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The impact of policy cuts on ableism in health care

Ashna Shome, MD
Policy
December 19, 2025
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I am a disabled doctor. Being in residency, where many of my peers are young and able-bodied, I entered medicine with extensive experience on the other side of the examination table. I also entered medicine wanting to emulate the best of the care I received, and minimize the worst.

Over time, I have met more and more doctors like me who struggle with temporary or permanent disability. I see how systems that purport to protect and accommodate us often fail us. This reality is inextricable from the rising tide of ableism made grotesquely visible in the current political climate.

I worry deeply about the future, for my disabled patients, my disabled colleagues, and myself. Federal officials responsible for the nation’s health have launched ongoing attacks on the disabled community, which includes more than one in four U.S. adults, through rhetoric and policy.

Robert F. Kennedy Jr., Trump’s Health and Human Services secretary, has repeatedly spread vaccine misinformation and claimed that “autism destroys families.” This type of rhetoric is not just incredibly offensive but a call back to the U.S.’s deep history of ableism and eugenics.

At the same time, vital programs are facing unprecedented cuts. Medicaid, which provides care for 15 million people with disabilities, has been cut by a historic half a trillion dollars. Special education programs like 504 accommodations, Social Security, Veterans Affairs, and even the Department of Energy are also getting gutted. As of this year, the Department of Energy no longer has to ensure physical access for buildings receiving DOE funds, despite a 50-year precedent of doing so. The impact of these policy changes will be profound for us disabled individuals, but also for the health care system that already struggles to care for us.

As doctors, we witness the cruelest effects of policy. We are already seeing the fallout in immigrant communities as ICE raids and horrific crackdowns leave undocumented families unable to seek the care they need out of fear of legal repercussions. Now we’re anticipating similar effects from this administration’s ableist policies. Doctors around the country are bracing ourselves for the impact of the “One Big Beautiful Bill Act” and its massive cuts to essential programs, rollbacks that are even more widely felt in a government shutdown.

Medicaid, Section 8 housing, WIC, and SNAP, are all lifelines for many in this country, especially disabled people. And our already resource-limited safety net hospitals will be further strained, further reducing access to care for disabled patients and caregivers.

Being a doctor does not protect me from systemic oppression. Medicine expects its workers to cope with physical exhaustion, sleep deprivation, secondary trauma, and so much more. This punishing system does not create fair and equal access for our disabled colleagues. We understand the threats of the recent budget bill and other policy changes firsthand and are working to protect our patients in a system that does little to protect us and our health needs. There’s an unspoken norm in medicine that health care providers should sacrifice themselves for the sake of their patients, and we do. Many of us are continuously fighting to advocate for our disabled patients. But the reality is that disabled physicians and disabled patients are often one and the same, and we all deserve to live in a world that truly cares for us.

Disability justice must take center stage in the fight against the authoritarianism we are witnessing in the U.S. and the dangerous policies coming from this administration. To not do so is to ignore the reality of millions of people, across race and class, who live with disabilities. As a member of my union, the Committee of Interns and Residents, I am proud to fight with over 40,000 resident physicians for health justice. And we unequivocally condemn the Trump administration for spreading misinformation that terrifies, shames, tokenizes, pathologizes, and harms disabled people and their families. We call on all of our elected officials to work with people with disabilities to make the U.S. more accessible, not less. And we will continue to fight for the rights and lives of our patients, colleagues, and community members with disabilities.

Ashna Shome is a pediatrics resident physician training in the Bronx. She is deeply committed to advancing child health and advocating for vulnerable patient populations through both clinical care and systems change.

Dr. Shome is active in union organizing with the Committee of Interns and Residents SEIU, working to strengthen resident physician advocacy and improve working conditions in academic medicine. Her interests also include disability justice and health equity, with a focus on ensuring that children and families receive compassionate, accessible, and structurally informed care.

She has contributed writing and commentary on health care and advocacy, with published pieces available through KevinMD.

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