Medicaid cuts threaten the ability of disabled Californians to live independent lives | Opinion

Congress recently voted on a federal budget bill that would all but guarantee cuts to the Medicaid insurance program. Known in California as Medi-Cal, the program insures more than one-third of the state’s population. What will happen to them?

While not everyone is on Medicaid, it is important to recognize that sharp funding cuts to the program would not only affect program recipients, but also the financial well-being of state economies. In the end, taxpayers will bear the cost of a preventable crisis.

Some policymakers argue that states should shoulder the responsibility. But Medicaid is a federal-state partnership for a reason. In California, our Medi-Cal budget is $161 billion, and more than half is funded by the federal government. Yet, under current congressional proposals, the state could lose $10 billion to $20 billion annually, according to the California Budget Policy Center. California will struggle to absorb the financial hit while facing impossible choices: Do we raise taxes, cut education or eliminate services?

Recently, the state’s Medi-Cal shortfall was brought up to $6.2 billion, according to CalMatters.

As all of this plays out on the federal and state levels, families and hard-working people throughout California are left worrying about how they will survive if funding is cut. And one group in particular — people with intellectual and developmental disabilities — often gets overlooked.

The California Department of Developmental Services serves just over 458,000 individuals with intellectual and developmental disabilities. In California, nonprofits work with individuals with intellectual and developmental disabilities by providing employment and vocational training, advocacy and support for families, often through partnerships with agencies like the state Department of Developmental Services.

For these individuals, Medi-Cal is more than just visits to the doctor and pharmacy costs, it provides services that help strengthen their independence. One such service is access to direct support professionals — people who work directly with individuals with intellectual and developmental disabilities to help them become more independent and better integrated into their community.

These skilled professionals assist with daily tasks such as personal care, meal preparation and medication management. They also help with job training, and help individuals build relationships, navigate crises, pursue goals and engage in their communities. These Medicaid-backed services can be the difference between a person holding a job and living independently or being isolated at home.

Medicaid reimbursement rates directly determine the wages of direct support professionals. Nonprofits that serve people with intellectual and developmental disabilities are already facing a severe direct support professional shortage — with 90% of community-based providers report staffing crises. Without Medicaid, this already struggling lifeline disappears, leaving families without options for critical care. Nonprofits that provide essential care will see their waitlists explode.

When these services disappear, the domino effect will be immediate. Families and friends of people with intellectual and developmental disabilities will feel it first. In a 2025 report from the Department of Developmental Services, 59% of family members have had to miss work or limit their personal activities in the last 12 months because of the direct support professional workforce shortage.

Without Medi-Cal, people with intellectual and developmental disabilities won’t just lose services, they will lose their ability to contribute to society; they will lose their jobs; they won’t be paying taxes and they’ll be forced to rely entirely on a system that’s already crumbling. The result? Families will have nowhere to turn. The systems designed to protect our most vulnerable will collapse.

In some areas of California, Medicaid is the only way health centers and hospitals can piece together enough revenue to stay open. This is not just about policy. It’s about people, and it’s about ensuring that Californians with intellectual and developmental disabilities can live with dignity and independence. Congress must protect Medicaid at all costs.