On Friday, President Donald Trump signed the One Big Beautiful Bill Act into law, which includes sweeping changes to Medicaid. This bill is expected to both directly and indirectly impact services for people with disabilities.
“I have learned that it's [Medicaid] not just one thing. Its, basically it helps me with my entire life," said Hannah Brecher, a self-advocate from Western New York.
35-year-old Brecher sees Medicaid as a lifeline and a safety-net. When doctors discovered issues with her ankles, she could get treatment to walk better. When she was diagnosed with autism, it also provided the resources she needed.
“I was diagnosed with autism in 2008 when I was 18 years old. I got therapy to be able to speak and to be able to do a lot of things," said Brecher. "So Medicaid has really been there for me.”
However, one of the biggest lifelines for Brecher, and for many people with disabilities on Medicaid, are Home and Community Based Services, or HCBS. These programs vary state by state and are determined by the states themselves, but usually focus on providing support that allow disabled people to live in their communities.
Brecher is able to access additional support, including a care coordinator, through this program. But that’s not all HCBS covers.
“I use Medicaid for aide service. It helps me to do daily living. Like, for example, I get help and I'm not afraid to say any of this, [with] bathing. I get helped with food preparation. I also get help with dressing," shared Mike Rogers, a self-advocate also from Western New York, who uses HCBS programs.
"Medicaid also pays for, probably, I can't say all of it, because I'm not sure, but I think it pays for all, if not a significant portion of my wheelchair," said Rogers.
While many are concerned about the direct cuts the One Big Beautiful Bill Act, or federal spending plan, makes to Medicaid, advocates worry about how states will make up for these cuts.
"For me, what, what scares me the most is, you know, not knowing what, what fully is going to be affected, and what does that mean down the road?" said Rogers.
The nonpartisan policy institute Center for American Progress has pointed out that previously, when federal funds to states for Medicaid have been lost, states have attempted to make up that loss by cutting programs determined by the states, including HCBS.
Both Brecher and Rogers say that while the cuts the federal budget bill makes are concerning, they worry about what we don’t yet know: how states will decide to cope with these cuts, and if that will include sacrificing vital programs within HCBS.
“We cannot lose these things or we lose our freedoms," said Rogers.
