May 30, 2025| Vol. MMXXV | Issue 114

Reconciliation

Now that the House of Representatives has passed its version of Republicans’ reconciliation bill, the action moves to the Senate as it prepares to work on its version of the package next week. Both House Speaker Mike Johnson (R-LA) and Senate Majority Leader John Thune (R-SD) say that they want the reconciliation bill to be sent to President Trump by July 4. Read more about what is in the House’s bill here.

Senate Republicans’ priorities are a little different from House Republicans. For example, some Senators want to make even deeper cuts to the budget than the House bill contains, and some are much more cautious about making Medicaid cuts. Senate process and rules differ a bit from the House as well. For one thing, the Senate’s reconciliation bill has to pass the Byrd rule, which essentially stipulates that the bill only deal with federal spending. The Senate parliamentarian is tasked with reviewing the bill to rule on whether or not it follows the Byrd rule, and if it doesn’t, that provision is typically removed. Read more about Senate reconciliation rules here.

The Senate will not publicly hold markups in committees, the way the House did, but will be conducting closed-door negotiations to prepare their retooled bill. They will likely then hold another vote-a-rama, which is a long process on the Senate floor where Senators consider a bill and can add as many amendments as they want. Once they finish, they need a simple majority to pass their budget resolution.

Key Takeaways

While Congressional processes can be complicated and often confusing, the bottom line remains that Congressional Republicans want to cut into Medicaid and other important programs in order to finance two main things: 

1. An extension of the Trump tax package from his first term—which gave massive tax breaks to billionaires and corporations 

2. Increased immigration enforcement 

Congressional Republicans have been saying that even though their bill would implement work requirements for Medicaid, it 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. 

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. Folks must continue to let their Members of Congress know how painful, misguided, and cruel any cuts to Medicaid would be.

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. 

• Action Item: Outreach and education efforts must now shift to the Senate to educate them on the negative effects of these cuts to Medicaid. Call your Senators and educate them on the importance of Medicaid for people with disabilities and their families and caregivers--you can use AUCD’s Medicaid fact sheet and talking points. Reach your Senators by calling the Capitol Switchboard at 202-224-3121.

Plain Language

Congress is in the middle of a long process of passing bills that affect how the government spends money, which is called reconciliation. 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. Republicans in the House might have different priorities than Republicans in the Senate, and the Senate has different rules than the House, so some things might change about the bill.

Republicans in both the Senate and House are trying to cut Medicaid and take it away from millions of people and even make it harder for people to get health insurance in other ways. 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.

• Action Item - Right now, people should let their Senators know how important Medicaid is for people with disabilities and their families. You can reach your Members of Congress by calling the Capitol Switchboard at 202-224-3121 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.

Budget and Appropriations

• Fiscal Year 2025 – On Thursday, Senate Appropriations Committee Vice Chair Patty Murray (D-WA) and House Appropriations Committee Ranking Member Rosa DeLauro (D-CT) sent a letter to Office of Management and Budget (OMB) Director Russ Vought about the Trump Administration’s failure to submit appropriations plans for each agency to Congress' Appropriations Committees. These plans were required—by the Full-Year Continuing Appropriations Act of 2025—to be submitted to the Appropriations Committees by April 29. The lawmakers write:
  
  “For example, the spend plan submitted for the Department of Health and Human Services (HHS)…includes only high-level funding amounts and does not provide funding levels for hundreds of specific programs and activities. Instead, it lists 530 asterisks in place of details about how this administration is choosing to fund—or not fund—hundreds of programs that the American people count on every day.”
  
  Director Vought is scheduled to testify at the House Appropriations Committee's budget hearing on Wednesday, June 4 at 2:00 PM.
  
  

• Fiscal Year 2026 – House Appropriations Chair Tom Cole (R-OK) has released his fiscal 2026 markup schedule. His plan is to get all 12 of the annual funding bills—which correlate to each House Appropriations Committee subcommittee—approved in committee before August recess. 

Key Takeaways

The Administration has provided opaque and inconsistent information about its plans to spend funding that Congress has appropriated. Some departments and agencies have been more forthcoming than others, which is not surprising, considering the Administration’s apparent disregard for typical procedures and processes in its relationship with the Legislative branch. As Representative Cole prepares to kick off FY26 markups, he and the Republican caucus will likely be taking cues from the President’s “skinny” budget. OMB Director Vought said that the President’s full budget won’t be sent to Congress until after the reconciliation bill passes.

Plain Language

Congress is in charge of deciding how much money different government programs and departments get. Congress already decided how much money programs will get in 2025, but the President and his Administration have to, by law, send a plan to Congress about what they will do with that money. Senator Patty Murray (D-WA) and Representative Rosa DeLauro (D-CT) sent a letter to the Administration asking for these plans, because they haven’t received them yet. They are worried that the Administration is not following the law. The Administration has not been following a lot of rules about how to work with Congress. In the House, Representative Tom Cole (R-OK) has announced that he wants to make a lot of decisions about the money that programs will get in 2026 before August.

Centers for Medicare & Medicaid Services

This week, the Centers for Medicare & Medicaid Services (CMS) announced increased federal oversight for states who help undocumented immigrants get Medicaid. The announcement alleges that some states have “pushed the boundaries” beyond what is legally allowed under Medicaid law in their efforts to cover undocumented immigrants. CMS will increase oversight and conduct more evaluations and reviews of states’ Medicaid spending reports and finances.

Key Takeaways

Undocumented immigrants are not eligible for Medicaid. However, some states opt to use their state funds to cover some immigrants with temporary status or other legal status. Some states use their state funds to provide medical coverage to immigrants regardless of immigration status; 24 states cover pregnant people, 14 states cover children, and 7 states and Washington D.C. cover some immigrant adults. There is also the use of Emergency Medicaid spending, which reimburses hospitals for emergency care they have to provide to people who might meet Medicaid eligibility requirements otherwise but don’t have an eligible immigration status. According to KFF, “Much of Emergency Medicaid spending goes toward labor and delivery costs. Without Emergency Medicaid, the costs of care would be shifted to hospitals that are required to treat individuals in emergency situations or fully to states.” This announcement from CMS is in line with the Administration’s hostile position on immigration and intentions to cut Medicaid costs.

The House reconciliation bill contains language similar to this announcement. If passed, it would cut Medicaid funds for states that use their own state dollars to provide health insurance coverage to undocumented immigrants. Adding to this picture is the piece of Congressional Republicans’ bill that would cut Medicaid in order to finance increased immigration enforcement funding.

Plain Language

The Centers for Medicare & Medicaid Services, which is in charge of Medicaid, has announced that they will do more work to stop states that help some immigrants get Medicaid. There are a lot of different types of immigration status, like having a green card or becoming a citizen. If someone came from a different country and doesn’t have certain documents, they are called an “undocumented immigrant.” It can be very hard to get these documents and while people are waiting to get them or applying to get them, they usually work and raise their families in this country. They have health care needs like everyone else. The President and his Administration think that a lot of states are using money from the federal government to give Medicaid services to immigrants who are not in the country legally. While there are some states that help undocumented immigrants who are children or are pregnant or have a health emergency, they use their state money, not the federal government’s money.

AUCD Story Collection 

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: 

• Medicaid and its impact on people's lives 

• The impact of dismantling ACL 

• The impact of zeroing out UCEDDs, LENDs, IDDRCs, PNS’s, DD Councils, P&As  

• Impact of grants that are being cut 

• 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. 

AUCD Policy Blog

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. 

Disability Policy for All with Liz

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 Gale Hann on autism and workplace accommodations.

Words to Know

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. 

Appropriations

This is money that is set aside by Congress for a particular use. The appropriations process happens once a year. Money is sometimes requested by the President’s Administration or by Congress for a specific program or agency.

Undocumented

If someone came from a different country and doesn’t have certain documents, they are called an “undocumented immigrant.” It can be very hard to get these documents and while people are waiting to get them or applying to get them, they usually work and raise their families in this U.S.