Have you found yourself stuck in limbo while awaiting a diagnosis, or struggling to find support after being diagnosed? If you’re neurodivergent, you might also have dealt with issues like sensory overload in hospitals or at the doctor’s office, or experienced communication barriers with your doctor or healthcare provider. If your answer is yes to any of the above, you’re not alone. These are just a few of the healthcare challenges experienced by millions of Americans (19-20%) who are neurodivergent (neurodiversity is an umbrella term, encompassing autism spectrum disorder, dyslexia, ADHD, and many others, that refers to differences in how the human mind functions).
In 2026, Americans who are neurodivergent are contending more than ever with a hostile healthcare environment, which includes drastic cuts to Medicaid and the Affordable Care Act (ACA), as well as restrictive work requirements and ambiguous exemptions. In the words of Dr. Wendy Ross: “So many neurodivergent patients do not get medical care once they age out of pediatrics, which leads to increasing morbidity and mortality and health care costs.” Ross adds that she and her team at Jefferson Health’s Center for Autism and Neurodiversity are “working on neurodivergent-affirming health care by creating processes and building environments to help support these often-overlooked patients.” In this article, we’ll explore why healthcare policy needs to change, as well as some of the approaches and strategies that can redefine U.S. healthcare policy to become more accessible, accommodating, and inclusive for people who are neurodivergent.
Dealing With Massive Cuts and Changes to Healthcare
Transforming health care policy is even more critical in the wake of historically huge cuts to Medicaid (nearly $1 trillion) approved by the U.S. Congress in the Summer of 2025 as part of the so-called “Big Beautiful Bill” Act (BBBA). Although the U.S. House of Representatives has approved a 3-year extension of expanded Affordable Care Act (ACA) subsidies, the legislation still faces long odds in the Republican-controlled Senate. Medicaid is the single largest healthcare program in the U.S., ensuring healthcare for around 15 million people with disabilities. In addition to the massive cuts already mentioned, the BBBA implemented “community engagement” requirements, which stipulate that many Medicaid beneficiaries must prove that they are working, volunteering, or attending school to qualify for Medicaid coverage. In December 2025, the Centers for Medicare and Medicaid Services issued guidance exempting individuals who are “medically frail” or have “special medical needs”, i.e., physical, intellectual, or developmental disabilities, from the new rules, as well as relatives and family caregivers of people with disabilities. Nevertheless, some disability advocates remain concerned that the guidelines are too vague and lacking in detail. “Congress promised that the ‘community engagement’ requirements would only cause coverage losses among those who can work but choose not to,” Michael Lewis, vice president of policy at the American Association of People with Disabilities, said, according to DisabilityScoop. “People with disabilities and chronic health conditions that limit their ability to find and keep work need significantly stronger assurances that they will not lose coverage when these requirements start.”
People who are neurodivergent are also suffering higher mortality rates as a direct result of restrictive and inadequate health care policies. A 2022 study found that individuals with autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) face a significantly higher all-cause mortality rate than the general population. A 2018 study, titled “A Scoping Review of Health Disparities in Autism Spectrum Disorder”, found that “individuals with autism spectrum disorder (ASD) experience increased morbidity and decreased life expectancy compared to the general population, and these disparities are likely exacerbated for those individuals who are otherwise disadvantaged.” Crucially, the study found that “In the general population, disadvantage is tightly linked to disparities, including lower life expectancy, worse health outcomes, and poorer health care access (Link and Phelan 1995; Hill et al. 2015).” Improving neurodivergent healthcare policy is also crucial in preventing neurodivergent young adults from proverbially “falling off the cliff” after graduating high school and college, and in helping them more effectively transition to fair-wage employment. One method for improving neurodiverse employment outcomes is through the “Six Core Elements of Health Care Transition (HCT)”, which facilitates transitioning from youth to adult health care. These are: transition planning, i.e., developing a personalized plan that includes a medical summary, assessing self-management skills, and considering family preferences; tracking and monitoring, or creating a system to track patients through the transition process; readiness assessment; planning for adult care; transfer of care; and transition completion. Addressing gaps between pediatric and adult healthcare and making health management much more continuous and accessible can prevent health crises that would disrupt employment. “Transition planning should be a collaborative process involving the young person, their family, the Department of Education, and other appropriate agencies,” SUNY Downstate Health Sciences explains in its resource packet. “The goal is to maximize individuals’ self-determination, utilizing person-centered planning, and building the capacity for self-advocacy—the ability to speak and act on their own behalf. Core elements of transition include post-secondary education, employment, independent living, and community participation.”
Another equally important point is that damaging changes to healthcare policy correlate strongly with medical gaslighting. Simply put, medical gaslighting refers to dismissing or invalidating the concerns of patients who are neurodivergent. Unstable coverage results in patients being much more easily dismissed, overly complex documentation can lead to them being framed as “noncompliant”, and precarious access can lead to doctors gatekeeping, rather than working with neurodivergent patients as partners in the treatment process. In other words, excessive paperwork, eligibility restrictions, and communication barriers can be seen as a form of gaslighting, where patients with disabilities might be told they qualify in theory, but end up being excluded in practice.
In response to the cuts and changes to Medicaid, the Bazelon Center for Mental Health Law and the Corporation for Supportive Housing has issued a guide for states on how to maintain compliance with the Americans with Disabilities Act (ADA) while implementing the new Medicaid requirements. The study points out that, while many Medicaid enrollees with disabilities are employed or exempt from the work requirement due to the nature of their disability, they will still face barriers in the form of documentation requirements, which can be difficult for many to navigate without help. “Similarly,” the guide points out, “a speech, vision, or hearing disability may make it difficult to communicate effectively with state or local Medicaid officials, including online and by phone.” To address this issue, the guide recommends that states provide people to assist Medicaid applicants or beneficiaries with collecting, producing, and submitting required documents. “Medicaid coverage is a lifeline for people with disabilities.” the guide explains. “Despite this, the OBBBA creates particular burdens for applicants and enrollees with disabilities, especially when it comes to work requirements and frequent eligibility redeterminations. Such burdens will almost certainly result in the inappropriate and devastating loss of health care coverage for those who rely on it. Federal disability rights laws, however, provide important protections to people with disabilities, ensuring they have equal access to Medicaid.”
Thankfully, there are a variety of policy-level solutions to prevent medical gaslighting and improve accessibility and inclusion for people who are neurodivergent. These include, but are not limited to, simplifying documentation; automatic exemptions; funded patient navigators; and explicit neurodivergent-inclusive standards in Medicaid and ACA implementation. Other policy changes include making telehealth permanent and accessible, extending Medicaid/Medicare coverage for home-based behavioral health beyond just temporary measures. Digital infrastructure can also be enhanced, with devices and tech support provided for underserved neurodivergent individuals. Legislators and supporters/members of the neurodivergent community should also advocate for ethical insurance policies that cover neurodiversity-affirming treatments. AutismSociety.org recommends maintaining the requirement that healthcare is comprehensive to meet the needs of individuals with autism (although this also applies to other forms of neurodivergence); creating transparency in all healthcare plans, and including the neurodiverse community in discussions to ensure that any changes meet their needs; protecting existing healthcare entitlements under Medicare and Medicaid, including Medicaid expansion; and ensuring that the essential health benefits package maintained, including comprehensive benefits like rehabilitative/habilitative services and mental/behavioral services. Youth for Neurodiversity, a United Nations-recognized, youth-led nonprofit, supports legislation like H.R. 4086, also known as the Autism Family Caregivers Act of 2025, which supports caregiver training and disability service access. Meanwhile, the National Association of Councils on Developmental Disabilities (NACDD) has urged Health and Human Services (HHS) Secretary Robert F. Kennedy JR. to support “policies that promote real involvement in community life, fund innovative programs, and promote change that empowers people with autism and other developmental disabilities to live self-determined lives in their communities.” Another prerequisite for improving policy is for health systems to include neurodivergent individuals in advisory groups, partnerships, and workforce development, as the American Academy of Pediatrics points out. In short, neurodivergent patients are not just misunderstood, but systematically underserved.
“Limited options are a major barrier, excluding us and our personal preferences and expression,” one neurodivergent individual told us. “Personally, things like generic garments, harsh smells, lighting, and sounds really discomfort me. I actually make a “kit” for my appointments—comforting scents, a fidget or book/Kindle, headphones, and prepared notes to ask/answer questions I might forget under pressure—to manage potential overwhelm. I’d love to see us highlight the need to normalize these preferences rather than forcing people into uncomfortable, generic environments.” And as Dr. Megan Neff writes, “Realizing in adulthood that you have a sensory processing disorder can be an eye-opening experience. Discovering that not everyone experiences the world as an intense sensory bombardment unlocks a new level of understanding and a whirlwind of emotions. Many feel a mix of surprise, confusion, and a sense of mourning for the years spent struggling without this knowledge. When I came to terms with my own sensory sensitivities, the world’s loudness and overwhelming nature hit me harder, sparking feelings of sorrow, frustration, and even despair….Managing these issues requires developing a mindful approach, acknowledging our sensory boundaries, and taking deliberate steps towards creating a sensory-friendly environment.”
In 2026 and beyond, it’s more important than ever to prevent injustice in healthcare, and for policies that safeguard the fundamental right to comprehensive and accessible healthcare, including for the millions of Americans who are neurodivergent, to be fully and effectively implemented and upheld.
Sources:
Mirel, D. (2025). “Championing and redefining care for neurodivergent patients”, American Medical Association. https://www.ama-assn.org/public-health/population-health/championing-and-redefining-care-neurodivergent-patients
Diament, M. (2026). “Medicaid Changes Could Limit Access For People With Disabilities, Advocates Warn”, DisabilityScoop. https://www.disabilityscoop.com/2026/01/05/medicaid-changes-could-limit-access-for-people-with-disabilities-advocates-warn/31789/
Bazelon Center for Mental Health Law (2025). “Preserving Medicaid Coverage for People with Disabilities: What Federal Disability Rights Laws Require of States”. https://www.bazelon.org/wp-content/uploads/2025/12/2025-Medicaid-Guide.pdf
NACDD (2025). “NACDD Urges HHS to Focus on Neurodiversity, Belonging, and Evidence-Based Support”, National Association of Councils on Developmental Disabilities. https://nacdd.org/nacdd-urges-hhs-to-focus-on-neurodiversity-belonging-and-evidence-based-support/
Autism Society (2026). “Public Policy Resources”. https://autismsociety.org/resources/public-policy/
Neff, M. (2024). “Managing Sensory Issues as an Adult with ADHD or Autism”, Neurodivergent Insights. https://neurodivergentinsights.com/sensory-issues-in-adults
JAMA Pediatrics, (2022). “Mortality in Persons With Autism Spectrum Disorder or Attention-Deficit/Hyperactivity Disorder: A Systematic Review and Meta-analysis”, National Library of Medicine. https://pubmed.ncbi.nlm.nih.gov/35157020
Bishop-Fitzpatrick, L. & Kind, A. (2017). “A Scoping Review of Health Disparities in Autism Spectrum Disorder”, National Library of Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC5693721
