OPINION: Rep. Malliotakis Promised to Protect Medicaid — Her Vote Risks Thousands of Lives – There Is Hope For Path Forward

Rep. Malliotakis Promised to Protect Medicaid — Her Vote Risks Thousands of Lives

By Joseph M. Macbeth, President & CEO, National Alliance for Direct Support Professionals (NADSP)

Editor’s note: We previously published a discussion of this very issue, specifically the ways in which extra paperwork creates extra red tape, and it actually costs taxpayers more, not less, and leads inevitably to people being removed from Medicaid that should not be.  We also interviewed a representative from Legal Services NYC, who discussed the many ways in which these cuts could play out, and what they will mean for ordinary Americans. We also published another op-ed about the ways these cuts can be expected to cause harm to the most vulnerable populations.  And if you want to see a specific breakdown of how this can play out in real life, Rep. AOC provided a helpful guide to what the cuts are, what they mean, and, most importantly, when they take effect.  Most of them will start to be felt after the mid-term elections next year, in late 2026. 

On April 14, Representative Nicole Malliotakis declared she “could not and would not” support any reconciliation bill that cuts Medicaid for vulnerable populations. For the people of Staten Island and south Brooklyn — where over 300,000 residents rely on Medicaid for care, including children with disabilities, low-income seniors, and adults with complex support needs — that sounded like a promise.

But when the time came to vote, Rep. Malliotakis supported the 2025 Reconciliation Act. And while some in Washington now insist that this law doesn’t “cut” Medicaid, what it actually does is quietly sabotage it.

The new law mandates that all Medicaid enrollees go through eligibility reviews every six months instead of once a year. In theory, that might sound like smart oversight. But in reality, it’s a paperwork trap. It’s a guarantee that more people — especially those with lifelong disabilities — will be dropped from coverage because of lost forms, system backlogs, or an overwhelmed caseworker who simply couldn’t get to the file in time.

A child with autism doesn’t stop needing Medicaid after six months. Neither does someone with cerebral palsy, chronic mental illness, or a missing limb. These aren’t temporary conditions. Yet under this new rule, people with lifelong disabilities will be forced to re-prove their eligibility twice a year — or risk losing everything.

And when Medicaid goes, so does the support that keeps people alive and safe. Home and community-based services disappear. Therapies stop. Some people are discharged from nursing homes or group homes. Others go without medication, case management, or in-home care until their status can be restored — which, in many cases, can take months or even years. For families already navigating enormous challenges, this isn’t just red tape. It’s trauma.

This isn’t speculation. The Government Accountability Office and Kaiser Family Foundation have both documented that the vast majority of Medicaid disenrollments happen not because someone became ineligible, but because of bureaucratic errors and missed deadlines. In New York, where many families face language barriers, digital access challenges, or simply don’t understand the complexities of Medicaid, those risks are even higher. They will fall hardest on those least able to fight back.

And the people who care for them — the Direct Support Professionals and other frontline workers who are already stretched thin — will be left scrambling. These professionals, who work in homes and community-based settings to support people with intellectual and developmental disabilities, are the backbone of the system. But their jobs rely on stable Medicaid funding. When people lose eligibility, services are interrupted. Jobs vanish. Trust is shattered. Lives are put at risk.

Rep. Malliotakis didn’t have to vote this way. She had already taken a public stand against Medicaid cuts. Her constituents heard that message and believed she would stand up for them. But her vote for this bill undermines that promise.

Still, there is a path forward.

If Rep. Malliotakis meant what she said — if she truly wants to protect Medicaid for those who need it — then she must act now to fix this rule. That could mean supporting legislation to restore annual eligibility for people with lifelong disabilities. It could mean urging the Centers for Medicare & Medicaid Services to create an exemption. Or it could mean calling on the President to act through executive authority.

There is no shortage of solutions. There’s only a shortage of time — and political will.

People with disabilities, their families, and their allies in this district are eager to work with Rep. Malliotakis. They want to believe she meant what she said. They want to believe she still has the courage to stand up, even if it means challenging her party or correcting a mistake.

Banner Image: Child with Down Syndrome. Image Credit – Alireza Attari