Federal Bill Impacting Medicaid Becomes Law

Updates:

The below updates are current as of 7/7/2025. Additional information will be shared when we are notified of new updates. 

7/4/2025 – President Trump signed the One Big Beautiful Bill Act (H.R.1) into law over the Fourth of July weekend.

On Thursday, New Jersey Department of Human Services Commissioner Sarah Adelman issued a statement about the impact that the legislation’s passage will have on New Jersey residents. Of the 18 items Commissioner Adelman highlighted, two are key for our community: the legislation will result in an annual $360 million cut to the state’s Medicaid program and will create stricter budget neutrality standard for 1115 waivers (The 1115 waiver includes funding for adult services though the Community Care Program and Supports Program). The gap in the state budget will impact many facets of healthcare coverage for New Jersey FamilyCare members, Medicaid providers and administrators, and SNAP assistance beneficiaries.

Currently, it is unclear how Governor Murphy and the New Jersey Department of Human Services plan to act in the wake of H.R.1’s passage, and whether the New Jersey Legislature plans to reconvene before the end of the summer to address the Medicaid changes. Reportedly, Governor Murphy does not have immediate plans to call the Legislature back into session.

We know many in our community are confused about how they will be impacted by these new federal laws. We’re in communication with state leaders, and we are working with them to clarify how these new federal laws will play out in New Jersey. We want to know what policy-related questions you have, so we can ask for clarification from state leaders, and provide you, our community, with answers as we find them. Email our Public Policy team at publicpolicy@autismnj.org or call our 800.4.AUTISM Helpline.

To read Autism New Jersey’s previous statement regarding ongoing federal actions, please click here.

5/22/2025 – The US House passed the One Big Beautiful Bill Act (H.R.1) which is a budget reconciliation bill that contains numerous provisions across policy areas like taxes, healthcare, energy, immigration, and nutrition. Some, but not all, the provisions of the bill include Medicaid adjustments to work requirements, eligibility determinations, cost sharing, coverage for undocumented immigrants, and provider taxes.  

Based on our review of the legislation, these changes might not directly impact funding for individuals with disabilities. That said, with an estimated annual loss of $3.6 billion for New Jersey’s Medicaid program (a quarter of the State’s $14 billion federal match), there could be seismic shifts in how the state allocates funding across all Medicaid categories. 

 The New Jersey Department of Human Services put up information on their website regarding these potential changes to Medicaid, which can be found here. 

 H.R.1 is now in the Senate where further discussions will occur and additional amendments may be made. 

2/27/2025 –The news regarding possible federal funding cuts over the past few weeks has been overwhelming, with a lot of information to review and evaluate for potential impact on individuals with autism, and their families, in New Jersey. It can be difficult to know what’s true and what it all means.

Right now, it’s still too early to know exactly how possible funding cuts could affect you and your family. However, we do know that many important programs for individuals with autism—like Medicaid and special education—depend on federal funding. Funding cuts for these programs could make it harder to get the support you need.

To help make sense of this, Autism New Jersey would like to provide some information about the federal funding process and the potential scope of the impact for individuals with autism here in New Jersey. This is what we know so far.

Federal Budget Process

The continuing resolution (CR), signed on December 21, 2024, currently funding the government expires on March 14, 2025. By this date, Congress will need to either pass a final spending bill, enact another CR to extend federal funding again, or face a partial shutdown of the federal government.  Congress is working on the budget resolution, which is a non-binding framework that defines overall spending limits for various programs for over ten years. The resolution instructs House and Senate committees to identify a certain amount of cuts. The majority in the House and Senate are attempting to use this opportunity to reduce spending (with estimates of up to $2 trillion) and extend President Trump’s 2017 tax cuts, with associated estimated costs of $4.5 trillion.

Medicaid

• 2/13/2025: Senate Budget Committee reported a budget resolution to the Senate that calls for a minimum of $1 trillion in cuts over a ten-year period to programs that fall under the Senate Committee on Finance’s jurisdiction, which includes Medicaid.
• 2/18/2025: House Budget Committee reported the budget resolution that calls for a minimum of $880 billion in cuts over a ten-year period to programs that fall under the Committee’s jurisdiction, which includes Medicaid.
• 2/21/2025: Full Senate passes budget resolution with a yea-nay vote of 52-48.
• 2/25/2025: Full House passed budget resolution with a yea-nay vote of 217-215.

The Senate and House must now work together to pass the same bill before it heads to the President for his signature. After the agreed-upon budget bill is enacted, Congress will then proceed with the annual departmental appropriations process. In the meantime, President Trump and Republican leadership have indicated that any cuts to Medicaid will target only waste, fraud, and abuse within the Medicaid program. Many members, including Republicans, have expressed concerns about potential cuts to Medicaid. Published reports indicate that these concerns stem from the fact that in order to pay for certain policy priorities cannot be funded without substantial cuts to Medicaid.

Potential NJ Impact

The New Jersey Department of Human Services released a report entitled Modeling Impact to NJ Medicaid of Congressional Budget Proposals that provides an overview of different scenarios related to potential changes to Medicaid.

• By law, the federal Medicaid match rate has a ceiling of 83 percent and a floor of 50 percent. New Jersey is one of 10 states that benefits from the statutory 50 percent floor on matching funds for most Medicaid services.
• In the absence of this floor, the per capita income formula would set a matching rate for New Jersey of around 38 percent. Reductions in federal matching funds for Medicaid could result in a deficit of $2.2 – $5.2 billion to New Jersey.

Special Education and DEI

New Jersey public schools receive approximately $430 million from the federal government annually for IDEA (Individuals with Disabilities Education Act), which is meant to provide equal education for students with disabilities.

As part of the efforts to end diversity, equity, and inclusion (DEI), President Trump’s administration has ordered schools that receive federal dollars to end programs aimed at providing assistance to students based on race or risk losing grants.

New Jersey Attorney General Matthew Platkin has expressed concern over the order’s ambiguous language and is prepared to litigate in this matter. The federal Department of Education has placed a March 1 deadline for schools to end their DEI programs.

What’s Next?

In the weeks and months ahead, more specific information about federal and state funding will become available. The federal government must take action by March 14th and New Jersey must pass a balanced budget by June 30th.

If you have questions or concerns about services, please call our 800.4.AUTISM Helpline to receive compassionate and individualized support.

If you would like to contact your three Congressional representative, you can find their contact information here. Every resident of New Jersey is represented by Senator Cory Booker and Senator Any Kim as well as one congressperson in the U.S. Congress.

Autism New Jersey is monitoring the situation and is communicating with elected officials about the budget and funding services that are critical to the community. Autism New Jersey will continue to keep the community informed.

Originally posted: February 27, 2025
Updated: June 2, 2025