Funding Cuts Threaten Access to Care for People of All Ages With Communication and Swallowing Disorders
ROCKVILLE, Md., July 24, 2025 /PRNewswire-PRWeb/ -- As the 60th anniversary of Medicare and Medicaid approaches on July 30, the American Speech-Language-Hearing Association (ASHA) is warning that at least 10 million people are set to lose necessary health care services due to deep funding cuts that have been signed into law.
"Both Medicare and Medicaid have provided Americans with vital support for decades, warranting a celebration of their anniversaries as well as continued support," said Bernadette Mayfield-Clarke, PhD, CCC-SLP, 2025 ASHA President. "Unfortunately, recent funding cuts stand to end that support—threatening the health and quality of life of people of all ages in communities across the country."
Cuts of roughly $1 trillion over 10 years to Medicaid and the Children's Health Insurance Program (CHIP) are slated to take effect beginning in 2027 after H.R. 1, commonly known as the One Big Beautiful Bill Act (OBBBA), became law on July 4, 2025. Additionally, there have been several rounds of budget cuts to Medicare since 2021. More budget reductions may be considered through coming legislative budget reconciliation processes.
The cumulative impact raises a worrisome question about the long-term sustainability of America's health care safety net. Medicaid programs provide health insurance for more than 80 million people, with Medicare covering almost 70 million lives. Cuts to Medicaid will be detrimental to people on Medicare as well, as one in five Medicare enrollees is also enrolled in Medicaid. ASHA members serve these populations every day in hospitals, outpatient clinics, schools, skilled nursing facilities, and other settings.
Of particular concern to ASHA is the impact on people with communication and swallowing disorders as well as the professionals—including audiologists and speech-language pathologists (SLPs)—who treat them. Individuals of all ages who have autism, who have had strokes, and who have head and neck cancer, hearing loss, and neurodegenerative conditions such as Parkinson's disease are among those who rely on audiologists and SLPs to help them. Of ASHA's 241,000 members, more than half provide services to Medicaid and Medicare beneficiaries. Without that coverage, those enrollees would not have access to that care.
Cuts to reimbursement rates across insurers—including private payers, Medicaid, and Medicare—are already forcing audiologists and SLPs to reduce services, close practices, or turn away patients—especially in rural and underserved communities. When health care facilities close, this affects everyone in the community—including people who are privately insured. Although H.R. 1 does provide a one-time source of $50 billion in funds to help protect rural hospitals, that falls well short of estimates for funding needed to keep all of the nation's current rural hospitals operating.
Without sustainable reimbursement structures, even large health care systems are struggling to staff and maintain audiology and speech-language pathology programs. Within schools, having fewer audiologists and SLPs means larger caseloads of students and less individualized care—which can affect students' long-term education outcomes and career prospects. ASHA notes that Medicaid provides funding for special education services in schools in most states; in fact, Medicaid is the fourth largest funding stream for schools.
At the same time, demand for audiology and speech-language pathology services continues to rapidly grow due to numerous factors that include the following:
- medical advances that are improving the survival rate of premature infants and individuals who have had trauma and stroke
- an expanding population of older Americans who often incur medical conditions that result in hearing, speech, language, and swallowing problems
"These services are lifelines for people relearning to speak after a traumatic brain injury, for children developing language skills for the first time, and for seniors who want to maintain their independence," stresses Mayfield-Clarke.
ASHA urges policymakers to honor Medicare and Medicaid's legacies not through cost-cutting but, rather, by investing in the services that uphold human dignity and improve quality of life. Sustainable reimbursement models, workforce support, and policies that prioritize long-term health outcomes are all essential. Specific policies that ASHA supports to achieve these goals include the following:
- Making audiologists and SLPs permanent Medicare telehealth providers so that patients in rural areas—or those who can't easily leave their homes—have easier access to needed health services.
- Setting sufficient provider payment rates so that (a) health care facilities and practices can continue to serve their communities and (b) schools can receive adequate funding to cover audiology and speech-language pathology services for students who need them.
- Removing unnecessary barriers that prevent seniors from accessing hearing and balance services—provided by audiologists—in a timely, robust manner due to antiquated policies that require a physician order for audiology services and limit reimbursement solely for diagnostic services.
"Protecting these services is not just a professional issue—it's a moral one," said Mayfield-Clarke. "Any one of us could experience a health event that impacts our ability to communicate effectively or to eat safely. We all deserve access to treatment services. ASHA's mission is to make effective communication, a human right, accessible and achievable for all. That right shouldn't be limited to those who can afford it."
About the American Speech-Language-Hearing Association (ASHA)
ASHA is the national professional, scientific, and credentialing association for 241,000 members, certificate holders, and affiliates who are audiologists; speech-language pathologists; speech, language, and hearing scientists; audiology and speech-language pathology assistants; and students. Audiologists specialize in preventing and assessing hearing and balance disorders as well as providing audiologic treatment, including hearing aids. Speech-language pathologists (SLPs) identify, assess, and treat speech, language, and swallowing disorders. http://www.asha.org
Media Contact
Francine Pierson, ASHA, 301-296-8715, [email protected], https://www.asha.org
SOURCE ASHA
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