• Improving exchange rules: CMS seeks public comment on strengthening family size and residency verification, and ways to strengthen oversight while limiting consumer burden and operational costs for state and federal exchanges.

The public comment period will be open for a 30-day period (CMS, October 23; CMS, October 23).

U.S. Sees Significant Increase in Uninsured in 2026, According to Commonwealth Fund Survey

The Commonwealth Fund released its biennial health insurance survey, detailing uninsured rates and access to care in the U.S. and comparing trends across 2022, 2024, and 2026. The survey responses for the 2026 survey were collected from May 7 through July 20 and included nearly 10,000 adults aged 19 and older. The U.S. saw a statistically significant increase in uninsured working-age (19-64) adults from 2024 to 2026. Young adults aged 19 to 34 saw a statistically significant decline in Medicaid coverage from 2022 to 2026 and in Marketplace and Individual coverage from 2024 to 2026. Two recent policies likely contributed to these declines in healthcare coverage: COVID-19 Medicaid unwinding and the loss of enhanced ACA premium subsidies.

Of working-age adults, 46% were “inadequately insured,” meaning that they were either uninsured, underinsured, or had a coverage gap at some point in the year. The Commonwealth Fund found that 30% of adults insured for the full year were underinsured, meaning they had out-of-pocket costs or deductibles that were high in comparison to their income. Half of Marketplace enrollees were underinsured using this definition. The number of people delaying or avoiding care due to costs also increased from 46% in 2022 to 50% in 2026, including those who were insured all year. Delaying or avoiding care included not filling a prescription, skipping a medical test or treatment recommended by a doctor, not seeing a physician when sick, or not seeking needed care from a specialist. Three in ten working-age adults reported paying medical debt, with underinsured adults and those with gaps in coverage reporting medical debt at higher rates. Notably, 73% of Commonwealth Fund survey respondents indicated that the federal government has a responsibility to ensure all Americans have healthcare coverage (The Commonwealth Fund, October 22).

CDC Deputy Director to Step Down in November

After joining the agency in April, Jennifer Shuford will step down from her role as Deputy Director and Chief Medical Officer for the Centers for Disease Control and Prevention (CDC) on November 12. Shuford, an infectious disease physician, previously served as the health commissioner of Texas. During her tenure at the CDC, she led strategic public health work and coordinated the agency’s response to an Ebola outbreak abroad. Satish Pillai will serve as the CDC’s acting deputy director in the interim. In speaking with The Washington Post, Shuford stated that she is leaving to spend more time with her family. The Post noted two sources who suggested that disagreement with the administration’s vaccine policy contributed to her departure (Washington Post, October 27).