Dossier
federal spending
Coverage of federal spending in the Nexus archive.
- Trump administration tightens oversight of state Medicaid demonstration programs
The Trump administration announced stricter financial oversight of Medicaid demonstration waivers, requiring certification from the CMS chief actuary to ensure programs do not increase federal spending. Starting January 1, 2024, states must provide enhanced spending analyses and documentation for waiver approvals, with CMS implementing increased monitoring and evaluation.
- Congress is breaking the appropriations process
Congress is urged to address the Senate filibuster rule to preserve the appropriations process, as using budget reconciliation bypasses it, reducing transparency and limiting federal spending oversight.