Join ASHA’s Fight to Stop Medicaid Cuts (Again)

April 20, 2026

What's Happening in Congress?

Congress is considering using special budget procedures to push through cuts to popular programs like Medicaid to pay for other policy priorities. Medicaid provides access to critical audiology and speech-language pathology services for low-income individuals, pregnant women, and individuals with disabilities.

If this sounds familiar, it's because Congress enacted legislation last year (the One Big Beautiful Bill Act, or OBBBA) that cut Medicaid funding and made changes to the program. These cuts are already forcing states to reduce provider payments and restrict eligibility for people who rely on Medicaid for essential services.

Lack of access to care will become more widespread and severe if Congress moves forward with additional changes or restrictions to Medicaid eligibility. Some policymakers have argued that fraud, waste, and abuse (FWA) in Medicaid justify additional changes-an assertion ASHA strongly disputes.

Why Is This Happening?

Congressional leaders want to fund a range of other policy priorities, including border security and other spending initiatives. However, there are not enough votes in the Senate to advance these proposals through the standard legislative process. As a result, leaders in both chambers want to use a mechanism called budget reconciliation to speed up consideration of legislation to pay for those priorities with a simple majority vote rather than the 60-vote threshold required to advance most legislation.

What's Happened in the States Since OBBBA Was Enacted?

ASHA spent the first half of 2025 warning Congress about the harmful impact of cutting federal Medicaid funding and making it harder for needy individuals to qualify and maintain eligibility for Medicaid. Although some of the most catastrophic changes proposed last year were defeated (like block granting the program and imposing per-capita caps on funding), other changes were enacted-including funding reductions, work requirements, and eligibility restrictions.

The results have been predictably problematic:

• Colorado announced Medicaid provider payment reductions, rolling back a 1.6% rate increase from 2024 and implementing a 9.2% cut to the primary speech-language pathology CPT code 92507. This contributed to nearly $90 million in total Medicaid reimbursement reductions for clinicians.
• North Carolina implemented Medicaid payment cuts ranging from 3% to 10% for all providers. State officials cited projected funding shortfalls caused by OBBBA and warned that the cuts will affect access to health services across hospitals, outpatient clinics, and specialty care settings.
• Idaho reduced Medicaid reimbursement rates by 4% for many providers, including audiologists and SLPs, following passage of OBBBA. The state has since added a new prior authorization policy for speech-language pathology services, while earlier proposals included eliminating coverage entirely.
• Georgia experienced significant Medicaid reimbursement cuts. Major managed care organizations reduced provider payment rates by approximately 20% with little notice, raising serious concerns about provider participation and patient access to care.

ASHA Continues Fighting

ASHA didn't stop fighting to preserve Medicaid, even after OBBBA's enactment last year, because these changes are already affecting providers and the patients they serve. From protecting coverage to pushing back on payment cuts, ASHA's advocacy is focused on maintaining access to care and supporting audiologists and SLPs. Since OBBBA's enactment, ASHA has:

• Hosted a Medicaid advocacy webinar that highlighted Medicaid policy changes in Colorado, Idaho, Pennsylvania, and Wisconsin;
• Secured removal of proposed Medicaid cuts to speech, physical, and occupational therapy and school-based services in Washington state through coordinated advocacy with the Washington Speech-Language-Hearing Association;
• Helped prevent elimination of Medicaid coverage for outpatient speech-language pathology and adult audiology services in Idaho through coordinated advocacy with the Idaho Speech, Language, Hearing Association;
• Submitted testimony [PDF] to the House Energy and Commerce Committee opposing additional Medicaid funding cuts and program changes;
• Submitted comments [PDF] to a Request for Information from CMS asking the agency to combat FWA using strategies that do not inappropriately penalize providers or the people with disabilities they serve;
• Signed a letter to congressional leaders [PDF] opposing federal actions that could restrict home and community-based services, helping ensure patients can continue to receive care in their communities;
• Attended congressional hearings examining FWA in Medicaid;
• Facilitated congressional meetings for ASHA members from Idaho, Iowa, and North Carolina to share firsthand experiences and highlight the harmful impact of last year's Medicaid changes in those states; and
• Met with state and federal legislators and policymakers to emphasize Medicaid's importance and prevent additional harmful changes.

How You Can Help

Now is the time to act. Visit ASHA's Medicaid reconciliation Take Action page to tell your members of Congress how last year's Medicaid cuts are affecting care and urge them to reject additional changes.

Your stories matter. Share your experiences to help demonstrate the real-world impact of these policies and explain why Medicaid must be protected.

Questions?

If you have questions, please contact ASHA's director of federal affairs for health care, Josh Krantz, at [email protected]. You can also explore ASHA's Medicaid resources.