Beginning on its first day, the Trump Administration has released an unprecedented number of executive orders, many of which may change how federally funded services are provided to disabled people. United Spinal is doing our best to analyze how these orders and all subsequent policy communications may impact people with spinal cord injuries and all wheelchair users. Please bookmark this page for regular updates, as the situation is fluid, and what may be true earlier in one day may have changed by nightfall.
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Where We Are Now
Potential Cuts to Disability Programs
April 17, 2025: United Spinal is aware of new reporting of possible elimination of additional critical disability programs and services essential to advancing the independence and community inclusion of older adults and people with disabilities. If true, we are deeply concerned about this proposal.
Vincenco Piscopo, President and CEO, United Spinal Association states that “a federal investment in rehabilitation research that makes individuals more independent is essential for our economy. That investment pays huge returns by reducing healthcare costs and producing healthier, more independent working American taxpayers across the nation.”
The Administration for Community Living was created around the fundamental principle that older adults and people of all ages with disabilities should be able to live where they choose, with the people they choose, and with the ability to participate fully in their communities. By funding services and supports provided primarily by networks of community-based organizations, such as centers for independent living grants, mental health and elderly justice and adult protection programs and with investments in research, education, and innovation, ACL helps make this principle a reality for millions of Americans.
Drastic Restructuring of the Department of Health and Human Services
March 27, 2025: A drastic restructuring of the Department of Health and Human Services is now underway. Thousands of federal employees are being fired. Twenty-eight divisions are being cut to 15. Many of the critical programs within HHS’s Administration for Community Living that support older adults and people with disabilities are being redistributed among other HHS agencies, including the Administration for Children and Families (ACF), the Office of the Assistant Secretary for Planning and Evaluation (ASPE), and the Centers for Medicare and Medicaid Services (CMS).
United Spinal Association is communicating with Members of Congress and the Administration to get answers to this major restructuring. We want to make sure that critical programs, services, and funding for the disability and aging communities, such as the Centers for Independent Living, Home and Community-Based Services and the National Institute for Disability, Independent Living, and Rehabilitation Research (NIDILRR) are not impacted.
House Passes Legislation to Fund Government Through September
March 11, 2025: The House passed, 217-213, legislation to fund the government through September and extend several health care provisions, including Medicare telehealth coverage. H.R. 1968 also includes an extension of funding for community health centers, the National Health Service Corps, teaching health centers that operate graduate medical education programs and the Special Diabetes Program for Type 1 diabetes.
It would also extend:
- Medicare add-on payments for hospitals serving small numbers of people and for rural ambulance services.
- Expiring telehealth flexibilities under Medicare that were first allowed under the COVID-19 public health emergency.
The Senate plans to vote on this funding package when they return from recess week of March 24.
Update on Federal Funding Freezes
February 26, 2025: A hold on funding freezes was partially lifted. The National Institutes of Health (NIH) can now review new grant applications for research into diseases ranging from heart disease and COVID to Alzheimer’s and allergies.
The freeze had previously forced the agency to cancel meetings to review thousands of grant applications. Last week, the NIH released a statement saying the agency could now “begin sending notices incrementally to the Office of the Federal Register to advertise meetings of scientific review groups/study sections and begin their resumption.”
On February 25, 2025, a federal judge, Judge Loren Alikhan, continued to block the Administration from freezing grants and loans potentially totaling trillions of dollars.
United Spinal is Monitoring Department of Education Status
February 13, 2025: United Spinal is closely monitoring the status of the Department of Education, a crucial federal agency for students with disabilities. The Department oversees the implementation of key legislation: the Individuals with Disabilities Education Act (IDEA), serving over 8 million students, and Section 504 of the Rehabilitation Act of 1973, supporting nearly 1.5 million students nationwide.
Judge Imposes National Restraining Order on NIH
February 10, 2025: Judge Angel Kelley of the U.S. District Court for the District of Massachusetts imposed a national temporary restraining order on the NIH in response to two lawsuits over the Trump administration’s research funding cut. One lawsuit was filed by 22 states and the other by medical, pharmacy and public health schools and Boston and New York hospitals. The cut would limit the amount a grantee can spend on “indirect costs” like buildings and support staff to 15% of its NIH grant. Some institutes receive indirect costs of 50% or higher.
From STAT: “It’s not a perfect system and we should all be working to fine-tune it to make it better and ensure that we get as much as we can out of every precious dollar spent in research,” said Robert Golden, dean of the School of Medicine and Public Health at the University of Wisconsin. But he warned that the cuts, as proposed, would do “apocalyptic” damage to the infrastructure that provides patients access to experimental new drugs and scientific education for the next generation of medical researchers. “This isn’t ensuring the investments are made in a wise and cost-effective way; This is blowing up the bank.”
NIH Announces Funding Cuts
February 7, 2025: The National Institutes of Health announced it would slash funding of “indirect costs” or “overhead” paid to universities, medical centers and other grant recipients to 15% of the grant. Research institutes use these funds to maintain buildings and labs and to pay support staff. This policy would grind medical research to a halt in many of our nation’s premier biomedical research facilities.
Federal Funding Freeze Blocked
February 3, 2025: The federal funding freeze remains blocked after Judge Loren L. AliKhan of the Federal District Court for the District of Columbia extended her restraining order. Also, the Justice Department told Chief Judge John J. McConnell Jr. of the U.S. District Court in Rhode Island that it interpreted his Jan. 31 ruling to apply to all 50 states, not just the ones that filed the original lawsuit. Taken together, these rulings are seen as a rebuke to an overreach by the Trump Administration that likely lacked legitimate authority.
January 31, 2025, 4:24 pm: A federal judge from Rhode Island has temporarily blocked President Trump’s funding freeze, granting requests from 22 states and the District of Columbia for a temporary restraining order.
January 31, 2025, 10 am: As of right now, the new administration’s attempt to pause all federal funding to a wide array of state programs has been blocked by a federal judge in Washington, D.C., until February 3. Affected programs span from research hospitals to programs that assist many people with disabilities, such as home care.
How We Got Here
On January 27, the Office of Management and Budget issued a vague and confusing memo directing all federal agencies to temporarily halt disbursements on grants, loans and other financial assistance. This resulted in many Centers for Independent Living, medical research facilities, and other federally funded service providers being blocked from accessing the Medicaid portals in every state. This meant no Medicaid payments could be processed.
There was immediate pushback, including a lawsuit by many state attorneys general and organizations representing nonprofits. By the end of the following day, a federal judge issued an order blocking the memo until arguments could be heard on February 3. OMB rescinded the memo, but the White House press secretary later said that even so, the pause was still in effect.
What is Being Impacted
According to the American Association of People with Disabilities, this federal funding freeze impacts two important categories of activity:
- Funding that goes from the federal government to states to fund programs that are important to disabled people
- Funding and grants that fund state and national disability organizations
Programs that are important to disabled people potentially affected by the freeze include, but are not limited to the following programs:
- Medicaid
- Medicaid grants like the Money Follows the Person program
- Special education, including personnel preparation and research
- Vocational rehabilitation
- Housing assistance
- Childcare
- School meals
- Adult protective services
- Veteran’s Administration grants
State and national organizations funded by federal dollars and potentially affected by the freeze include but are not limited to:
- Protection & Advocacy agencies
- Developmental Disability Councils
- University Centers of Excellence in Developmental Disabilities
- Centers for Independent Living
- State Independent Living Councils
- Resource centers for people with paralysis, limb loss, and traumatic brain injury
- Disability Innovation Fund awards
- Parent Training and Information Centers
- Grants from the Office of Disability Employment Policy
- Special Olympics
- Cooperative agreements through the Centers for Disease Control to organizations working on epilepsy, AIDS, blood disorders, and other chronic conditions
- Payments to universities for research grants and graduate medical education