Federal Power, Local Consequences: A 100-Day Policy Review

Picture of the Capitol building with the words "The Bellevue Compass: 100 Days"

Summary

We’re three weeks out from President Trump’s first 100 days back in office—and while the headlines often focus on what’s been said, we’ve spent the last few months tracking what’s actually happened.

Since January, we’ve analyzed how the administration has approached core policy areas, from federal agency restructuring to infrastructure funding, public health, and procurement. While many executive orders have been signed, few have moved through Congress or undergone full regulatory implementation. Still, the early directives provide a clear preview of this administration’s governing philosophy: centralization of executive authority, regulatory rollback, and a preference for privatization over public investment.

Over the next two editions of the Compass, we’re doing a policy sweep: what’s changed since we last reported, what hasn’t, and what that means for Pennsylvania and Philadelphia going forward.

This list is formatted in order of our blog posts. You can find them here. 

Education

  • On March 20, President Trump signed an executive order directing the dismantling of the U.S. Department of Education. The order outlined a phased reallocation of responsibilities to the Departments of Labor and Health and Human Services, signaling a broad shift away from federal oversight of education policy (White House Fact Sheet, March 2025).

  • Pennsylvania receives more than $4.6 billion in federal education funding annually, supporting programs like Title I, special education, Pell Grants, and early learning initiatives. In Philadelphia, where the school district is already managing a $300 million shortfall, federal cuts could directly affect classroom staffing, support services, and college readiness programs.

  • While the Department of Education has not yet been formally dissolved, several key grant programs have been suspended, including a $600 million teacher training initiative that supported workforce development in high-need districts. 

  • We anticipate growing pressure on state education departments to absorb administrative and compliance duties previously handled by the federal government. That will be a heavy lift in Pennsylvania, where state-level education staffing has remained flat for years. School districts and nonprofits working on education access may need to expand their grant tracking, legal compliance, and program evaluation efforts—all without additional resources. Legal challenges to the DOE’s restructuring are expected to continue, especially around civil rights enforcement.

    Pennsylvania officials, including Governor Josh Shapiro, have pledged to maintain commitments to diversity, equity, and inclusion in education despite federal pullbacks. However, advocates warn that the loss of federal oversight could deepen disparities for students in under-resourced communities. As political battles over curriculum and equity intensify at the state level, the stakes for local decision-making in education will only grow.

Transportation and Infrastructure

  • The Commonwealth of Pennsylvania, which insures nearly 3.5 million residents through Medicaid—including 750,000 covered through expansion—could face billions in federal funding losses under a capped funding model. These changes would directly threaten the infrastructure of care across both urban and rural communities. Governor Josh Shapiro and the Department of Human Services (DHS) have voiced strong opposition, and their concerns are shared across party lines.

    While the state is actively working to strengthen the Medicaid system—including increasing 2024 reimbursements to Managed Care Organizations (MCOs) to stabilize provider networks and address inflationary cost pressures—these gains could be undermined by federal caps. The recent adjustments were specifically designed to:

    • Sustain provider participation by offsetting rising labor and operational costs.

    • Maintain critical access to behavioral health, maternal health, and primary care services.

    • Support rural hospitals and safety-net institutions facing financial fragility.

    • Encourage investment in community-based care and preventative models.

    Knowledge Base: 

    Expansion: Medicaid expansion, a key provision of the Affordable Care Act (ACA), allows states to expand Medicaid coverage to low-income adults with incomes up to 138% of the federal poverty level, increasing access to healthcare for previously uninsured individuals.

    Proposed federal changes would threaten these objectives by:

    • Jeopardizing home- and community-based services, particularly for seniors and individuals with disabilities.

    • Undermining rural hospital solvency, especially in areas already struggling to attract healthcare professionals.

    • Disrupting behavioral health and substance use treatment systems, many of which are dependent on Medicaid expansion.

    • Reducing provider participation, as capped rates may no longer cover basic service delivery costs.

    • Straining workforce pipelines, by creating financial instability for agencies that serve as clinical training sites.

    During recent Pennsylvania Health and Human Services budget hearings, several Republican senators raised concerns about the state’s ability to maintain solvency for rural hospitals and healthcare providers. They emphasized the growing crisis in rural healthcare—pointing to provider shortages and ongoing hospital closures as urgent challenges. Their comments reflected deep concern about how proposed funding changes could further erode access to care in their districts, underscoring a bipartisan recognition of Medicaid’s critical role in sustaining rural health systems and ensuring quality care statewide.

  • Pennsylvania had secured $143.6 million in federal support for a second daily Amtrak route between Harrisburg and Pittsburgh—funding that’s now under review. In Philadelphia, where SEPTA depends on federal capital assistance, the risk of stalled modernization projects is growing. Projects tied to the NEVI Formula Program, which supports EV infrastructure, also face uncertainty under the new administration’s posture toward clean transportation investment.

  • In March, Elon Musk, now head of the Department of Government Efficiency (DOGE), called for full privatization of Amtrak, labeling it “inefficient” and “obsolete.” Amtrak CEO Stephen Gardner subsequently resigned, raising alarms among transit advocates and states that depend on federal partnerships to maintain long-distance service.

  • Federal funding cuts will likely shift more infrastructure financing responsibility to states and municipalities. Pennsylvania may have to reallocate state funds or restructure existing agreements to maintain project momentum. Long-term, the federal government’s exit from public transportation support could widen geographic and income disparities, particularly for communities outside of high-profit corridors. Expect delayed projects, constrained transit authorities, and increased reliance on public-private models moving forward.

Healthcare

Procurement

Environment and Energy

Immigration

Housing

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Federal Power, Local Consequences: A 100-Day Policy Review, Part 2

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Under the Knife: Navigating the Future of Medicaid and Medicare