As the Board of Directors of the National Alliance for Direct Support Professionals (NADSP), we speak today not only as organizational leaders but as steadfast advocates for more than 1.5 million direct support professionals (DSPs) and the millions of people with intellectual and developmental disabilities they support.

We call on the United States Senate to reject the House-passed Reconciliation Budget Act, a bill that would recklessly strip more than $715 billion from Medicaid and nearly $300 billion from the Supplemental Nutrition Assistance Program (SNAP), threatening the lives and livelihoods of millions of Americans.

This legislation is a blueprint for dismantling the community-based support systems that have taken generations to build. Its consequences would be catastrophic:

• For people with disabilities, it means the loss of autonomy, dignity, and the right to live independently in their communities.
• For direct support professionals, it means mass job losses, wage stagnation, and the elimination of vital food assistance for thousands of frontline workers.
• For states, it means devastating budget deficits that will lead to either deep service cuts or crushing tax increases.
• For the nation, it represents a betrayal of our most fundamental moral obligations.

Medicaid is more than a line item, it is a partnership between the federal government and the states that sustains healthcare, housing, and human dignity. Cutting $715 billion will force states to gut home and community-based services, disenroll those in need, and re-institutionalize people with disabilities—reversing decades of civil rights progress. The principle of “community living,” protected under federal law and affirmed in Olmstead v. L.C., would become a hollow promise.

Direct support professionals are highly trained, deeply compassionate professionals who ensure that individuals with disabilities live full, safe, and meaningful lives. Nearly all direct support services are funded through Medicaid. Slashing Medicaid funding will eliminate jobs, deepen the workforce crisis, and stretch remaining staff beyond their limits. The result is predictable and devastating:

• People with disabilities left without necessary support.
• Emergency rooms and crisis centers overwhelmed.
• Family caregivers even more overburdened.

The direct support workforce is already on the brink. These cuts would break it.

The proposed $300 billion in SNAP cuts are equally indefensible. SNAP supports working families, including thousands of direct support professionals, most of whom earn poverty-level wages. They are the people who show up every day to care for others. Denying them food is not fiscal responsibility, it is cruelty masquerading as policy.

The ripple effects of SNAP cuts will worsen child nutrition, health outcomes, and educational performance, while hollowing out local economies. This bill is regressive.

The Congressional Budget Office confirms that at least 13.7 million Americans will lose healthcare under this legislation. States will be financially incentivized to deny Medicaid expansion. Harsh work requirements will remove coverage from those least able to comply. All to fund tax cuts for the wealthiest Americans.

To every U.S. Senator: this is a moral crossroad. Will you stand for the dignity and wellbeing of your constituents, or allow systems that reward inequity to persist at their very expense? The disability community has a long memory. We remember our champions, and those who turned their backs when it mattered most.

We urge the Senate to reject the House Reconciliation Act in its entirety.
Reject the Medicaid cuts.
Reject the assault on food assistance.
Reject the betrayal of people with disabilities.

Stand for community. Stand for dignity. Stand for justice.

Stand for community. Stand for dignity. Stand for justice.

Signed,

The Board of Directors
National Alliance for Direct Support Professionals (NADSP)