March 28, 2025 | Vol. MMXXVVV | Issue # 105

Budget Reconciliation

After both chambers of Congress passed two different partisan budget resolutions, Congressional Republicans are eager to move forward in the budget reconciliation process. There have been key issues that the House and Senate disagree on, including making the 2017 tax cuts permanent, cutting $880 billion from programs that the House Energy and Commerce Committee oversees, and more.

While House Energy and Commerce Chair Brett Guthrie (R-KY) has said that his committee could cut $880 billion by targeting non-Medicaid programs, including repealing some Biden-era energy policies, some Senators have publicly distanced themselves from the House’s plan because of the potential cuts to Medicaid.

Now, Senate Majority Leader John Thune (R-SD) is saying that he wants a “generic” bill that simply instructs committees to either cut spending or raise the deficit. The Senate may vote as early as next week to approve their budget resolution.

Key Takeaways

As the House and Senate continue to debate over cuts to Medicaid, it is vital that people let their Members of Congress know how detrimental any cuts to Medicaid would be. These cuts might be in the form of work requirements, per capita caps, decreasing the federal match, and beyond—they would all have negative consequences for people with disabilities. The Trump tax package from his first term gave massive tax breaks to billionaires and corporations that are set to expire this year. Congressional Republicans want to cut into Medicaid and other important programs in order to extend those tax breaks for the richest Americans and corporations.

Many Republicans are deflecting from this politically uncomfortable issue by saying they are simply searching for waste, fraud, and abuse, or they want “able-bodied” Medicaid recipients to report on their work or volunteer activity, in a proposal referred to as work requirements.

Members of Congress need to know that a) Medicaid is a lean and cost-efficient program—any focus on waste, fraud, and abuse is a distraction and will not bear out actual cost-savings, and b) work requirements do not work—they cost millions of dollars in expensive administrative tracking systems and are built around the false premise that people with disabilities don’t work and don’t want to work. The reality is that Medicaid actually helps people get work and just because someone appears to be “able-bodied” does not mean that they are not disabled or in need of support.

• Action Item - Protect Our Care has an easy tool to find your elected official and some advice on what to say - https://www.protectourcare.org/hands-off-medicaid. Call your Member of Congress and educate them on the importance of Medicaid for people with disabilities and their families and caregivers. Reminder: AUCD Network members should educate rather than lobby when talking to Members of Congress and their staff. Learn more here.

Plain Language

Congress is in the middle of a long process of passing bills that that affect how the government spends money, which is called reconciliation. The Senate and House of Representatives have different ideas of how they want to do this and how they want to spend money. The people who want to pass these bills want to make the government spend less money, so they are working on how to do that.

The Senate and House have both passed their own budget resolutions, which are agreements on how to cut funding in government programs. Now, they need to come together to agree on a plan. Some lawmakers are talking about taking money away from Medicaid. AUCD and other organizations will work to protect Medicaid.

• Action Item - Right now, people should let Members of Congress know how important Medicaid is for people with disabilities and their families. They can use this link to call them and talk about how Medicaid helps people get home and community-based services, employment support, and more. If you have a personal story, it is really helpful to share! Here is some more information about Medicaid in plain language.

Nominations and Confirmations

• Centers for Medicare and Medicaid Services (CMS) - On March 25, the Senate Finance Committee voted to advance the nomination of Dr. Mehmet Oz to be the CMS Administrator. Next, the full Senate will vote on the nomination. Dr. Oz has stated that he is in favor of establishing work requirements for Medicaid.
  
  

• Food and Drug Administration (FDA) and National Institutes of Health (NIH) - On March 25, the Senate confirmed Dr. Marty Makary to be Food and Drug Administration (FDA) Commissioner and Dr. Jay Bhattacharya to be National Institutes of Health (NIH) Director.
  
  

• Centers for Disease Control and Prevention (CDC) - On March 24, President Trump announced his nomination of Susan Monarez to be the CDC Director. She was previously the deputy director of ARPA-H, the Advanced Research Projects Agency for Health.

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. You can read Dr. Oz’s responses to questions for the record during his Senate Finance Committee hearing on March 14.

NIH Director Bhattacharya told the Senate Health, Education, Labor and Pensions (HELP) Committee that he would reconsider the Administration’s previous decision to cut the funding the NIH pays to universities and grantees for administrative and overhead expenses. He also said he would make sure scientists have the funding they need.

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.

Dr. Jay Bhattacharya is the President’s choice to lead the National Institutes of Health, which is a government department that does a lot of work to improve health and help scientists do their research. Many people at universities are worried because the Administration said they would not give as much money for them to do their research. Dr. Bhattacharya has said he would make sure scientists have the funding they need.

Department of Health and Human Services Announces Plans to Restructure

On March 27, the U.S. Department of Health and Human Services (HHS) announced plans to restructure the department “in accordance with President Trump's Executive Order, ‘Implementing the President’s ‘Department of Government Efficiency’ Workforce Optimization Initiative.’” The restructuring includes a reduction in workforce of about 10,000 employees, consolidation of the 28 divisions of HHS into 15 new divisions, and closure of five of its 10 regional offices. HHS Secretary Robert Kennedy, Jr. has created a new subdivision called the Administration for a Healthy America, which combines HHS offices that address substance use disorders and toxic substances as well as others to one office that focuses on chronic disease prevention and health resources for low-income Americans.

The effective date of the reductions in workforce is May 27. The cuts include:

• 2,400 employees at the Centers for Disease Control and Prevention

• 1,200 employees at the National Institutes of Health by centralizing procurement, human resources, and communications

• 300 employees at the Centers for Medicare and Medicaid Services

Administration for Community Living (ACL) – The reorganization of the Administration for Community Living includes spreading programs that support people with disabilities and older adults across other HHS agencies, including the Administration for Children and Families, Assistant Secretary for Planning and Evaluation, and the Centers for Medicare and Medicaid Services. The announcement from HHS says that “this reorganization will not impact Medicare and Medicaid services.”

Key Takeaways

This Administration has been focused on addressing chronic diseases, especially among children, and making HHS (and the rest of the federal workforce) more efficient. However, this reduction in force and consolidation of Department subdivisions has the potential to diminish HHS’ capacity and take away vital resources from people with disabilities and older adults. These are potentially damaging changes. Read AUCD’s statement on the restructuring here.

• 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 Health and Human Services (HHS) does to protect and support people 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 Health and Human Services is a government department that works to improve the health of people in the United States. They do a lot of work that affects people with disabilities, including helping people live in the community and making sure people with disabilities can go to the doctor’s office and get health care just like nondisabled people. The Trump Administration decided to fire many people in the Department of Health and Human Services and combine a lot of sections of the Department. This could be bad for people with disabilities because it will take away resources, make people in the Department stop working on their projects, and remove workers in the Department who are experts in helping people stay healthy and live in the community.

• Action Item - 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 Health and Human Services (HHS) does to protect and support people with disabilities and their families. You can reach your Members of Congress by calling the Capitol Switchboard at 202-224-3121.

Trump Administration to Move Special Education to HHS

On the heels of the Trump Administration’s new Executive Order to start dismantling the Department of Education, the President announced he would move special education oversight to the U.S. Department of Health and Human Services (HHS). However, the Individuals with Disabilities Education Act (IDEA) mandates that “there shall be, within the Office of Special Education and Rehabilitative Services in the Department of Education, an Office of Special Education Programs, which shall be the principal agency in the department for administering and carrying out this title and other programs and activities concerning the education of children with disabilities.” It is unclear how the Administration will be able to make this change without Congress amending the original law—they could run into legal challenges.

Key Takeaways

Moving special education oversight to HHS is likely to be damaging to IDEA oversight and could affect students with disabilities across the country. Disability advocates are concerned that this move will weaken protections for students with disabilities and lead to segregation and stigmatization of students with disabilities. It is also concerning to broaden the jurisdiction of the HHS Secretary, Robert Kennedy Jr., who has espoused anti-vaccine rhetoric, claiming vaccines cause autism.

Plain Language

The Department of Education supports many students with disabilities and makes sure that they have protections against discrimination at school. The Department is supposed to make sure that states are doing a good job providing special education to students with disabilities. The President decided to change how the government does this. He said he would move special education from the Department of Education to the Department of Health and Human Services. This could be bad for students with disabilities because the Department of Health and Human Services does not have the right resources to focus on special education. People are worried that this big change will mean that students with disabilities are going to have less protections in school and might get separated from students without disabilities.

Voting Accessibility Updates

Executive Order - On March 25, President Trump signed a new Executive Order (EO) titled “Preserving and Protecting the Integrity of American Elections.” This EO will require documentary proof of U.S. citizenships in voter registration, directs the Department of Homeland Security (DHS) and the non-governmental Department of Government Efficiency to review state voter rolls, directs the Election Assistance Commission to amend the Voluntary Voting System Guidelines 2.0, and other guidance to “provide that voting systems should not use a ballot in which a vote is contained within a barcode or quick-response code in the vote counting process except where necessary to accommodate individuals with disabilities and should provide a voter-verifiable paper record to prevent fraud or mistake.”

Disability Voting Rights Court Ruling - In Texas, a federal court ruled that Texas Senate bill 1 (S.B.1), legislation that imposed new restrictions for voting, violates the rights of voters with disabilities. The bill created new identification requirements for voting by mail and created new requirements for people helping voters. The court found that the bill violates both the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act.

Key Takeaways

Folks in the disability community tend to oppose paper ballot mandates as they are not always accessible. For many voters with disabilities—particularly people who are blind or have low vision, or have motor limitations—paper ballots do not allow for independently, manually casting a vote. The Texas ruling is encouraging as it found that voters with disabilities should not have to overcome extra hurdles in order to vote like their nondisabled fellow citizens.

Plain Language

President Trump made a new rule that is about voting. People with disabilities are worried that it might make it harder to vote, especially for people who have a hard time using paper ballots.

There was a court case in Texas where some people said that a new voting law in Texas was not fair to people with disabilities. The judge agreed and said the new law was not allowed.

New: Tuesdays with Liz is now Disability Policy for All with Liz!

Join Liz on Instagram Reels, where she will continue to provide plain language updates on policy, highlighting current issues and hot topics in federal disability policy.

Liz Weintraub is AUCD's Senior Advocacy Specialist and the host of “Disability Policy for All with Liz.” She has extensive experience practicing leadership in self-advocacy and has held many board and advisory positions at state and national organizations, including the Council on Quality & Leadership (CQL) and the Maryland Developmental Disabilities Council.

Watch Liz's most recent video on the Executive Order dismantling the Department of Education.

Words to Know

Reconciliation

This is a process of passing bills that that affect how the government spends money. It is unique because usually, you need more people to vote ‘yes’ for a bill. With reconciliation, you don’t need as many lawmakers to vote ‘yes.’ This is why reconciliation is usually used when lawmakers in one political party (either Democrat or Republican) want to pass bills they know the other political party wouldn’t like very much. They can do this when there is the same political party in charge of the House of Representatives, the Senate, and the Presidency.

Executive Order

This is when the President makes a new rule. The rule doesn’t automatically mean that everyone has to follow it, but it tells the other parts of the government how to do things. Executive orders can’t change a law that already exists. It has to follow the laws.