Key takeaways:
- President Donald Trump signed a bill in July that would implement cuts to Medicaid enrollment and funding, which will be rolled out over the next three years. The cuts would increase medical costs for many Americans with disabilities and may make it harder for some families to save or balance their budgets.
- Disabled people concerned about Medicaid cuts can consider opening an ABLE account or looking into personalized job assistance.
Alexis Leone, a 34-year-old mother of five in rural Mississippi, initially tried her best to juggle her full-time job with her youngest child’s needs.
Leone’s son is partially deaf and has a severe allergy to ants. But her workplace was unable to accommodate Leone’s multiple appointments a week for speech therapy, weekly allergy treatments and other medical needs for her son, and she says it was unwilling to work with her Family and Medical Leave Act (FMLA) request. (FMLA is a federal labor law that requires most companies to offer unpaid, protected leave for a family or medical reason.) So, she quit her job, and she now relies on Medicaid and her husband’s commission-based income to meet her family’s health and financial needs.
Under her old workplace’s insurance, medical co-pays alone for her son cost $200 a week, which she already struggled to afford before she quit her job. Today, those co-pays — as well as health care for her other four children — are completely covered under Medicaid. But, because of the Trump administration’s sweeping Medicaid cuts that passed in July, Leone isn’t sure how much longer she’ll be able to afford her children’s health care.
The cuts are part of President Donald Trump’s broad tax and spending bill, dubbed the One Big Beautiful Bill (OBBB) Act, and mainly tighten restrictions on disabled adults’ access to care, not children’s. Still, the cuts might affect Leone’s family’s access to Medicaid through new, stricter work requirements for adults and additional paperwork that families will have to fill out every year to keep their coverage. What’s more, the National Rural Health Association estimates rural hospitals will lose a significant amount of funding due to the bill or could close outright, which could affect Leone’s family’s access to local health care providers. Leone has difficulty accessing providers that accept Medicaid near her, as it is — her children’s dentist is a two-hour drive away.
Leone hopes her family’s financial situation will improve to the point that they won’t need to rely on Medicaid by the time most of the changes go through in 2027. If their financial situation doesn’t improve, she just hopes her child with a disability will continue to have access to health care, despite the cuts.
“If we have to have private insurance or no insurance (for my kids), it’s going to be almost impossible to then afford to get the services that are needed,” Leone says.
This summer, the 70 million Americans enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) learned that the vital health care they’d come to rely on through public assistance could disappear, as the Trump administration gutted the 60-year-old program. The OBBB Act that passed this year and was signed by Trump in July would cut funding by nearly $1 trillion and would lead to 10.5 million fewer people enrolled in Medicaid over the next 10 years, according to estimates by the Congressional Budget Office. The Trump administration says the bill will lead to less Medicaid fraud. However, Medicaid cuts will increase costs and limit provider availability for many disabled Americans. With limited or no access to Medicaid, many Americans with disabilities will have to make tough choices about where their money goes.
Today, Leone’s family doesn’t save money and can barely cover their bills, which is more common for people with disabilities and their families than the general American population. While 24 percent of employed people feel they are completely financially secure, only 7 percent of unemployed, permanently disabled people say the same, according to Bankrate’s Financial Freedom Survey. Similarly, 65 percent of unemployed, permanently disabled people feel they are not completely financially secure and likely never will be, compared to 25 percent of employed people.
“Meeting financial goals such as saving for emergencies and retirement or paying for basic necessities like quality healthcare and groceries is a formidable challenge for every American,” says Bankrate U.S. Economy Reporter Sarah Foster, who has reported on economic policy and its effect on American households for over six years. “Add in the experience of living with a chronic illness or disability, and those aspirations may feel almost insurmountable.”
4 tips for disabled Americans concerned about their finances under the Medicaid cuts
People with disabilities often face financial pressure from two sides: They may pay more in health care costs than other households, and they may also struggle to pay those costs because they can face barriers to attaining well-paying, accessible jobs.
“People with disabilities might lack adequate transportation to and from work; they might need on-the-job assistance or more flexible paid time off that workplaces don’t provide,” Foster says. “It’s also true that their jobs get cut faster during the busts and take longer to come back during the booms. All of those factors can confine them to a sustained state of financial stress and insecurity.”
However, there are federal and online resources that can help you look for a higher-paying job, balance your budget and save money. If you’re looking for new strategies to manage your money in anticipation of Medicaid cuts, these tips can help get you started.
1. See where you can cut expenses
Whether you earn a wage through a job, receive benefits or both, if you’re interested in saving more, it’s worth your time to find where you can cut back on both fixed and variable expenses.
Variable expenses — expenses that aren’t set from month to month, such as food or transportation costs — are easier to cut down on than fixed expenses, which remain the same from month to month. If you want to save on variable expenses, you can make small changes starting today, like buying in bulk, using public transportation instead of ride-shares or thrifting for clothing, furniture and home goods, instead of buying new.
It’s a little bit more work to save money on your fixed expenses, but you may be surprised at how often you can negotiate your regular bills. Consider these methods to save money on your fixed expenses:
| Fixed expenses | Ways to cut back |
|---|---|
| Rent or mortgage, including utilities, taxes, fees and maintenance | Live with roommates or family, if possible (even temporarily). You can save money on energy bills by unplugging devices when you aren’t using them and using room-temperature water when doing laundry. The U.S. Department of Energy also has a guide on how to save on energy bills. |
| Phone, internet and cable bills | You may be able to negotiate your phone or internet bill if you call your provider. |
| Debt repayment, such as for a car, student loans or credit cards | If you have outstanding credit card or automotive debt, you may be able to call your issuer to negotiate your balance to avoid the balance being sent to collections. Most automotive, student loan and credit card issuers might also offer hardship programs or be willing to settle your debt for a lower amount. |
| Medical coinsurance, co-pays and prescription costs | If you have existing medical debt, call the provider and see if you can negotiate for a payment plan or lower balance. You can also often access prescription coupons from the manufacturer’s website or through third-party platforms like GoodRx. |
| Child care costs | Consider alternative child care options, such as family, nanny shares or child care co-ops. You may also be able to access certain tax credits for families, such as the child and dependent care credit or the child tax credit. |
| Memberships, such as gym memberships | Try out DIY options, such as buying home gym equipment secondhand or doing beauty treatments (such as your hair and nails) at home. |
2. Look into specialized assistance
If you have a disability and need help paying for expenses, you may qualify for local and state programs. You can find more information through your state’s Health and Human Services office. Nationally, you may also qualify for assistance with your:
- Rent or mortgage. Non-elderly disabled vouchers can help people under the age of 62 with a disability find and pay for affordable rentals. If you’re a senior citizen, you can also access housing choice vouchers, affordable housing or public housing.
- Utilities. The Low Income Home Energy Assistance Program (LIHEA) helps with heating and cooling bills. Some states also offer help with electric bills.
- Phone and internet. Lifeline offers discounts on phone and internet bills for low-income households.
- Food and household goods. Depending on your age and members of your family, you may be eligible for food assistance, including the Supplemental Nutritional Assistance Program (SNAP). If you’re disabled or homebound, your local food bank may be able to deliver food, personal hygiene products and cleaning supplies. Reach out to your nearest food bank to learn what resources they offer for disabled individuals.
If you’re a disabled veteran struggling financially, you can also turn to certain specialized programs and grants.
3. Save more by opening an ABLE account
If you’re concerned about being able to afford health care as a disabled person, you might want to consider saving money now in an ABLE account. An ABLE account is a tax-advantaged savings account specifically for people with disabilities who qualify. You can use the funds only for disability-related expenses, including housing, education, transportation, health, prevention and wellness, assistive technology and personal support services, according to the U.S. Internal Revenue Service. To open an ABLE account, there are a few qualifications you need to meet — notably, your disability must have started before you were 26 years old. (This will increase to 46 in January 2026.)
While you must have a disability that started before the age of 26 to open one, anyone can contribute to an eligible person’s ABLE account, though annual contributions are limited to $19,000, as of 2025.
If you’re worried about a major upcoming expense, like a medical procedure, or if you want to make sure you have funds to use in an emergency, you should prioritize saving, starting today. Ideally, it’s best to save 20 percent of your take-home pay for emergency savings, retirement and debt repayment, but it’s OK if you’re not able to save that much. If you receive the average Social Security Disability Insurance (SSDI) payment of $1,738 per month, try saving as little as $50 per month, which could help pay for a future car tire or minor medical bill.
To open an ABLE account, check out your state’s program.
ABLE accounts and benefits
Many disabled people receive some form of federal aid, such as Supplemental Security Income (SSI), Social Security and Disability Insurance (SSDI), Medicare or Medicaid. Generally, you can keep funds in an ABLE account without it affecting your eligibility for benefits, but you may be unable to receive SSI if you have more than $100,000 in an ABLE account.
4. Look for job assistance near you
If you’re concerned about losing your Medicaid eligibility and are interested in going back to work (or working for the first time), you don’t have to face today’s challenging job market alone. Federal and state-level programs are designed to help you find the right job placement. If you’re on SSI or SSDI, you may even be able to keep your benefits while you work. Generally, you can receive SSI if you make less than $2,019 per month as a single person. You can receive SSDI benefits if you earn less than $1,550 per month.
Check out these programs for more help with finding the right job:
- Ticket to Work: Ticket to Work is a free program administered by the Social Security Administration (SSA) for those 18 to 64 on Social Security disability benefits. It provides one-on-one guidance, such as resume and interview help, as well as benefits counseling to explain how returning to work affects your federal and state benefits. Through Ticket to Work, if you earn enough at your new job that your SSDI payments stop, you can continue to receive Medicare for more than 7 years.
- State Vocational Rehabilitation Agencies: Different states offer different vocational services for adults with disabilities, and many offer specialized services for the blind or visually impaired, as well as for people under the age of 18. In Texas, for example, a counselor can help place you with a job that aligns with your needs and interests through tuition assistance, specialized training, vehicle modification, therapy and other services.
The bottom line
If you receive disability benefits, understanding your financial options can help you navigate your personal finances with confidence. You can also check out other financial resources for disabled or low-income families, which can help you establish credit or even purchase a home.
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