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May 20, 2025
The Honorable Mike Johnson
Speaker
U.S. House of Representatives
Washington, DC 20510
The Honorable Hakeem Jeffries
Minority Leader
U.S. House of Representatives
Washington, DC 20510
RE: Vote NO on Deadly Reconciliation Provisions and Medicaid Cuts
Dear Speaker Johnson, Leader Jeffries and Members of the House of Representatives:
The Disability Rights Education and Defense Fund (DREDF), along with 730 national, state and local organizations, urges all members of the House of Representatives to vote “NO” on the “One Big Beautiful Bill Act”.[1] If passed the bill will jeopardize our nation’s well-being and lead to dangerous, life-threatening Medicaid cuts. DREDF calls on all members of Congress to defend the health of our communities and commit to ensuring Medicaid remains a program that provides all people in need reliable healthcare, supports and services.
DREDF is a cross-disability national civil rights law and policy center led by individuals with disabilities and parents who have children with disabilities. Our mission is to advance the civil and human rights of people with disabilities through legal advocacy, training, education, public policy and legislative development. We have persistently fought for the right of people with disabilities to be fully integrated within all aspects of community life. DREDF’s work is based on the knowledge that people with disabilities are capable of achieving self-sufficiency and contributing to their communities with access to needed services and supports, protection from discrimination, and the reasonable accommodations and modifications enshrined in U.S. law.
Make no mistake, the proposed bill would lead to nearly $800 billion in cuts to Medicaid and at least 13.7 million people losing health coverage over ten years.[2] Homecare services that are optional for states to provide, but not optional for people who need them, will inevitably be reduced.[3] The proposed text targets already vulnerable low-income people, people with disabilities, students, immigrants, transgender youth, and Black, Brown and Tribal communities.
Proposed provisions that will harm people with disabilities, our neighbors and families, include but are not limited to:
- Inefficient and burdensome job loss penalties and increased eligibility renewals.[4] While there are carve outs for the penalties, only people that meet very narrow disability criteria will be exempt. States will bear the costs of implementing the complicated provisions. Low-income people who need insurance to be healthy enough to work will lose access to care and face barriers to employment;[5]
- Targeted cuts to Affordable Care Act Medicaid dollars for 34 states and the District of Columbia (DC) that provide essential healthcare coverage for lawfully residing children or pregnant mothers. 14 of the states and DC use only their own funds to provide coverage for residents, mostly children, regardless of their immigration status;[6]
- Cuts to federal Medicaid funding for critical gender affirming care for minors and barriers to anyone receiving gender affirming care through health exchanges;
- Mandated out-of-pocket costs for some adults who rely on Medicaid for their health insurance if they have incomes above the federal poverty level (FPL). FPL is currently a mere $15,650 a year for an individual or $32,150 for a household of 4.[7] These fees could lead to fewer visits for preventative or even critical care;
- Denial of future healthcare access to people living in states that have not taken advantage of additional Medicaid enrollments through the Affordable Care Act;
- Prohibition of funding to community providers that offer critical reproductive healthcare to millions of low-income and uninsured people, including for people with disabilities in rural areas. Without access to these centers, barriers will be created to preventive and sexual and reproductive health care such as mammograms, cancer screening, pap smears, STI testing, contraceptive counseling, and prenatal care;
- Cuts of nearly $300 million from the Supplemental Nutrition Assistance Program (SNAP) which would disproportionately decrease access to food for students, single mothers and their families;
- Repealing of funding to address air pollution in schools which would disproportionately harm students with disabilities and chronic health conditions;
- Expedited natural gas project permits and barriers to judicial review which raise civil rights concerns. The bill allows companies to pay a large fee to fast-track their request, limits the amount of time impacted groups would have to review plans which could harm the health of their communities, and tries to dictate how courts handle any appeal of a permit; and
- Prohibiting states from regulating artificial intelligence systems for 10 years, including testing guardrails that address unintended bias, discrimination and environmental impacts.[8]
DREDF believes that health care and access to healthy and safe communities is a human right for all people. No matter our disability, race, gender, sexual orientation, citizenship status, income, or ZIP code – we all deserve to access the care and services we need to live, full stop. Without these services and programs people will die.
The efforts of courageous disabled activists and Congressional members helped save Medicaid in 2017. DREDF will continue to advocate alongside our disability, social justice, and human rights partners. We call on all members of Congress to vote against tax cuts for billionaires at the expense of Medicaid and the programs people in all districts need to live safe, healthy and fulfilling lives.
Please do not hesitate to reach out with any questions by contacting Carol Tyson, Government Affairs Liaison, ctyson@dredf.org, and Silvia Yee, Policy Director, syee@dredf.org.
Sincerely,
Michelle Uzeta
Interim Executive Director
[1] https://www.c-c-d.org/fichiers/Aging-Disability-Sign-on-for-Reconciliation-House-Floor-Vote-5_20_25.pdf
[2] https://democrats-energycommerce.house.gov/sites/evo-subsites/democrats-energycommerce.house.gov/files/evo-media-document/cbo-emails-re-e%26c-reconcilation-scores-may-11%2C-2025.pdf, and https://www.cbo.gov/publication/61420
[3] https://geigergibson.publichealth.gwu.edu/history-repeats-faced-medicaid-cuts-states-reduced-support-older-adults-and-disabled-people
[4] https://www.cbpp.org/blog/more-frequent-medicaid-renewals-would-increase-errors-and-lead-eligible-people-to-lose-health
[5] https://healthlaw.org/resource/top-10-reasons-why-house-republicans-work-requirement-proposal-will-harm-low-income-people/
[6] https://www.nilc.org/articles/the-house-reconciliation-bill-threatens-working-families-and-our-democracy/
[7] https://www.medicaidplanningassistance.org/federal-poverty-guidelines/
[8] See DREDF concerns and recommended guardrails at: https://dredf.org/disability-bias-in-clinical-algorithms-recommendations-for-healthcare-organizations/ and https://dredf.org/addressing-disability-and-ableist-bias-in-autonomous-vehicles-ensuring-safety-equity-and-accessibility-in-detection-collision-algorithms-and-data-collection/