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In its April 10 news release, CMS cited examples of spending that fall outside Medicaid’s core scope: $20 million in broadband grants for rural healthcare providers in North Carolina $241 million in nonmedical in-home support programs in New York CMS says these initiatives “distract from the core mission of Medicaid” and sometimes “serve as an overly creative financing mechanism to skirt state budget responsibilities.” The Bigger Picture: Budget Pressures The same day CMS issued this notice, House Republicans passed the Senate’s FY 2025 budget blueprint, directing the House Energy and Commerce Committee to identify $880 billion in federal healthcare cuts—a target widely expected to affect Medicaid programs disproportionately