Webinar Overview

January 27, 2026

In early 2026, the Care for All with Respect and Equity (CARE) Fund convened funders and movement leaders for a timely webinar examining the consequences of H.R. 1 and the urgent work ahead to protect and rebuild the nation’s care infrastructure. The conversation brought together national policy experts and frontline organizers to assess what the new federal law means for states, families, care workers, and people who rely on care—and how philanthropy can help turn crisis into collective action.

Moderator:
Anna Wadia, Executive Director of the CARE Fund

Speakers:
Sharon Parrott, President of the Center on Budget and Policy Priorities
Amber Christ, Managing Director, Health Advocacy, Justice in Aging
Dessa Cosma, Executive Director, Detroit Disability Power
Jaimie Worker, Director of Public Policy at Caring Across Generations

The Impact of H.R. 1 on States and Care Systems

To address looming budget shortfalls, state policymakers are making crucial decisions right now about raising revenue or making significant cuts to programs across the board—not only Medicaid and food assistance, but also education, childcare, transportation, housing, you name it.
— Anna Wadia, Executive Director of the CARE Fund

In the Summer of 2025, Congress passed and the President signed a major budget reconciliation law—H.R. 1—that slashed over one trillion dollars from vital care and nutrition programs to finance massive tax cuts for wealthy individuals and corporations and supercharge the immigrant deportation machine ransacking our communities. The impact of the law will be even more far reaching because of the way it guts state budgets. States will simultaneously face cuts in federal funding for Medicaid and SNAP, while being forced to greatly increase administrative costs to implement provisions aimed at kicking people off these benefits. To address looming budget shortfalls, state policymakers are making crucial decisions right now about raising revenue or making significant cuts to programs across the board. These decisions will impact not only Medicaid and food assistance, but also education, childcare, transportation, housing, and more.

Anna Wadia, Executive Director of the CARE Fund, opened the webinar, explaining how the CARE Fund is proud to support an unprecedented coalition of organizations advocating for children, older adults, people with disabilities, workers and tax justice to educate the public and policymakers about these harms. These coalitions are continuing to work together to advocate for state mitigation and revenue strategies, and look to opportunities for reversals at the federal level. They are also talking to the millions of people who will be harmed to bring them into the movement and hear what type of policies they actually need to best care for themselves and their families.

Sharon Parrott, President, Center on Budget and Policy Priorities, then provided an in-depth look at how H.R. 1 is shifting massive new costs onto states while simultaneously reducing federal support for essential programs such as Medicaid and SNAP. A link to her presentation “Challenges and Opportunities for Care” can be accessed here. She explained that:

• States are facing structural budget shortfalls due to past tax cuts, the end of COVID-era federal aid, and slowing revenue growth.
• H.R. 1 adds billions in new costs, including state cost-sharing for SNAP benefits, higher administrative burdens, restrictions on Medicaid financing, and cuts to emergency Medicaid.
• These pressures could lead states to reduce enrollment, scale back home- and community-based services, lower provider payments, or cut investments in child care, pre-K, and other care supports.

Parrott emphasized that while the situation is severe, state policy choices still matter. Decisions about implementation, budgeting, and revenue can significantly reduce—or worsen—the harm to families and care workers. Parrott also reminded us that this is all happening in a context of virulent anti-immigrant policies; for example, the Administration issued a directive (blocked by a federal judge) that would have excluded certain immigrant children from Head Start.

We would be in challenging budget times in many states even if we didn’t have federal action. But the actions the federal government has taken aren’t helping.
— Sharon Parrott, President, Center on Budget and Policy Priorities

Lessons From Cross-Sector Organizing

Panelists reflected on how the care movement mobilized over the past year to oppose HR1 and educate the public:

• Building broad coalitions: Advocates for older adults, people with disabilities, children, workers, and tax justice worked together—often alongside unusual allies such as hospitals, business groups, and local governments.
• Centering lived experience: Storytelling from caregivers, Medicaid recipients, people with disabilities, and older adults helped demonstrate that care policy affects people across the lifespan and in every community.
• Pairing stories with data: Research and budget analysis strengthened advocacy by clearly documenting the scale of the cuts and who would be harmed.
• Reframing the narrative: Organizers consistently highlighted that H.R. 1 prioritizes tax cuts for the wealthy over families’ basic needs.

For the first time, Detroit Disability Power and the Michigan Hospital Association were on the same page singing from the same hymnal… really disparate voices, essentially saying the same things.
— Dessa Cosma, Executive Director, Detroit Disability Power

Mitigating Harm at the State Level

Speakers outlined how organizations are now pivoting to reduce damage and protect access to care:

• Educating communities about new work reporting requirements and benefit changes.
• Working with state agencies to prevent unnecessary loss of Medicaid coverage.
• Supporting coalitions that advocate for streamlined systems, fair implementation, and continued access to services such as home- and community-based care.
• Engaging in state budget debates to push for revenue solutions instead of cuts.

Examples included state efforts to raise taxes on high-income households and corporations, close loopholes, and establish dedicated trust funds to stabilize Medicaid and other care programs.

Without new revenue, it’s almost inevitable that cuts are going to happen to our care infrastructure and beyond.
— Amber Christ, Managing Director for Health Advocacy, Justice in Aging

Building Long-Term Power for Care

Panelists stressed that this moment is not only about defense. This year, Caring Across Generations is going to be engaging one million people in conversations focused on care, and going beyond where we, as a movement, have been to build broader bases. They hope this will:

• Engage people who have not been part of the care movement as we learn from them about what a system that truly works would look like for them.
• Support grassroots organizations that are trusted messengers in their communities.
• Create spaces for people most affected to connect, organize, and shape future policy solutions.
• Develop a positive, shared vision for a care system that offers dignity, stability, and real choices for families and workers.

Care connects us all. Each of us has received or will provide care at some point in our lives… A major lesson learned for us is that because we made Medicaid and care really central to this fight, we were able to make sure that at the end of the day, it was clear, broadly and deeply, that this bill was not a good deal for families. And that really took a multi-issue led movement to do.
— Jaimie Worker, Director of Public Policy, Caring Across Generations

A Call to Philanthropy

Funders have a critical role to play in protecting communities and sustaining democratic systems during prolonged periods of fiscal and political constraint. Throughout the webinar, panelists shared what they believed funders could do:

1. State revenue and budget battles are not short-term fights. The current constraints will persist, making sustained, long-term investment in state fiscal advocacy and organizing essential, particularly in shaping budget priorities over time rather than reacting to individual cycles.
2. Fund cross-sector coalitions that bring together care, health, housing, food security, disability, aging, reproductive rights, LGBTQ+ rights, and immigrant-rights advocates.
3. Investments in harm mitigation are essential. How states implement cuts, enforce policies, and allocate resources has immediate, life-altering consequences for real people. Supporting efforts that influence state-level implementation may not be as aspirational as long-term visioning, but it is where lives can be protected right now.
4. Funders should prioritize documenting harm as it occurs. Rigorous data collection, storytelling, and analysis are vital for building the public and legal case to reverse harmful policies and to inform future reforms.
5. Federal policy fights remain indispensable. Recent developments underscore that disengagement at the federal level is not an option, especially for states with chronically low public investment. Coordinated funding that supports both state and federal advocacy is necessary to drive equitable outcomes and prevent further erosion of public systems.

This webinar was hosted by: CARE Fund, Economic Opportunity Funders, Heising-Simons Foundation, Schusterman Family Philanthropies, Tax Equity Funders Network, and the Women’s Funding Network.

This webinar was co-sponsored by Asset Funders Network, Better Taxes for a Better America, Children, Youth & Family Funders Roundtable, Early Childhood Funders Collaborative, Grantmakers in Aging, and Grantmakers In Health.

Summary prepared by Christina Fialho