Cuts with Consequences

The One Big Beautiful Bill significantly cuts Medicaid. Cutting Medicaid puts infants, toddlers, and young children at risk by reducing and possibly eliminating early intervention and child care.

Key Facts

• As of 2023, Medicaid was the third largest funding source for early intervention services. Early intervention services (e.g. speech and physical therapy for babies with disabilities and their families), which often occur in partnership between the Individuals with Disabilities Education Act (IDEA) Part C and Medicaid, are at serious risk for many children across states if cuts occur.
• In the proposal to cut Medicaid, children would be significantly impacted due to loss of health care coverage through the Children’s Health Insurance Program (CHIP).
• The child care workforce relies on Medicaid for health care coverage. Cuts to the program put child care in many states at significant risk.

Stories

Alyssa from Powell, Ohio (Story shared by MomsRising)

"Our 4-year-old daughter is disabled and medically complex. She receives Medicaid through a waiver. Without Medicaid, we would not be able to afford the surgeries, appointments, therapies, and medical supplies and equipment she needs. Medicaid also provides extra support in the home to help keep her safe and out of the hospital as much as possible."

Dena from Oklahoma (Story shared by ZERO TO THREE)

"Medicaid has been absolutely essential in supporting both of my children, Eli and Adelaide, since their adoptions from Oklahoma’s foster care system. Medicaid has covered the specialized care he needs to survive and thrive—cardiology, occupational therapy, physical therapy, behavioral health services, medications, and in-home supports that help keep him safe and stable. Adelaide came to me at just four days old after testing positive for drug exposure at birth. She is a high-needs toddler with early trauma and severe behavioral challenges related to mental health issues yet to be diagnosed due to her young age. Medicaid has covered trauma-informed therapy, diagnostics, specialist visits, hearing screenings, and the upcoming surgery she needs to breathe and hear more easily.

As a single, working mom, I depend on reliable child care and respite to maintain employment. But when specialized child care falls through—which it often does for kids with complex needs—I’m left without options. Medicaid-funded supports can make the difference between being able to work or losing my job."

Jeralyn from Utah (Story shared by ZERO TO THREE)

"Despite our advanced education and stable, though not incredibly lucrative employment, affordable access to healthcare has been a substantial barrier for us. We love our daughter with an extra chromosome, and Down syndrome has taken control of our finances every year since Emily was born. Each cold and flu season we expect at least one extended stay in the pediatric intensive care unit—bringing large hospital bills, usually around Christmas. At just 3 months old, Emily was diagnosed with sleep apnea. In order to breathe safely at night, Emily needs a ventilator and c-pap machine which costs about $1,300 each month until our out-of-pocket max is met. These medical expenses bury us with medical debt that could be alleviated by Medicaid. We make too much money to qualify by just a few dollars, but not enough money to be able to afford the cost of these treatments without sacrificing other basic needs like housing and groceries. As part of the Down syndrome community, I know countless other families who rely on Medicaid to make ends meet."

Shiloh from Texas (Story shared by ZERO TO THREE)

"As a family of four with two [children with disabilities] who have benefited from Early Childhood Intervention (ECI) services, we are worried that Medicaid cuts would end services for children like mine. We were able to get our first child through ECI. We watched her go from nonverbal to singing a solo in her first grade choir class. I hope we are able to see the same progress with our youngest child. Thanks to Medicaid ECI, we can afford occupational, physical and speech therapy for our youngest, who has trouble walking. Otherwise we would not be able to afford such services, let alone the travel that such services would require in rural West Texas.

As parents, we can only prepare so much before things are out of our hands. Being in a rural area with few resources makes us cherish what resources we have. But it makes us all a little anxious not knowing from one morning to the next what resources remain available. When Medicaid was paused for 24 hours, we received calls from caseworkers telling us to start getting on yearlong waitlists for therapists who are two hours away in case services were cut forever. At least this time, Astrid did not go long without the therapies she needs. If this ECI was cut due to funding issues, not only would we have to pick up the remainder of what therapy costs, but we would also have to find ways to travel to Lubbock six times a month for therapy. That kind of cost would be devastating to our family."

The One Big Beautiful Bill cuts Medicaid. Cutting Medicaid harms schools and students.

Key Facts

• Medicaid is the fourth largest funding source for schools across the country, helping pay for school nurses, mental and behavioral health services, and assistive technology, among other services, supports, and screenings.
• Cutting Medicaid will “devastate” schools across the country. According to surveys, significant layoffs and reductions in staff would be expected given the immediate cuts in funding (approx. $7.5 billion in services each year).
• Similar to early intervention, Medicaid works with IDEA funding to help ensure students get all the services they need in schools. Without Medicaid, there is concern about a reduction in services, which would not align with individualized educational goals for students.

Stories

Smith Sisters from Oklahoma (Story shared by Council of Parent Attorneys and Advocates)

The Smith sisters live in a rural Oklahoma town where their school relies on Medicaid reimbursement to fund critical services like occupational therapy, speech therapy, and physical therapy. Jane, who has autism and complex medical needs, receives feeding therapy and behavior supports partially funded through Medicaid.

If Medicaid cuts pass, her district may be forced to cut school-based Medicaid services. That could mean Jane loses access to feeding therapy and Millie, who also receives support, is left without necessary interventions. Their family would face traveling hours for care they used to receive at school—an impossible burden without reliable transportation and flexible work.

Mike from Oklahoma (Story shared by Council of Parent Attorneys and Advocates)

Mike is a 9th grader navigating anxiety and sensory integration challenges. Like many students, he relies on school-based counseling and accommodations. These are possible because schools can use Medicaid funds for qualified mental health providers.

If Medicaid cuts pass, districts may eliminate positions like school-based counselors and social workers. In already-overloaded Oklahoma schools, mental health supports will vanish. Students like Hayden will be disciplined instead of supported.