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CMS explained that: “DSHPs and DSIPs have grown from approximately $886 million in 2019 to nearly $2.7 billion in eligible expenditures in 2025, representing increasing costs to the federal government without a sustainable state contribution.” CMS’s policy announcement follows another policy change in early March, when CMS signaled it would evaluate state requests for federal Medicaid support for housing and nutrition services and supports on a case-by-case basis – rolling back broader flexibilities previously offered to state Medicaid programs to address health-related social needs