Breakdown of Proposed Cuts to Medicaid

Work Requirements

What’s in the bill:

• Requires “able-bodied” adults (19–64) in Medicaid expansion to work or complete approved activities 80 hrs/month.

Why It Hurts People with Disabilities:

• Many people with developmental disabilities are in the Medicaid expansion group. The bill says they’re exempt—but in states that tried this before, those exemptions didn’t work well. People still lost coverage because of paperwork, red tape, or confusion about the rules.
• Family caregivers who rely on Medicaid could lose it if they can’t work enough hours due to their caregiving responsibilities.
• Many Direct Support Professionals (DSPs) rely on the ACA for affordable health coverage. With premium subsidies set to expire, many could lose their insurance—further destabilizing a workforce that people with disabilities depend on.

Cost Sharing

What’s in the bill:

• Allows states to charge people with low incomes up to $35 every time they go to the doctor or get care.

Why It Hurts People with Disabilities:

• People with disabilities often need a lot of care. These extra costs would force many to skip appointments or medications.
• Even small fees can be a barrier if you’re already living close to the poverty line

Eligibility Redeterminations

What’s in the bill:

• Requires states to check if someone still qualifies for Medicaid every 6 months instead of once a year for the expansion population.

Why It Hurts People with Disabilities:

• People often lose coverage just because they miss a notice or don’t complete paperwork in time—even when they still qualify.
• This adds a lot more red tape, especially for people with disabilities who may already struggle with forms or communication barriers.
• People with complex or ongoing health needs can’t afford gaps in coverage—missing even a short period of care can lead to serious health problems.

Limits State Ability to Fund Medicaid

What’s in the bill:

• Blocks states from creating or increasing provider taxes, which they use to help fund Medicaid.

Why It Hurts People with Disabilities:

• These taxes help states pay for their share of Medicaid. If states can’t adjust them over time, they can’t keep up with inflation. That effectively acts as a cut—shrinking what states can do, even as costs go up.
• Without flexibility, states may be forced to cut eligibility, reduce services or pay providers less, making it even harder to find support. Home and Community-based services are optional services under Medicaid.

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