PROPOSED CHANGES TO THE ACA
The NDNRC wants to make sure that people with disabilities are aware of potential changes to their healthcare as the current administration proposes major funding cuts to federal healthcare programs. The disability community utilizes Medicaid, and the ACA (Affordable Care Act) Marketplace plans at a higher rate than those without disabilities due to their unique needs.
By updating this newsletter with resources and educational pieces on where disability health policies stand, we hope to ensure that the disability community continues to have access to accessible and affordable healthcare coverage no matter what changes occur in the foreseeable future.
As of June 20, 2025, CMS finalized these policies that would negatively impact the disability community and access to affordable healthcare coverage. These changes would have stricter income verification requirements with shorter deadlines and open enrollment periods and requiring back-premium payments. Overall, these rules are meant to decrease improper enrollments and lower federal costs but really, it will impact people with disabilities by making it harder for them to enroll in the Marketplace.
The American Association on Health and Disability (AAHD) submitted comments to the Centers for Medicare and Medicaid Services (CMS) with the Lakeshore Foundation on the ACA Marketplace Proposed Rules on April 11, 2025. Both organizations emphasized the negative impacts on the disability community’s access to healthcare from these proposed rules.
This was further covered by the Center on Health Insurance Reforms (CHIRblog)’s blog post, noting how the proposed rule changes will still include complicated paperwork for people with disabilities in being able to sign up for healthcare coverage through the Marketplace.
Georgetown University’s Center for Children and Families released a blog post on the “One Big Beautiful Bill” (OBBB) and its even bigger cuts to Medicaid. This will decrease coverage and directly impact children and families who rely on Medicaid for healthcare coverage and the Supplemental Nutrition Assistance Program (SNAP).
The Kaiser Family Foundation (KFF) covered even more in an issue brief on the cuts to SNAP and its negative impacts on food security for many Medicaid enrollees. According to a report from the Food and Nutrition Service, about 17% of people who benefit from SNAP are a part of the disability community – that is over 7 million people.
The Commonwealth Fund discussed further in an issue brief how these cuts would cost states more than what the federal government would save. These cuts would impact services like home and community-based services, which allow people with disabilities to get care in their own homes and communities, and would lead to many HCBS workers losing their jobs.
AAHD posted on social media the impacts of Medicaid cuts on rural communities, especially for people with disabilities. KFF released an issue brief on five key facts about coverage for people living in rural areas:
- 1 in 4 people in rural areas have Medicaid coverage
- Medicaid expansion states have more people enrolled in coverage
- Children and adults in expansion states make up half of Medicaid enrollees
- 4 in 10 rural Medicaid enrollees have a chronic condition
Archives of our weekly updates are available on the NDNRC website.