3/31/26 - Medicaid threats, and a look at internalized ableism

Hello!

How is your week going so far? Here are three links that I found wonderfully clarifying. The issues are awfully difficult, but the writers discuss them quite clearly, and that goes a long way.

The Perfect Storm Is Here for Medicaid Long-Term Services and Supports: Part 1

Cindy Mann, Melinda Dutton and Patti Boozang, The 80 Million - March 19, 2026

"HCBS are under immediate and growing pressure from a perfect storm of forces: rapidly rising demand as the population ages, a severe workforce crisis, deep federal Medicaid cuts, tight state budgets, and unprecedented federal threats to HCBS under the banner of fraud, waste and abuse (FWA)."

The Perfect Storm is Here for Medicaid Long-Term Services and Supports: Part 2

Cindy Mann, Melinda Dutton and Stephanie Anthony, The 80 Million - March 26, 2026

"Without durable reform to fix its structural problems, our nation’s long‑term services and supports (LTSS) system, a lifeline for older adults and people with disabilities, will remain fragile and ill-equipped to deal with rapidly growing demand — to the detriment of families and state and federal Medicaid budgets."

These articles do more than remind us of the stakes with Home and Community Based Services, (HCBS) in the United States. They break down the specific, distinct, but connected threats to stable services right now, and offer at least some fairly fresh ideas for long-term solutions. It's worth noting that these articles take a policy approach, focused on how these programs are structured and funded. So, they may read as less personal – maybe lacking in real human stories and emotional urgency. But, the pieces make up for this in exceptional clarity and in-depth expertise. They take us into the weeds. But we're not likely to feel lost – which is emotionally satisfying in its own way.

Why are some access needs harder to talk about than others?

Lucy Webster, The View From Down Here - March 25, 2026

"I think one of the main messages we get from society is that it we mustn’t be too needy. This is obviously ableist (and, I’m willing to bet, sexist). No one is too needy, we just all have different needs. As I have said a hundred times in a hundred talks: a disabled person is simply a person whose needs society doesn’t meet by default."

What is your emotional relationship with asking for accessibility, accommodations, or other kinds of help? Send me your thoughts to: apulrang@icloud.com.

Disability Thinking Weekday is a Monday-Friday newsletter with links and commentary on disability-related articles and other content. You can help promote Disability Thinking Weekday by forwarding it by email or posting on your social media. You can also comment by sending me an email at: apulrang@icloud.com. Collected comments are shared on the first of each month. A free subscription sends a newsletter to your email each weekday. Benefits of paid subscription include:

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