May 27, 2025  – In a narrow 215 to 214 vote, the U.S. House of Representatives approved a bill this week that would slash federal Medicaid funding by hundreds of billions of dollars. The legislation, dubbed the “One Big Beautiful Bill Act,” now advances to the Senate and has drawn strong criticism from disability advocates who say the cuts would severely damage already-strained services for people with disabilities.

The bill includes major structural changes to the Medicaid program. Among its provisions are work requirements for many adult beneficiaries and more frequent eligibility checks, measures Republicans argue will help reduce fraud and curb unnecessary spending. According to the Congressional Budget Office, the bill would cut approximately $698 billion in federal Medicaid subsidies between 2026 and 2034.

But disability advocates offer a sharply different view. “No matter what some Congressional leaders repeatedly deny, this budget contains some of the largest cuts to Medicaid in history,” said Nicole Jorwic, chief program officer at Caring Across Generations. “This will impact disability service systems. Providers will close, wages will go down for an already underpaid (direct support professional) workforce, and disabled people will be at risk of losing their coverage if they don’t break through red tape and jump through the hoops being created by eligibility checks and work requirements.”

While the bill does not explicitly target disability services, experts argue that its impact on funding would indirectly but profoundly affect people with disabilities. Elise Aguilar, senior director of federal relations at ANCOR, warned that “community-based services for people with disabilities are not federally mandated and are especially vulnerable to Medicaid funding reductions at the state level.” She added that, “Historically, when states face Medicaid funding shortfalls, non-mandatory services like home and community-based services are among the first to be scaled back, restricting access to essential supports people with disabilities need to live, work and thrive in their communities.””

Indeed, when states face budget pressures, home and community-based services (HCBS), which help individuals live independently, are among the first to be scaled back. According to the Kaiser Family Foundation (KFF), more than 700,000 people nationwide are already on waitlists for Medicaid waiver services. A recent survey of nearly 500 community-based providers found that 69% had turned away new clients and 39% had shut down programs due to staffing and funding issues.

Disability rights advocate Lydia Nunez Landry with ADAPT warned the proposed cuts would force many individuals out of the community. “Disabled people will be socially removed into institutions and die,” she said, adding that the changes would worsen existing waitlists and reduce opportunities for independent living.

As the bill moves forward, disability organizations and advocates across the country are mobilizing in opposition, warning that the proposed cuts will not simply tighten spending, but will dismantle the very supports that help millions of Americans with disabilities live safe, dignified, and independent lives.