‘Big Beautiful Bill’ raises concerns for Ohioans with disabilities
BY Cincinnati
CINCINNATI — A sweeping federal budget proposal under debate in Congress is raising alarms among disability advocates, who say it could threaten critical services for millions of Americans, including more than 1.7 million people with disabilities in Ohio.
Dubbed “The Big Beautiful Bill” by supporters, the legislation includes substantial changes to Medicaid, reductions in Supplemental Nutrition Assistance Program (SNAP) benefits and tax cuts projected to add trillions to the national deficit. Critics warn the bill could strip vital support from vulnerable populations.
For Susan Koller of Hamilton County, the stakes are deeply personal.
“I need help with every single activity of daily living that you can think of,” said Koller, who lives with cerebral palsy and relies on Medicaid to cover around-the-clock care and adaptive technology in her home—including tools that allow her to type using only her voice.
Koller is one of more than 38,000 Ohioans with disabilities who receive Medicaid waiver services, according to Disability Rights Ohio. But those services could be reduced or eliminated under the proposed legislation.
Among the key changes outlined in the House version of the bill:
- New work requirements for Medicaid, mandating 80 hours of work per month for able-bodied adults
- Stricter eligibility criteria
- Reduced provider reimbursements
- The introduction of co-pays for services
“I would not be able to get any medical coverage. I would not be able to afford my prescriptions,” Koller said.
Advocates argue these requirements overlook the realities faced by people with disabilities.
“Someone might be capable of working, but not always capable of meeting that specific requirement,” said Kerstin Sjoberg, president and CEO of Disability Rights Ohio. “If you’re making Medicaid dependent on that, you’re actually creating a further barrier to work.”
The House version of the bill also includes discretionary spending cuts that could impact federal funding for the U.S. Department of Health and Human Services. That funding helps support organizations like Disability Rights Ohio, which provide legal and advocacy services to individuals with disabilities.
“If we take away one more potential safety net or support that people rely on, we’re going to exacerbate an already inequitable system,” Koller added.
Despite her physical limitations, Koller is a powerful voice in the disability community. She serves on the Hamilton County Board of Developmental Disabilities and is a former board member at Disability Rights Ohio. She said she speaks out to help inform policy and inspire action.
“We don’t know what can change until we try,” she said. “Because if you don’t try, then there is nothing.”
The Senate is deep in negotiations, and lawmakers are trying to hammer out a version of the bill that could pass before the recess.
As of now, the Senate version of the bill does not include the discretionary funding cuts present in the House draft. However, advocates caution that those provisions could be revived through future appropriations or reconciliation measures.
The Senate is expected to vote in the coming days. If passed, the bill would then head to the president’s desk.