What You Need to Know About the Proposed Medicaid Cuts

At Skylands, we know how vital Medicaid is for individuals with disabilities and their families. It’s a lifeline that provides access to medical care, home and community-based services, and long-term support, all of which help people live full, independent lives. That’s why we want to make sure you’re informed about proposed changes to Medicaid and what they could mean for you.

Recently, federal lawmakers have introduced several proposals that could significantly impact Medicaid. While these plans are still under debate, it’s important to understand what’s on the table.

Major Funding Reductions

Some proposals include cutting Medicaid funding by over $2 trillion over the next decade. These cuts would be achieved by limiting the amount of federal funding states receive through a method called a per capita cap, which means a set amount of money per enrollee, no matter the actual costs. Under a per capita cap, if someone’s medical needs increase—for example, due to an unexpected hospitalization or the need for additional therapies—the funding available to support them would not automatically rise with it. In practice, this could leave states with less flexibility and fewer resources to support people with complex needs.

Changes to Medicaid Expansion

The Affordable Care Act (ACA) allowed states to expand Medicaid to cover more low-income adults. However, under the proposed changes, the federal government would reduce its support for this expansion. This could lead states to scale back coverage or tighten eligibility, putting coverage for many at risk.

Stricter Eligibility and Work Requirements

Some proposals would require Medicaid recipients to work a certain number of hours or meet additional eligibility requirements. While these rules are aimed at promoting employment, in reality, they often create bureaucratic hurdles that make it harder for people with disabilities—and their caregivers—to access the services they need. Past attempts to impose work requirements in Medicaid programs have shown that even people who are technically exempt, such as individuals with disabilities, often lose coverage due to administrative errors or overwhelming paperwork burdens.

Grant Blocking

There’s also a push to shift Medicaid to a block grant system. This means states would get a fixed lump sum of money instead of matching federal funds based on need. If costs go up—due to rising healthcare prices or emergencies like a pandemic—states would be stuck with the shortfall. That could result in fewer services or longer wait times for vital programs.

How Could These Changes Affect You?

If you or a loved one relies on Medicaid for services, these proposals could:

• Limit access to home and community-based services that help people live independently
• Reduce provider payments, leading to fewer available doctors and support staff
• Increase waitlists for services like day programs or personal care
• Threaten funding for long-term care, including residential and nursing support
• Make it harder to qualify for or keep Medicaid coverage

Why This Matters in New Jersey

Here in New Jersey, over two million people rely on Medicaid, including tens of thousands of individuals with disabilities. Medicaid (called NJFamilyCare in New Jersey) funds services through the Division of Developmental Disabilities (DDD), which many of our Skylands families depend on for:

• Support coordination
• Home and community-based services
• Employment supports
• Residential services
• Day programs
• Assistive technology and environmental modifications

Cuts to Medicaid would threaten the availability and quality of these services. It could mean fewer provider options, and ultimately, fewer opportunities for people with disabilities to live full, independent lives.

What You Can Do

We have the power to protect Medicaid and ensure that vital services stay strong for our loved ones—but it starts with raising our voices. Now is the time to make sure New Jersey’s elected officials know just how much Medicaid means to our families and communities. When we speak out together, we have the tools to protect the care system our loved ones with disabilities rely on every day.

Here are a few ways you can make an impact:

• Sign Skylands’ Protect Medicaid Petition 
• Call or write to Congress
• Request a meeting with your members of Congress
• Share your story on social media and in the press
• Ask questions at town halls and events

Care connects us all. By coming together and lifting our voices, we can protect the programs that provide essential care, services, and supports for people with disabilities and their families across New Jersey.

READ MORE: Take Action Against the Proposed Medicaid Cuts: 5 Steps You Can Take Now

We’re With You Every Step of the Way

At Skylands, we believe that everyone deserves the right to live with dignity, choice, and opportunity, and Medicaid is a key part of making that possible. We’ll continue advocating for policies that protect and strengthen support for individuals with disabilities—and we’re always here to support you and your family.

If you have questions or concerns about how these proposed changes could affect your services, don’t hesitate to reach out to your support coordinator. We’re in this together.