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May 23, 2025 | Vol. MMXXV | Issue 113 |
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Reconciliation |
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Early Thursday morning, House Republicans passed their reconciliation bill out of the House on a 215-214 vote. Earlier this week, the bill passed out of the Budget Committee after failing to pass a vote there last week. The bill then moved to the Rules Committee, where a 45-page amendment to the bill was adopted that made key changes to win over Republican holdouts.
Changes to the bill included moving up the start date of the Medicaid work requirements from January 1, 2029 to December 31, 2026 and expanding the criteria for states that could lose a portion of their federal payments if they offer coverage to undocumented people. The underlying bill already made drastic changes to Medicaid that could lead to at least 7.6 million people going uninsured. These cuts will equal about $716 billion, the largest cut in the program’s history.
The legislation would:
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Implement work requirements for “able-bodied adults” ages 19-64
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Freeze state provider taxes at their current rates and prohibit them from establishing any new taxes
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Repeal the Medicaid Enrollment and Eligibility Rules
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Make pharmacy benefit manager reforms
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Allow states to charge low-income Americans up to $35 per health care service
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Cut Medicaid funds for states that use their own state dollars to provide health insurance coverage to undocumented immigrants
The reconciliation bill makes many changes to federal financial aid for students. Specifically, the changes will negatively affect the ability of all students in higher education to access Pell grants. This will especially affect students with disabilities who may take less than a full caseload of classes as a reasonable accommodation, including those with intellectual disabilities in IPSE programs. The bill would:
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Require that students enroll in at least 30 credits per year to be considered full-time and eligible for a full grant (up from 24 credits)
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Eliminate eligibility for students enrolled less than half time (so called “part time Pell”)
The bill now heads across the Hill to the Senate where it is expected to face significant challenges by Republicans who want steeper cuts to social safety net programs like SNAP or Medicaid, or Republicans who are concerned about the impact of these cuts on their states. |
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Key Takeaways |
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The Congressional Budget Office has scored that limiting or eliminating provider taxes would leave 3.9 million people without coverage, repealing the Medicaid Eligibility and Enrollment rules would leave 600,000 people without coverage, and implementing work requirements could leave 2.5 million uninsured. The bill would disqualify people from getting “health insurance at lower costs through the Affordable Care Act marketplace if they otherwise qualified to receive Medicaid but failed to meet new work requirements.”
Congressional Republicans want to make these cuts to finance two main things:
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An extension of the Trump tax package from his first term—which gave massive tax breaks to billionaires and corporations
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Increased immigration enforcement
Because of pushback from people with disabilities, older adults, healthcare providers, and many more advocates, Congressional Republicans are feeling pressure to limit their proposals to cut Medicaid.
Congressional Republicans have been saying that the bill will not take health care away from people with disabilities and other “deserving” beneficiaries. However, previous models of work requirements (in Georgia and Arkansas) resulted in many people with disabilities and older adults losing health care coverage, despite their eligibility, and did not boost employment. Additionally, decreasing federal funding for Medicaid will leave states with less money to spend on all Medicaid services, putting optional services like home and community-based services in jeopardy.
There are Republican Senators who are not fully sold on the Medicaid cuts and are expressing concern about how they might negatively impact rural communities, people with disabilities, families, hospitals, and more. There are also Republican Senators who have been vocal about how this reconciliation bill would not impact people with disabilities—it is important that they hear from the disability community that they are not correct in that assertion. If the House’s bill passes, states will have to change how they finance their programs and they will reduce benefits. Outreach and education efforts must now shift to the Senate to educate them on the negative effects of these cuts to Medicaid—you can use AUCD’s Medicaid fact sheet and talking points.
Read Answers to FAQ on Medicaid and Budget Reconciliation Proposals from the Consortium for Constituents with Disabilities (CCD) and the Disability and Aging Collaborative here.
Read Top 10 Reasons Why House Republicans’ Reconciliation Bill is Bad for Medicaid (and the ACA) from the National Health Law Program here.
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Plain Language |
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Congress is in the middle of a long process of passing bills that affect how the government spends money, which is called reconciliation. This week, the House of Representatives passed their bill. Next, the Senate will need to vote on their bill. Reconciliation is sometimes a long and complicated process. This is because you don’t need as many lawmakers to vote ‘yes.’ It 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. This time, Republicans did not all agree on what they want, and they have to agree or else the bill will not pass. Here is what they finally agreed to:
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Making people report how many hours they worked in order to get Medicaid
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Giving less money to states that use their own state money to help some people who don’t have legal immigration status get health care. There are a lot of different types of immigration status, like having a green card or becoming a citizen.
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Making students take more classes every year in order to get financial support
If this bill becomes a law, it will take Medicaid away from millions of people and even make it harder for people to get health insurance in other ways. Republicans are in charge of this reconciliation process, and they want to spend less money on Medicaid so that the government can spend more money on immigration police and helping some rich people spend less on their taxes. We do not think this is fair.
Because many people with disabilities, older adults, and advocates are speaking out, Republicans are having a hard time moving this process forward. We can make a difference if we keep speaking out.
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Action Item - Right now, people should let Senators 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.
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U.S. Department of Health and Human Services |
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Secretary Kennedy Hearing – On Tuesday, U.S. Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr. testified in front of the Senate Appropriations subcommittee. While the subject of the hearing was centered on the Trump Administration’s proposed budget for HHS for fiscal year 2026—which would cut the agency’s discretionary funding by 26 percent—Democratic Senators asked several questions about what is happening at the agency now, in fiscal year 2025, as HHS has cut 20,000 jobs and cut billions of dollars for scientific research. Senators asked about cuts to the National Institutes of Health (NIH), Head Start, and more, as well as the withholding of funds appropriated by Congress.
MAHA Report – Secretary Kennedy’s long awaited “MAHA Report” came out on May 22. The report, titled “The MAHA Report: Make Our Children Healthy Again,” discusses a range of drivers behind what it describes as a "chronic disease crisis," including high rates of obesity, asthma, autoimmune conditions, and behavioral health disorders among kids. The report suggests links between autism and food dyes or environmental toxins, but does not discuss Kennedy’s previous claims that there is a link between vaccines and autism. |
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Key Takeaways |
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This was Kennedy’s third hearing on the Hill in a week and despite that, there is still very little clarity about the future of HHS and the agencies and programs that serve people with disabilities.
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Over and over again, autism advocates and researchers have come out against Kennedy’s suggestions that rates of autism spectrum disorder are booming due to environmental and pharmaceutical factors. Kennedy, however, continues to promote misinformation about causes that is not backed in science.
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Plain Language |
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Secretary Kennedy is in charge of the Department of Health and Human Services (HHS). The Administration wrote a budget that shows they want to make billions in cuts to this department. They want to take money away from many government programs that support people with disabilities and their families, and have already started firing a lot of people and stopping a lot of money from going to important programs. Secretary Kennedy met with a committee in the Senate to talk about this budget. Members of Congress asked him about these firings and about the money that is being stopped from going to important programs that affect people with disabilities, children, older adults, and more. Secretary Kennedy showed that he did not know a lot about the firings or the money.
Secretary Kennedy released a new report from HHS that is about chronic diseases. When something is chronic, that means it is ongoing. It usually doesn’t go away, but people have it for a long time. Diabetes is an example of a chronic disability. Kennedy’s report says that there are probably other causes of autism, like food dye, which is not true. Autism is a genetic disability, which means autistic people are born autistic. Many studies have proved this, so it is concerning that Secretary Kennedy keeps saying that he wants to find out the cause of autism. |
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U.S. Department of Education |
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In a hearing with the House Appropriations Labor-HHS-Education Subcommittee this week, Secretary of Education Linda McMahon defended the Trump Administration's cuts to the Department of Education and described the effort to shutter her department as the “final mission.” She was asked about the President’s “skinny” budget that would block grant crucial programs like Title I (which provides funding to low-income schools) and the Individuals with Disabilities Education Act (IDEA), though McMahon claims they will be “funded in full.” Secretary McMahon also voiced support for ongoing efforts for school privatization, a movement that will leave behind students with disabilities. |
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Plain Language |
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The Secretary of Education, Linda McMahon, met with a committee in the House that works on education. She said she supported the goal of the Trump Administration to close the Department of Education and that they should keep making cuts to public education funding. She said that different programs that help students with disabilities would be “funded in full,” which means they would get the full amount of money that they usually do. However, the President’s budget proposal shows that they want to reduce the money that they give to these programs. |
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AUCD Story Collection |
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AUCD is collecting stories from the Network on a variety of topics to amplify the effects of this Administration on real people and our programs. If you have a story, we want to hear it.
We are interested in stories about:
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Medicaid and its impact on people's lives
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The impact of dismantling ACL
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The impact of zeroing out UCEDDs, LENDs, IDDRCs, PNS’s, DD Councils, P&As
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Impact of grants that are being cut
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Stories responding to RFK Jr.’s claims about autism or the autism registry
You can use this link to provide information and let us know if you are comfortable sharing your story with Members of Congress and their staff. |
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AUCD Policy Blog |
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AUCD invites Network members to fill out this form if you’re interested in writing for the AUCD policy blog. We are open to a variety of issues areas, and we will follow up with you as relevant issues come up that we’d like you to write about. |
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Disability Policy for All with Liz |
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Join Liz on Instagram Reels, where she provides 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 interviewing Bridger Reed-Lewis on autism. |
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Words to Know |
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Reconciliation
This is a process of passing bills that affects 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.
Work Requirements
Work requirements are a part of the law that makes people fill out a form or prove to their government that they are working at a job for a certain number of hours every month in order to get services. These services might be Medicaid, SNAP (which helps people afford food), or other services that the government is in charge of. Sometimes, work requirements can include things like volunteering or going to school, if you can prove that you can’t get a job. Work requirements can be very hard for the government to check, because it takes a lot of people and a lot of time to check if people are reporting their work. Sometimes people think that work requirements get more people to have jobs, but in the examples we have seen, it doesn’t really help people get jobs.
Qualify
When you qualify for something, it means you can get certain benefits or support. Usually, if the government has a program that gives people money to afford health care, helps people live in the community, or runs a program to bring people together to get community supports, people need to qualify for it. That means people might have to have a certain disability or have a low amount of money in their bank account. You can qualify for benefits in different ways, it depends on the program. |
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