Impending Medicaid cuts will limit assistive technology accessibility

By Kaylie Foster

Medicaid, a federal health insurance program that provides essential resources to individuals with intellectual and developmental disabilities (IDD), is particularly important in promoting access to assistive technology (AT). As Medicaid is facing a loss of funding in the coming ten years, people with IDD may lose vital access to AT.

As of earlier this year, one in three Americans with disabilities is enrolled in Medicaid for health benefits [1]. Of those nearly 15 million Americans, 1.2 million or more have IDD [2].

Many Americans with IDD submit waivers for AT coverage through Medicaid. AT helps to increase function and independence for people with disabilities. AT includes everything from durable medical equipment (DME) – such as wheelchairs, hearing aids, and magnifiers – to home- and community-based services (HCBS), which allow people who would typically be moved to alternative institutions to maintain a life at home [3].

To receive AT through Medicaid, a person must first be evaluated by a medical professional to establish the need for a device and determine the best device for the patient. The doctor will write a Letter of Medical Necessity, which the patient must give to a vendor of the device requested. After the vendor authorizes the product, Medicaid reviews the request for approval before the patient can have access to the device. These claims can sometimes be denied [4].

AT can be difficult to access, due to barriers such as a lack of funding, high prices, limited availability, and inadequate assessments [3]. Medicaid covers Americans with low income and those who receive monthly Supplemental Security Income, a stipend catered to people with disabilities and the elderly who lack income and resources [5]. While Medicaid can remove affordability barriers for people with disabilities, the process of applying for AT can still be tedious.

AT improves health and well-being, cognition, mobility, and autonomy, and can help improve education and employment outcomes for people with IDD while reducing additional stress. However, roughly one-third of the 2.5 billion people who need AT lack access, and cuts to Medicaid will continue to complicate this issue in a variety of ways [3].

The One Big Beautiful Bill Act of 2025, passed in July, makes it difficult for states to fund the Medicaid programs that provide AT by forbidding states from increasing certain taxes for healthcare. States may be forced to maintain only federally mandated Medicaid services, which would leave HCBS and other AT services underfunded and less available[6].

Limiting HCBS could prevent people with IDD from accessing services for personal care and many services offered in intermediate care facilities. With HCBS becoming more difficult to access, those with IDD may lose connection with their homes and communities [6].

Certain DME is also optional for states to cover. These can include cochlear implants, hearing aids, prosthetics, and eyeglasses. Such devices can have out-of-pocket costs up to $100,000 (in the case of cochlear implants). Without Medicaid coverage that helps pay for DME, people with IDD could have a more arduous time at work, in school, and in their communities [6].

3DA will continue to advocate for an increase in Medicaid funding to better serve those entitled to services such as HCBS. Medicaid funding is imperative to mitigate waitlists for assistive technology. Federal policy decreasing Medicaid funding will inevitably increase wait times, when waitlists should be eliminated altogether.  

To read more about how The Big Beautiful Bill will impact those with disabilities, click here.

Sources

[1] Burns, A., & Cervantes, S. (2025, February 7). 5 key facts about Medicaid coverage for people with disabilities. Medicaid. https://www.kff.org/medicaid/5-key-facts-about-medicaid-coverage-for-people-with-disabilities/

[2] MACPAC. (2024, February). Access in brief: Adults with intellectual disabilities and developmental disabilities. Medicaid and CHIP Payment and Access Commission. https://www.macpac.gov/wp-content/uploads/2024/02/Access-in-Brief-Adults-with-Intellectual-Disabilities-and-Developmental-Disabilities.pdf

[3] Friedman, C. (2023). Assistive technology for people with intellectual and developmental

disabilities in the United States in Home and Community Based Services. Disability and

Rehabilitation: Assistive Technology, advanced online publication. https://doi.org/10.1080/17483107.2023.2272849

[4] Conklin, B. (2024, January 5). Assistive technology through Medicaid or Medicare. Disability Rights Rhode Island. https://drri.org/assistive-technology-through-medicaid-or-medicare/

[5] Social Security Administration. (2025). Supplemental security income (SSI). Social Security. https://www.ssa.gov/ssi

[6] Ives-Rublee, M. (2025, May 16). Federal Medicaid cuts would force states to eliminate services for disabled adults, older adults, and children - center for american progress. The Center for American Progress. https://www.americanprogress.org/article/federal-medicaid-cuts-would-force-states-to-eliminate-services-for-disabled-adults-older-adults-and-children/