The Hidden Cost of Budget Cuts: How Slashing Medicaid Puts Children with Disabilities at Risk

A few hundred billion here, a few hundred billion there—and the lives of children with disabilities are suddenly in the crosshairs.

Lawmakers in Washington are once again proposing massive cuts to Medicaid, one of the few programs in this country that truly meets children with disabilities where they are. To some, these cuts may appear as just numbers on a spreadsheet—part of an abstract debate over deficits and debt ceilings. But for the families affected, the stakes couldn’t be higher.

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When you cut Medicaid, you cut access to therapies that help a child speak their first words. You cut the home nursing that keeps a medically fragile child alive. You cut the school supports that allow kids to learn alongside their peers. These aren’t optional extras. They’re lifelines.

What Medicaid Really Does for Kids with Disabilities

It’s easy to misunderstand Medicaid. People often think of it as “health insurance for poor people,” but that barely scratches the surface—especially for kids with disabilities.

Medicaid is the only insurance program in the country that guarantees comprehensive care for children through something called EPSDT—Early and Periodic Screening, Diagnostic and Treatment. That includes speech, physical, and occupational therapies, specialized equipment like wheelchairs or feeding tubes, medications, and behavioral supports. Medicaid also covers long-term services and supports through home and community-based waivers, giving families help in their homes so they don’t have to turn to institutions.

It even funds school-based services, reimbursing districts for therapists, aides, and nurses who serve students with IEPs. Without Medicaid, many schools would struggle to deliver the basic services students with disabilities are entitled to under federal law.

What’s Being Proposed—and Why It Matters

This year, House Republicans introduced a plan to reduce federal Medicaid funding by as much as $880 billion over 10 years. The proposal includes work requirements, more frequent eligibility checks, and reduced flexibility for states. Supporters frame this as eliminating waste or promoting self-reliance—but that ignores how Medicaid actually functions for children with disabilities.

When you slash Medicaid funding, states have little choice but to cut services, reduce eligibility, or put more people on waitlists. Some children will lose access to the care they need. Others will stay on paper but see delays, disruptions, or reductions in critical services. Either way, families pay the price.

What This Looks Like for Real Families

Families may lose the therapies that help their child make progress. A child who was finally learning to speak may lose their speech therapist. A parent who relied on in-home nursing to sleep at night might have to quit their job or face burnout caring for a child with complex medical needs.

Without Medicaid, some families may be forced into debt to cover the cost of medical equipment or medications. Others could face an unthinkable choice: placing their child in an institution because home supports are no longer available.

And then there are the ripple effects. Schools that rely on Medicaid dollars for special education services could be left scrambling. Fewer aides. Fewer therapists. Bigger caseloads. Less inclusion.

Who Gets Hurt the Most

The impact won’t be felt evenly. States with limited Medicaid funding already—like Texas, Georgia, and Florida—could see even longer waitlists and more service cuts. Children from low-income families or communities of color, who already face barriers to care, will be hit harder. And those with the most complex needs—the kids who need multiple supports to survive and thrive—stand to lose the most.

What Advocates Are Saying

Disability rights groups have been clear: these proposed cuts would be devastating. Organizations like The Arc and ADAPT have called on Congress to reject them outright. Senate Democrats have gone as far as calling the budget plan a “war on kids.”

They’re not exaggerating. Behind every dollar cut from Medicaid is a child who will be directly affected—often in ways that can’t be undone.

What You Can Do

If you’re a parent, educator, or ally, now is the time to speak up.

• Call your representatives. Tell them what Medicaid means to your family.

• Share your story. The more we make this personal, the harder it is to ignore.

• Join advocacy campaigns. Organizations across the country are mobilizing to protect this essential program.

You don’t have to do everything, but doing something matters.

The Bottom Line

Medicaid isn’t just a policy. It’s the reason many children with disabilities are alive, learning, and included in their communities. Slashing it won’t just balance budgets—it will upend lives.

The question isn’t whether we can afford Medicaid. The question is whether we can afford to lose what it makes possible.