What Is Medicaid?
Medicaid is a healthcare program run by both state and federal rules. The federal government makes the general rules that all state Medicaid programs must follow. Each state then has its own rules about who can get Medicaid and what healthcare costs it will cover.
Medicaid covers healthcare costs for disabled people and people who do not make a lot of money.
Medicaid is also the only healthcare insurance program that pays for Home and Community-Based Services (HCBS) Waivers. These waivers enable disabled people to remain in their communities instead of being forced into group homes or other institutions.
Recent Threats to Medicaid
In July 2025, the United States Congress passed a budget bill that will cut $1 trillion from Medicaid in the federal budget. This bill — the One Big Beautiful Bill Act — is expected to reduce federal Medicaid spending by around $1 trillion from 2025 through 2034.
A budget bill is a kind of bill that lets the government spend money for a set period of time. It outlines how much money will go to different government programs and services.
These cuts to Medicaid mean:
States will either have to pay for it all themselves or have fewer services available.
Fewer people will get Medicaid, and those who do may lose some or all of that help.
States are less able to collect money from healthcare providers, like hospitals, which makes it even harder for states to pay for Medicaid.
How Does This Affect Disabled People?
Medicaid is the main source of funding for long-term services and supports (LTSS) in both institutional and home and community-based settings. More than 10 million disabled people are currently on Medicaid.
Home and Community-Based Services (HCBS) are services for people in their homes or community settings that support their well-being and enable them to live independently. 86% of all optional national Medicaid spending goes to HCBS and other long-term care services.
These cuts will force disabled people to rely on family or institutions to function day-to-day.
Why Does This Matter for the South?
1.3 million of the 3 million disabled and older people who could lose access to Medicaid services live in 14 Southern states.
The three states in the South that would see the most people lose access to Medicaid services are:
Florida — 339,000 disabled and older people
North Carolina — 132,000 disabled and older people
Louisiana — 108,000 disabled and older people
These cuts could lead to disabled and older people in the South losing access to community care and healthcare services that they need to survive.
What Should Be Done?
New Disabled South Rising has two recommendations:
Members of Congress should repeal the One Big Beautiful Bill Act and fully fund Medicaid and expand access to federal money.
State lawmakers should make rules that would allow more people to get Medicaid in their state.
Take Action
Contact your State Representative, State Senator, and Members of Congress. Ask them to fund Medicaid and other healthcare programs that we rely on.