On a typical morning, Maria — a 54-year-old woman with multiple sclerosis who lives in a mid-size city in the Midwest — follows a routine built on a network of federal programs. A Medicaid-funded personal care attendant helps her get dressed. A Social Security Disability Insurance payment covers her rent. A state-run home- and community-based services waiver keeps her out of a nursing facility and in the apartment she has lived in for eleven years. Her sister, who works part time so she can provide backup care, depends on a local Area Agency on Aging — funded through the Older Americans Act — to connect her with respite services.
That network is undergoing its most significant restructuring in decades. Over the course of 2025 and into 2026, the Trump administration, Congress, and federal agencies have made a series of changes to the programs that millions of Americans with disabilities, seniors, and their families depend on — changes that supporters describe as necessary to control federal spending and reduce government inefficiency, and that disability rights advocates characterize as the most consequential rollback of disability support in a generation.
This article provides a factual, sourced account of what has changed as of July 2026, drawn from Congressional Budget Office estimates, Bureau of Labor Statistics data, federal agency announcements, and statements from both supporters and critics of the changes. Because this policy landscape is shifting rapidly, readers are encouraged to verify specifics at the sources cited before making any decisions based on this information.
The Baseline: Who Relies on Federal Disability Programs, and Why the Gap Matters
Before examining specific policy changes, it is useful to understand the scale of the population affected and the documented disparities between Americans with and without disabilities.
According to the U.S. Bureau of Labor Statistics’ 2025 annual report on people with disabilities, the employment-population ratio — the share of people who are employed — was 22.8 percent for people with a disability, compared with 65.2 percent for people without a disability. Among working-age adults (ages 16 to 64), the employment rate for people with a disability was 38.1 percent, versus significantly higher rates for non-disabled adults. About 75 percent of people with a disability were not in the labor force in 2025, compared with about 32 percent of those without a disability.
The poverty rate for people with disabilities is persistently more than double the rate for non-disabled Americans (BLS, 2025). These persistent gaps mean that federal income support, healthcare coverage, and community services are not supplementary benefits for most people with significant disabilities — they are the primary infrastructure of daily life.
Approximately 72 million Americans are enrolled in Medicaid, and people with disabilities account for a disproportionate share of program spending: while they represent roughly 15 percent of Medicaid enrollees, they account for approximately 40 percent of Medicaid expenditures, reflecting the intensity of their healthcare and long-term support needs. More than 8 million Americans receive Social Security Disability Insurance (SSDI), and approximately 7.5 million receive Supplemental Security Income (SSI) — programs administered by the Social Security Administration that together provide baseline income to people who are unable to work due to disability.
Medicaid: The Largest Single Policy Change — The One Big Beautiful Bill Act
The most consequential federal action affecting people with disabilities in this period is the One Big Beautiful Bill Act (OBBBA), signed into law by President Trump on July 4, 2025.
The nonpartisan Congressional Budget Office (CBO) estimated that the OBBBA will reduce federal spending on Medicaid and the Children’s Health Insurance Program (CHIP) by $1.02 trillion over the 2025–2034 period. The CBO projected that more than 7.8 million people will lose Medicaid coverage as a result of the law’s provisions. State Medicaid budgets are projected to face reductions of $665 billion over the same decade, with states required to absorb a larger share of program costs.
The law’s supporters, including House Speaker Mike Johnson and the Republican caucus that passed the bill, have characterized these changes as necessary to control federal deficits and ensure the long-term sustainability of Medicaid for the most vulnerable Americans. They argue the bill targets Medicaid expansion coverage — a group added under the Affordable Care Act that includes many working-age, able-bodied adults — rather than core disability beneficiaries, and that work requirements create incentives for labor force participation among those who are able to work.
Jonathan Ingram of the Foundation for Government Accountability, a conservative research organization, stated that work requirements address beneficiaries who “could and should work” rather than cutting coverage for disabled or medically frail individuals.
Critics from the disability community dispute that characterization. Beginning in January 2027, Medicaid expansion enrollees must document at least 80 hours per month of “community engagement” — employment, volunteerism, or education — to maintain coverage. The law includes exemptions for people who are medically frail, including individuals who are blind or disabled, individuals with physical, intellectual, or developmental disabilities, individuals with substance use disorder or a “disabling” mental disorder, and those with “serious or complex” medical conditions. However, advocates argue that the exemption criteria are unclear, that many people with disabilities who qualify for exemptions will lose coverage due to documentation failures or administrative errors rather than ineligibility, and that the most acute concern is for optional Medicaid services — particularly home- and community-based services (HCBS). See Medicaid.gov’s HCBS resources for program details.
Zoe Gross, Director of Advocacy at the Autistic Self Advocacy Network, stated in July 2025: “States faced with a huge loss of federal funding for Medicaid will cut HCBS first. This will lead to disabled people going without lifeline services like assistance with eating, dressing, using the bathroom, going to work.” Home- and community-based services are an optional Medicaid benefit — meaning states are not required to offer them — and they are typically among the first programs reduced when states face budget shortfalls.
Additional OBBBA provisions affecting people with disabilities include: a requirement that states conduct Medicaid eligibility checks every six months for expansion enrollees (up from annually); cost-sharing of up to $35 per healthcare service for expansion recipients; and a prohibition on implementing two finalized rules until October 1, 2034 that would have made it easier for low-income Medicare enrollees to access Medicare Savings Programs.
The Center on Budget and Policy Priorities, a left-leaning think tank, noted that the last provision disproportionately affects people with disabilities, who are more likely to have lower incomes and dual-eligibility for both Medicaid and Medicare.
Barbara Merrill, CEO of the American Network of Community Options and Resources (ANCOR), which represents disability service providers, stated: “Despite Congress’ stated intent of protecting people with IDD [intellectual and developmental disabilities], this bill cuts the very funding on which people with disabilities depend for critical supports and life-saving health care.” Andy Imparato, CEO of Disability Rights California, said in July 2025: “In my 34 years of work in disability advocacy this is the most harmful bill for disabled people that I have ever seen.”
As of July 2026, states are beginning to implement the OBBBA’s requirements. A March 2026 analysis by Disability Belongs found that the state-level implementation of Medicaid changes is “raising serious concerns for disabled people who rely on Medicaid for both healthcare and long-term services and supports.” A RAND Corporation analysis examined the state-level financial impacts of the key provisions, finding significant variation in projected coverage losses and state budget impacts across states
Social Security: Staffing Cuts, Processing Delays, and a New Rule Now in Effect
The Social Security Administration (SSA) — which administers both SSDI and SSI — underwent significant changes in 2025 and 2026 under the Department of Government Efficiency (DOGE) initiative.
According to a June 2026 report by Fortune magazine, the SSA lost 7,100 workers — the largest staff reduction in the agency’s history. The agency hired fewer than 100 employees in all of 2025, the lowest number on record. Between January 2025 and January 2026, the SSA lost 13 percent of its administrative law judges — the largest one-year drop on record. Administrative law judges are the officials who hear appeals from applicants whose disability claims have been denied, making their departure a direct factor in processing timelines.
As of July 2025, nearly 1 million people were waiting for decisions on SSDI and SSI applications and appeals, according to reporting by Binghamton University News, which cited the consequences of “decades of understaffing made worse by cuts led by DOGE.” The SSA has also consolidated ten regional offices into four and moved more customer service functions online, changes that disability advocates have raised concerns about for rural residents and those with cognitive or sensory disabilities who may face barriers to online access.
The Trump administration’s stated rationale for SSA restructuring is that the agency has been chronically inefficient, that overpayment recovery is a legitimate program integrity function, and that modernizing SSA’s technology and service delivery will improve long-term performance. SSA Commissioner Frank Bisignano, confirmed in May 2025, has said the agency is focused on eliminating waste and ensuring that benefits reach those who truly qualify for them.
A regulatory change that was long-proposed became confirmed when it took effect on October 1, 2024. A second, more targeted rule change affecting certain SSI recipients took effect on June 4, 2026. The SSA reinstated an older interpretation of the “in-kind support and maintenance” (ISM) rule, eliminating the public-assistance household exemption that had previously protected SSI recipients who live with family members receiving SNAP food assistance. According to the Center on Budget and Policy Priorities, this change was projected to reduce or eliminate SSI benefits for approximately 400,000 low-income disabled and older people — including adults with Down syndrome and other intellectual disabilities who live with their parents. The SSA’s own internal analysis warned that the rule change could result in benefit cuts for over 275,000 people and complete loss of benefits for more than 100,000. ProPublica reported in April 2026 that the rule “targets disabled adults who live with their families.” People who believe their SSI benefit has been affected by this rule should contact the Social Security Administration directly at 1-800-772-1213 (TTY: 1-800-325-0778) and may request an appeal within 60 days of receiving a notice of benefit change.
A separate regulatory change would have reduced the share of SSDI applicants who qualify for benefits by up to 20 percent, according to an Urban Institute analysis. The Center on Budget and Policy Priorities reported in November 2025 that the Trump administration had “set aside plans” to propose this regulation, though the administration had not publicly confirmed the change in plans.
The contrast with nondisabled Americans is significant: workers without disabilities experiencing job loss have access to state unemployment insurance systems with defined appeals processes and staffing specifically dedicated to claimant service. The SSDI and SSI systems — which serve people who are unable to participate in the standard labor market — are operating with significantly reduced capacity at a time of increased application pressure.
Civil Rights Enforcement: ADA Guidance Withdrawals and the Olmstead Question
The Americans with Disabilities Act has not been repealed or formally amended, but the federal infrastructure for interpreting and enforcing it has shifted in notable ways since January 2025.
In March 2025, the U.S. Department of Justice removed 11 ADA guidance documents from ADA.gov — materials that provided practical compliance explanations for businesses, local governments, and service providers in areas including retail accessibility, lodging, service animals, and public accommodations. The DOJ stated the action was taken in response to President Trump’s January 2025 memorandum directing agencies to reduce regulatory burdens and the cost of living. The rescinded documents included materials dating back to 1999. The Hill and Disability Scoop reported on the withdrawals in March 2025.
Supporters of the guidance withdrawals have argued that practical guidance documents can function as de facto regulatory expansions and that businesses should not face compliance uncertainty from non-binding agency documents. Critics, including the American Bar Association’s Disability Rights committee, have argued that removing guidance documents leaves businesses and local governments without clear direction, which can result in reduced accessibility investments rather than increased certainty.
A more significant development emerged in June 2026. NPR and STAT News reported on an internal DOJ memo circulated in June 2026 indicating that the department was reconsidering its approach to enforcing the Olmstead decision — the landmark 1999 Supreme Court ruling that found the unjustified institutionalization of people with disabilities is discrimination under the ADA. The Olmstead decision has been the legal foundation for decades of policy moving people with disabilities from institutions into community-based settings. Disability rights organizations expressed alarm that a reduced federal commitment to Olmstead enforcement could slow or reverse that transition, potentially affecting hundreds of thousands of people with disabilities in institutional settings or on HCBS waiting lists.
In April 2026, Disability Scoop reported that the Trump administration had expressed doubt about implementing new ADA web accessibility rules — specifically the 2024 DOJ Title II rule requiring state and local government websites to meet WCAG 2.1 Level AA accessibility standards. The compliance deadline for larger jurisdictions has already been extended to April 2027; further administration ambivalence about enforcement creates uncertainty for the approximately 61 million Americans with disabilities who rely on accessible digital government services.
Special Education: IDEA Funding Maintained, But Oversight Infrastructure Reduced
The Individuals with Disabilities Education Act (IDEA), which guarantees a free appropriate public education for the nation’s 7.5 million students with disabilities, has not been defunded. The FY 2026 federal budget maintained IDEA funding at $15.5 billion — the same level as FY 2025.
However, the infrastructure for overseeing IDEA compliance has been significantly reduced. On October 10, 2025, 415 employees were laid off from the Department of Education, including 121 from the Office of Special Education and Rehabilitative Services (OSERS). According to reporting by the Center for American Progress and Understood.org, fewer than half a dozen employees remained within the Office of Special Education Programs (OSEP) following the layoffs — the office responsible for monitoring states’ compliance with IDEA, administering technical assistance to millions of families, and overseeing the rights of students with disabilities nationwide.
In May 2026, the Trump administration withheld $2 billion in education grants, according to Education Week. On June 16, 2026, the U.S. Department of Education announced it was splitting oversight of special education between the Department of Health and Human Services and the Department of Justice — a structural change that disability education advocates said created uncertainty about accountability and federal-state coordination.
Administration officials have stated that the Department of Education’s restructuring is part of a broader effort to reduce federal bureaucracy and return education decision-making to states and local communities — a position consistent with longstanding conservative education policy principles. Lindsey Burke, a Project 2025 author and administration official, stated in January 2026 that the administration was not planning cuts to special education funding. Critics, however, note that funding levels alone do not determine whether IDEA’s guarantees are enforced: without federal monitoring capacity, states have less accountability for compliance with Individualized Education Program (IEP) requirements and procedural safeguards.
For families of students without disabilities, federal education policy changes — such as school choice expansions and Title I adjustments — have different implications and tradeoffs. The reduction of OSEP oversight capacity is specific to the disability education population, creating a disparity in federal oversight between disabled and non-disabled students
The Caregiving Infrastructure: ACL, the Older Americans Act and a $1 Trillion Informal System
The Administration for Community Living (ACL) is the federal agency that administers the Older Americans Act and coordinates federal disability and aging services. On March 27, 2025, the Department of Health and Human Services announced a major reorganization in which more than 40 percent of ACL’s staff was fired, including entire budget and grants teams, policy and evaluation teams, and regional staff, according to reporting by Health Affairs Forefront and the National Council on Aging (NCOA).
The Trump administration’s FY 2026 budget proposed dissolving ACL as an independent entity and merging its functions into a newly created Administration for Children, Families, and Communities (ACFC). The proposal also recommended cutting the Alzheimer’s disease support program from $32 million (FY 2025) to $17 million (FY 2026) and eliminating funding for several Older Americans Act programs, including the Long-Term Care Ombudsman program (Title VII) and elder justice programs including Adult Protective Services. The budget also proposed eliminating State Health Insurance Assistance Programs (SHIPs), which help Medicare beneficiaries navigate their coverage options — a service used disproportionately by lower-income seniors and people with disabilities. More information is available through Benefits.gov and the NCOA’s BenefitsCheckUp tool.
The FY 2026 budget that Congress passed on February 3, 2026 level-funded ACL’s programs — meaning none were formally eliminated in the enacted budget, providing relief from the proposed cuts. However, the NCOA and LeadingAge noted that ACL’s capacity to disburse funding and provide technical assistance to grantees has been significantly impaired by the staff reductions, even where program funding was maintained.
The administration’s position is that ACL and similar agencies accumulated administrative overhead that can be reduced without cutting front-line services, and that consolidating agencies improves coordination. Critics, including aging services organizations and disability advocates, contend that ACL’s staff reductions have delayed grant disbursements, reduced technical assistance to area agencies on aging, and left a population that depends on these services without adequate federal coordination.
The policy debate over formal federal caregiving support occurs against a backdrop of what AARP’s 2026 update to its “Valuing the Invaluable” report describes as a $1.01 trillion informal caregiving system. In 2024, an estimated 59 million Americans provided unpaid care to adults — providing 49.5 billion hours of care at an estimated average value of $20.41 per hour. That $1.01 trillion total exceeds total federal and state Medicaid spending ($932 billion) and exceeds private business spending on health insurance ($967 billion). Individual caregivers typically incur out-of-pocket expenses averaging over $7,000 per year, according to the same analysis.
A 2025–2026 analysis by Seniorly found that nearly half of U.S. states (48 percent) are at the brink of an unpaid family caregiving emergency, with caregiving capacity rated “critical” or “high risk” in 24 states. The 85-and-older population — which requires the most intensive care — is projected to more than double by 2050, to 17.4 million Americans, according to U.S. Census Bureau projections.
For context: a non-disabled adult who loses a job has access to state unemployment insurance. A non-disabled adult who cannot afford healthcare has access to ACA marketplace plans with income-based subsidies. An unpaid family caregiver supporting an adult with a significant disability or a senior with dementia has no direct federal compensation, no guaranteed respite services, and an informal system worth over $1 trillion annually that is largely invisible to federal economic accounting
The Nonprofit Sector: Funding Freezes and Program Uncertainty
Many of the organizations that provide direct services to people with disabilities and their families — disability rights legal organizations, independent living centers, aging services providers, and advocacy groups — operate primarily on federal grants and contracts. The disruptions to federal funding have had direct effects on this sector.
Since January 2025, the Trump administration canceled or froze roughly $425 billion in federal funds across health care, arts, education, and other sectors, according to Foundation List’s analysis of federal funding actions. The American Association of People with Disabilities (AAPD) published an analysis titled “Federal Funding Freeze” noting that funding “that goes from the federal government to states to fund programs important to disabled people and funding and grants that fund state and national disability organizations were particularly impacted by federal funding freezes.”
An Urban Institute survey of nonprofits affected by early 2025 funding disruptions found that 30 percent of nonprofits receiving federal grant funds faced “a wide array of challenges” including terminated grants, frozen funding, and forced program changes. Many disability service organizations, independent living centers, and protection-and-advocacy organizations that receive federal funding through programs like the Center for Independent Living grants and the Protection and Advocacy for Individual Rights program reported uncertainty about future federal support.
The administration has characterized nonprofit funding reviews as part of an effort to eliminate waste, fraud, and abuse in federal contracting and grant-making, and has argued that many organizations receiving federal funds were not delivering measurable value. Critics counter that many of the affected organizations provide legally mandated services — such as protection-and-advocacy for people with disabilities — that federal law requires states to support
The Documented Disparity: Disabled vs. Non-Disabled Americans in 2026
Pulling together the data, the disparity in federal support, economic security, and institutional capacity between Americans with disabilities and their non-disabled peers is substantial and measurable:
Employment: The employment rate for people with disabilities is 22.8 percent overall and 38.1 percent for working-age adults, versus 65.2 percent for non-disabled Americans (BLS, 2025). The employment gap between people with and without disabilities is larger than any racial, ethnic, or educational attainment employment gap in the United States, according to analysis by the Federal Reserve Bank of New York (January 2026).
Income: People with disabilities are more than twice as likely to live in poverty as non-disabled Americans. SSI — the primary income support for low-income people with disabilities who cannot work — pays a maximum federal benefit of $967 per month in 2025 (for an individual), which is below the federal poverty line in every state. Current SSI payment information is available at ssa.gov/ssi.
Healthcare: Medicaid is the primary health insurer for people with disabilities and long-term care. The OBBBA’s $1.02 trillion in projected Medicaid reductions will — if CBO projections prove accurate — remove millions of people from coverage. Non-disabled, higher-income Americans have access to employer-sponsored insurance or ACA marketplace plans; people with significant disabilities who cannot work typically do not have access to either.
Caregiving: The $1.01 trillion informal caregiving system described in the AARP “Valuing the Invaluable” report is provided by unpaid family members — disproportionately women and lower-income families — with no direct federal compensation. By contrast, non-disabled adults aging into care needs may have more resources to purchase private care or access Medicare’s post-acute services. Families supporting adults with lifelong disabilities typically face caregiving costs and responsibilities beginning in childhood with no time-limited endpoint.
Civil rights enforcement: The withdrawal of 11 ADA guidance documents from ADA.gov and the reported reconsideration of Olmstead enforcement represent, if implemented, a reduction in the practical enforceability of civil rights protections that apply specifically to people with disabilities. No equivalent rollback of civil rights enforcement has been documented for non-disabled Americans in the same period.
What to Watch: Key Developments Expected in Late 2026 and 2027
HCBS waiver state responses: As states face reduced federal Medicaid funding beginning in 2025–2027, whether and how they reduce home- and community-based services waivers will determine the direct impact on people with disabilities who rely on in-home support. Watch state Medicaid agency announcements.
Work requirement implementation (January 2027): The OBBBA’s Medicaid work requirements are set to begin in January 2027. The scope of exemptions — specifically how “medically frail” and disability exemptions are operationalized by CMS and states — will determine how many people with disabilities are affected. The Center on Budget and Policy Priorities and Urban Institute have both committed to ongoing tracking.
SSI in-kind support rule: The proposed SSI rule restoring the public-assistance household exemption is finalized, approximately 400,000 low-income disabled and elderly people could see reduced or eliminated benefits. (SpecialNeeds.com)
SSA backlog: The size of the SSDI and SSI application backlog and average wait times are updated regularly at ssa.gov. With the agency operating at significantly reduced staffing, processing times are expected to be a continued watch item.
IDEA oversight transition: The announced transfer of special education oversight from the Department of Education to HHS and DOJ is scheduled to proceed but has not been fully implemented as of research date. Advocacy organizations including the National Council on Disability and Disability Rights Education and Defense Fund (DREDF) are monitoring the transition.
ACL and Older Americans Act: The Older Americans Act requires reauthorization; its funding and structure are subject to ongoing congressional negotiation. Watch the National Council on Aging (ncoa.org), the U.S. Administration for Community Living(acl.gov), and the Leadership Council of Aging Organizations for updates
KEY RESOURCES: KNOW YOUR RIGHTS AND GET HELP
IF YOUR MEDICAID OR SERVICES ARE AFFECTED:
• Contact your state Medicaid agency: Medicaid.gov
• Find your state’s Disability Rights (Protection & Advocacy) organization: Disability Rights Advocates directory
• Disability Belongs
IF YOUR SSI BENEFIT HAS CHANGED (June 4, 2026 Rule):
Social Security Administration | 1-800-772-1213 (TTY: 1-800-325-0778)
Request a hearing within 60 days of your benefit change notice
Disability Rights Education and Defense Fund (DREDF)
IF YOUR SSDI IS AFFECTED:
Social Security Administration | 1-800-772-1213 (TTY: 1-800-325-0778)
Request a hearing within 60 days of any denial or benefit change
IF YOU HAVE AN ADA COMPLAINT:
• ADA National Network | 1-800-949-4232
• DOJ ADA complaint: ada.gov/file-a-complaint
• EEOC (employment discrimination)
FOR OLDER ADULTS AND CAREGIVERS:
• Eldercare Locator | 1-800-677-1116
• National Council on Aging
• AARP | 1-888-687-2277
• ARCH National Respite Network (respite care)
FOR SPECIAL EDUCATION / IDEA:
• Parent Training and Information Centers
• Understood.org
• National Council on Disability
The policy landscape affecting Americans with disabilities and their families is changing rapidly, with new developments expected through 2027. Staying informed is the most important first step for individuals, families, and advocacy organizations alike.
AmeriDisability.com will continue to track and report on federal disability policy developments. If you have questions about how a specific policy change may affect you or someone you support, the ADA National Network (adata.org, 1-800-949-4232) and your state’s Protection and Advocacy organization can provide guidance specific to your situation. Decisions about benefits, coverage, and legal rights should be made in consultation with qualified professionals familiar with your individual circumstances.
