March 21, 2025 | Vol. MMXXVVIV | Issue # 104

Budget and Appropriations

Passing the CR - On March 15, President Trump signed a partisan Continuing Resolution (CR) (H.R. 1968) to continue funding the government through September 30, averting a government shutdown. The CR cuts funding for nondefense programs by about $13 billion. Unlike in previous CRs, this bill included no instructions or guidance to the agencies as to how much to spend for each program so specific levels remain somewhat unclear. It increases defense spending by $6 billion, including funding for deportations, the military, and veterans’ health care.

Key Takeaways

The CR shows a trend in cuts to domestic programs, including those that serve people with disabilities and their families. As we come up on reconciliation and Fiscal Year 2026 appropriations, people should be attentive and ready to engage.

Plain Language

On March 15, President Trump signed a bill that would make sure the government can stay funded and won’t shut down. This bill was mostly supported by Republicans. It adds a lot of money to defense funding, which is money the government gives to the military and some police. It takes money away from a lot of other programs that could affect people with disabilities and their families.

Changes at the Department of Education

Background

The Administration has pledged to abolish the Department of Education, and has begun to take actions to that end. The Department enforces protections for students with disabilities and houses the Office of Special Education Programs (OSEP). OSEP distributes funds from the Individuals with Disabilities Education Act (IDEA) as approved by Congress, funds essential programs to inform parents and train teachers, monitors states to make sure they’re complying with IDEA and enforces consequences for noncompliance, and more. Eight million children in the U.S. are now served under IDEA.

• Linda McMahon Confirmation - On March 3, Linda McMahon was confirmed as the Secretary of Education. Secretary McMahon has said that she wants to “reorient” the Department, moving control over education to the states, but has acknowledged in confirmation hearings that only Congress can shut it down completely. She suggested the civil rights arm of the Department could be moved to the Justice Department. She has also suggested that oversight of IDEA should be moved outside of the Education Department and that “special education...could go back to HHS where it started.” Secretary McMahon has said that programs like IDEA won’t fall through the cracks, but has proven to have limited knowledge of what the program does.
  
  

• Department of Education Layoffs - On March 11, the Administration cut nearly half of the Department of Education staff. Democratic attorneys general in 20 states and the District of Columbia are suing the Trump Administration and alleging that these cuts incapacitate the Department and violate Congress’ mandate to require the Department to carry out certain functions.
  
  

• Executive Order - On March 20, President Trump signed an Executive Order (EO) to direct “the Secretary of Education to take all necessary steps to facilitate the closure of the Department of Education” and return control of education to the states. Shutting down the Department officially would require an act of Congress. The Administration has said that for now, the Department of Education would continue to oversee funding for special education. Read AUCD’s statement in response to the EO here.

Key Takeaways

The Administration and Secretary McMahon are starting to carry out President Trump’s plan to dismantle the Department and weaken the mechanisms in the Department that oversee special education and civil rights compliance. Students with disabilities, families, and educators will all likely be affected by these changes, which AUCD will continue to monitor.

• Action Item - Call your Members of Congress—your Representative and Senators—and reach out to your state officials, such as the governor’s office, to educate them on the important work that the Department of Education does to protect and support students with disabilities and their families. You can reach your Members of Congress by calling the Capitol Switchboard at 202-224-3121.

Plain Language

The Department of Education supports many students with disabilities and makes sure that they have protections against discrimination at school. The President signed an order to get rid of the Department of Education, which could be bad for people with disabilities. The Secretary of Education, Linda McMahon, is in charge of the Department. She wants to change a lot about how the Department works.

Call your Members of Congress—your Representative and Senators—and reach out to the government officials in your state, such as the governor’s office, to educate them on the important work that the Department of Education does to protect and support students with disabilities and their families. You can reach your Members of Congress by calling the Capitol Switchboard at 202-224-3121.

Nominations and Confirmations

• Centers for Medicare and Medicaid Services (CMS) - On March 14, the Senate Finance Committee held a hearing to consider the nomination of Dr. Mehmet Oz to be the CMS Administrator. Dr. Oz has stated that he is in favor of establishing work requirements for Medicaid.
  
  

• Centers for Disease Control and Prevention (CDC) - Dave Weldon’s nomination to run the CDC was pulled by the White House on March 13. The nomination was pulled because there were not enough votes to confirm Weldon, who has professed skepticism about the safety of vaccines and has repeated debunked conspiracies about vaccines being linked to autism. These views were the primary reason that several Republican lawmakers—including Senator Lisa Murkowski (R-AK), a key vote—had concerns about the nomination. A new nominee has not yet been announced.
  
  

• Food and Drug Administration (FDA) and National Institutes of Health (NIH) - On March 13, the Senate Health, Education, Labor, and Pensions (HELP) Committee voted to move forward the nominations of Dr. Marty Makary as FDA Commissioner and Dr. Jay Bhattacharya as NIH Director. The next step is for the full Senate to vote on these nominations.

Key Takeaways

President Trump’s Cabinet nominees, including those nominated to lead key health agencies, have typically been confirmed by the U.S. Senate, which currently has a Republican majority. The nominees mentioned above are expected to be confirmed when their nominations are brought to the Senate floor. Dr. Oz is likely to be confirmed as CMS Administrator and we can expect that he will be in favor of taking actions that may cut funding from Medicaid.

Plain Language

President Trump chose a few people to be in charge of the U.S. departments and agencies that work on health and research. The U.S. Senate decides if they will approve those people. Most of the lawmakers in the U.S. Senate are Republicans right now, and they have usually been confirming these people. These decisions happen in committees, which are groups of lawmakers who work on a certain issue or topic. Dr. Mehmet Oz is the President’s choice to lead the Centers for Medicare and Medicaid Services, which is a government agency that controls Medicaid. Dr. Oz is in favor of work requirements, which are when the government makes some people who get Medicaid report to the government how much they are working or volunteering. This could take away Medicaid from people with disabilities and caregivers.

Federal Workforce

• Mass Firings - Over the past few months, the Trump Administration has fired tens of thousands of probationary federal employees. These firings are in line with President Trump’s Executive Order to establish the Department of Government Efficiency (DOGE) and the President’s claims that the federal workforce is too large. Nineteen states and the District of Columbia filed a lawsuit and on March 13, a federal judge ordered federal agencies to reinstate those employees, after finding that those firings were made illegally. There are now more than 24,000 workers at 18 federal agencies who have been rehired after this court ruling. In the Department of Health and Human Services (HHS) alone, 3,248 probationary workers were fired, and then all were later sent notifications of reinstatement by email or letter.
  
  Large-scale firings have also taken place within the Departments of Education, Homeland Security, Energy, Veterans Affairs, Agriculture, Interior, and Defense, as well as the Consumer Financial Protection Bureau, Environment Protection Agency, Office of Personnel Management, General Services Administration, Small Business Administration, and the Internal Revenue Service.
  
  

• Fork in the Road Offers – On January 28, federal employees were sent an email providing them the option to stay in their current positions with the warning that their position or agency may not be safe from elimination, or resign utilizing a deferred resignation program. The deadline for choosing this “fork in the road” was February 12. HHS employees were also offered a voluntary buyout, the deadline for which was March 14. We still don’t know how many HHS employees chose to leave, and which programs will be impacted by that reduction in workforce.

Key Takeaways

The tumult of these firings and re-hirings may affect AUCD Network members who have contact with federal workers, including program officers. AUCD Network members should be sure to inform the Policy team of impacts they experience. Since the federal government is the largest employer of people with disabilities, this raises concerns about losing progress on disability employment overall. 

Plain Language

The President and the people who work with him have fired a lot of people from the government. A judge said that was illegal and made them hire those people back. Many people with disabilities work for the federal government, so this is an issue for them. People in the AUCD Network should tell the AUCD Policy team if they are affected by these hiring and firing changes in any way.

Trump Administration Rescinds ADA Guidance

On March 19, the Justice Department rescinded 11 pieces of guidance, which had been issued to clarify the Americans with Disabilities Act (ADA), in response to President Trump’s "Delivering Emergency Price Relief for American Families and Defeating the Cost-of-Living Crisis" Presidential Memorandum. The rescinded guidance included a 10-part manual for business owners and operators to help them comply with the ADA and an Q & A document issued during the COVID-19 pandemic. The guidance also included information about accessibility requirements for hotels, retail establishments, and gas stations.

Key Takeaways

These rescissions are in line with President Trump’s focus on scaling back the scope of the federal government. Removing this guidance might make it harder for businesses to know what their accessibility requirements are. There is still a lot of work to be done to make all areas of public life accessible for people with disabilities.

Plain Language

The Justice Department is in charge of civil rights law. The Americans with Disabilities Act is an important civil rights law that makes sure people with disabilities are involved in community life and have rights. The Justice Department got rid of some documents that help businesses know what rules they need to follow under the Americans with Disabilities Act. Removing this information might make it harder for businesses to know what the rules are and make their businesses accessible to people with disabilities.

New Report from MACPAC to Congress

On March 13, the Medicaid and CHIP Payment and Access Commission (MACPAC), sent its March 2024 report to Congress. The report reviews quality review of Medicaid managed care, improving access to home and community-based services (HCBS), and reducing states’ administrative burdens in providing HCBS.

Key Takeaways

MACPAC’s analysis found gaps in the external quality review process and how to use external quality review to improve care. They make recommendation to the HHS Secretary to direct CMS to issue guidance on how states can use provisional plans of care. The report also makes a recommendation to reduce administrative burden for states and the federal government.

Plain Language

There is a commission that studies Medicaid and the Children’s Health Insurance Program (CHIP) called MACPAC. They sent a new report to Congress on how to help people access home and community-based services and make it easier to improve those services.

New Bipartisan Legislation on Pharmacy Benefit Managers

On March 11, U.S. Senators Peter Welch (D-VT), Roger Marshall (R-KS), Mark Warner (D-VA), and Bill Cassidy (R-LA) introduced the Protecting Pharmacies in Medicaid Act (S. 927), which would crack down on pharmacy benefit manager (PBM) use of “spread pricing.” Spread pricing is a practice where PBMs charge a health insurance provider more for a prescription drug than the PBM pays the pharmacy, which makes a profit for the PBM. Spread pricing can drive up costs for Medicaid, as PBMs might charge Medicaid more for a drug than it reimburses the pharmacy.

The Protecting Pharmacies in Medicaid Act would require PBMs to pass Medicaid payments directly to pharmacies, without the extra profit. The Senators say that their bill "would save Medicaid an estimated $2 billion over 10 years."

Key Takeaways

Bipartisan legislation can be rare when it comes to Medicaid. You can read more about this legislation in Senator Welch’s one pager.

Plain Language

There are people who work with both healthcare providers and pharmacists called pharmacy benefit managers. They sometimes charge more money from health care providers and then pay less money than that to pharmacies. They get to keep the extra money. Senators introduced a bill to make sure that these pharmacy benefit managers don’t make extra money in this process. They say it will save Medicaid a lot of money.