Federal Shifts and State-Level Impacts and What 2025 Means for Autism Policy in California

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Policy Brief: ASSD-HC-040125-001 

2025 has already brought changes at the federal level that are rippling through to states like California—changes that may have profound effects on individuals and families impacted by Autism Spectrum Disorder (ASD) and other neurodevelopmental differences. 

With the new presidential administration, health and social policies—especially those tied to Medicaid and federal research funding—are in flux. At Autism Society San Diego, we are tracking these developments closely to understand how they might shape services, rights, and opportunities for the Autism community here in California.

Federal Policy Changes and Their Implications: Medicaid and Medi-Cal Funding Challenges 

The Trump administration has proposed substantial cuts to the Department of Health and Human Services (HHS), potentially reducing its discretionary budget by over 30% for fiscal year 2026. Th is plan includes eliminating numerous public health programs, notably those targeting autism, and reducing funding for major agencies like the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC) by over 40% .​POLITICO 

In California, these federal cuts coincide with a $6.2 billion shortfall in the state's Medi-Cal program, exacerbated by higher-than-expected costs from expanding coverage to undocumented immigrants AP News. Governor Gavin Newsom has signed legislation to allocate $2.8 billion to address this deficit, but the financial strain remains significant.​ 

CalAIM Waiver Renewal Uncertainty 

California's CalAIM initiative, authorized through Section 1115 and 1915(b) waivers, aims to transform Medi-Cal by integrating services and addressing social determinants of health. These waivers are set to expire on December 31, 2026 DHCS. The state's ability to renew and sustain CalAIM is uncertain amid federal funding reductions and the Medi-Cal budget shortfall.​ 

Federal Laws Supporting Individuals with Autism 

Despite current uncertainties, several federal laws continue to protect and support individuals with autism: 

  • Section 504 of the Rehabilitation Act: Prohibits discrimination based on disability in programs receiving federal funding.​ 
  • Americans with Disabilities Act (ADA): Protects against discrimination in employment, public services, and accommodations.​ 
  • Autism CARES Act: Reauthorized in 2024, it provides $2 billion over five years for autism research, services, and training .​Autism Speaks+1Autism Speaks+1 

Leadership Changes at HHS and Autism Research 

Robert F. Kennedy Jr.'s appointment as HHS Secretary has introduced controversial perspectives on autism. He has announced plans to investigate environmental factors contributing to autism, including mold, air, water, food, medications, and parental health . However, his previous support for discredited claims linking vaccines to autism has raised concerns among experts and advocates .​CNN+7people.com+7AP News+7AP News+2Reuters+2Time+2 

Additionally, the proposed restructuring of HHS includes the creation of the Administration for a Healthy America, which would consolidate various functions and potentially eliminate programs vital to individuals with disabilities, including those with autism. The Autism Society of America has expressed strong opposition to these changes, emphasizing the threat to essential services .​POLITICO+4POLITICO+4Fierce Healthcare+4Autism Society+1CNN+1 

Changes to ACA Marketplace Enrollment 

The Centers for Medicare & Medicaid Services (CMS) has proposed the 2025 Marketplace Integrity and Affordability Rule, which includes:​American Academy of Actuaries+5Health Management Associates+5Centers for Medicare & Medicaid Services+5 

  • Shortening the Open Enrollment Period from 75 to 45 days.​ 
  • Eliminating the low-income Special Enrollment Period.​ 

These changes could hinder access to healthcare coverage for vulnerable populations, including individuals with autism and their families .​ 

Advocacy and Staying Informed 

Stay Informed, Stay Involved 

Now more than ever, it’s crucial that our community stays informed and connected. Autism Society San Diego will continue to track legislative and policy changes and provide updates, resources, and advocacy opportunities. 

Watch this space—and subscribe to our newsletter—to stay updated as we navigate a challenging but critically important year for Autism policy. 

The Autism Society San Diego remains committed to advocating for the rights and needs of individuals with autism. We encourage our community to stay informed about policy changes and participate in advocacy efforts.

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