Leucovorin Spike

A number of posts discussed Trump's support for dubious notions about autism.

The history of autism "cures" is a history of dashed hopes and frequent danger

A release from the University of Michigan:

Leucovorin prescriptions for children spiked after federal officials claimed the drug was an effective treatment for autism during a September 2025 press conference, according to a new Michigan Medicine-led study published in The New England Journal of Medicine.

During the highly publicized event, the United States Department of Health and Human Services announced a plan to update leucovorin’s label to include cerebral folate deficiency, a rare genetic condition that can sometimes include symptoms of autism.

At the same time, federal officials also touted leucovorin’s effectiveness for autism, despite limited evidence supporting that claim.

After the press conference, the number of children aged 0-17 with a filled leucovorin prescription increased 46%, from 4.6 children per 100,000 in the week before the conference to 6.7 per 100,000 during the week of the conference, according to the new research.

"Our findings suggest the press conference may have increased off-label prescribing of leucovorin to children with autism,” said lead author Kao-Ping Chua, M.D., Ph.D., a pediatrician and researcher at University of Michigan Health C.S. Mott Children's Hospital and director of the Susan B. Meister Child Health Evaluation and Research Center.

"This increase is concerning because the effectiveness and long-term safety of leucovorin for children with autism is uncertain."

The authors analyzed a database representing nearly all prescriptions filled in U.S. retail pharmacies.

During 2025, the database included 150,026 leucovorin prescriptions dispensed to 47,394 children.

The weekly number of children with filled leucovorin prescriptions rose from 734 to 5,858 children between the beginning and end of 2025 – a 700% jump.

Much of this increase was driven by the spike in leucovorin dispensing after the press conference, and the largest increases were seen among children ages 6 to 11 and in the southern United States.

By comparison, leucovorin dispensing to adults did not spike after the press conference.

Leucovorin, a decades-old version of Vitamin B9, has mainly been used to counter side effects from methotrexate, a drug used in treating cancer and autoimmune conditions.

A handful of small studies have suggested that leucovorin can help improve some autism symptoms in children, but large randomized clinical trials have not been conducted.

By using a comprehensive national database, the new study builds on earlier research that used smaller databases to assess changes in leucovorin prescribing to children after the press conference.

Concerns about increased off-label use

The new research also showed that there was an increase in leucovorin dispensing to children even before the press conference.

The trend may have been driven by national news coverage featuring compelling patient stories that may have increased interest among some families.

Chua says the rise in leucovorin use among children raises several concerns, including the potential to create false hope for families, displace evidence-based therapies and expose young children to a treatment whose effectiveness and long term safety have not been established.

Other researchers have speculated that increased off-label prescribing of leucovorin may have contributed to ongoing drug shortages that have reduced access for cancer patients who depend on the medication.

"Our findings demonstrate the power of the federal government to influence medical practice," Chua said.

"Given this power, it is important that the government’s messaging about medications is based on rigorous evidence.”

Additional authors: Sijia He, M.S. and Rena M. Conti, Ph.D.

Study Cited: "Leucovorin Dispensing to U.S. Children in 2025,” NEJM.

Ending the Subminimum Wage Does Not Have Adverse Employment Effects

 Michelle Yin, Regina Seo, Hoa Vu, The labor market effects of subminimum wage elimination: Evidence from a national analysis, Labour Economics, Volume 100, 2026, 102884, ISSN 0927-5371, https://doi.org/10.1016/j.labeco.2026.102884.

Highlights

• First national quasi-experimental analysis of subminimum wage elimination for PWD.
• Elimination reduced 14(c) employment by around 2000 workers per state within two years.
• No significant reductions in overall employment, hours worked, or wages for PWD.
• Reduced welfare receipt suggests elimination promotes economic self-sufficiency.
• Results support federal phase-out of Section 14(c) without adverse employment effects.

Abstract

This study examines the labor market effects of eliminating Section 14(c) subminimum wage employment laws for people with disabilities in the United States. We construct a novel panel dataset combining the universe of Department of Labor Section 14(c) administrative records (2015–2024) with individual-level data from the Current Population Survey (2009–2024). Exploiting the staggered elimination of Section 14(c) across fifteen states, we employ event-study and difference-in-differences designs to identify dynamic treatment effects. We find that elimination policies reduce formal subminimum wage employment by approximately 2000 workers per state within two years. Importantly, we find no statistically significant reductions in overall employment rates, competitive integrated employment, or hours worked among workers with disabilities. Estimates suggest economically meaningful reductions in welfare income receipt. These findings indicate that subminimum wage abolition achieves its intended policy objective by eliminating formal sheltered employment without imposing the adverse employment effects that critics of minimum wage policies predict. Our results inform ongoing federal deliberations over phasing out the Section 14(c) program.

Trump Lies About Vaccines (Again)

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by llowing diseases to spread.    Examples include measles, COVID, flu, and polio.

A number of posts discussed Trump's support for the discredited notion.

Daniel Dale at CNN:

President Donald Trump made numerous false or misleading claims about vaccines and autism on Monday.

Trump has long pushed vaccine misinformation. He delivered his latest inaccurate remarks at a White House event during which he signed an executive order that recommends that US children receive fewer vaccinations over a longer period of time than they do today.

Trump again floated the idea that vaccines cause autism, though that notion has been thoroughly debunked by extensive research in multiple countries. He again baselessly impugned the safety of the combination vaccine for measles, mumps and rubella, which has for decades proven highly safe and highly effective.

He again wildly overstated the size of the vaccine doses children receive, which are nowhere near “the size of a bottle of soda.” He again wildly understated the prevalence of autism 20 years ago. And he again exaggerated the number of injections children have been required to receive.

I have been tracking Trump's autism lies for a long time.  From 2015:

During the recent GOP debate, Donald Trump suggested that kids are developing autism because they are getting too many shots too soon. “Just the other day, two years old, two and a half years old, a child, a beautiful child went to have the vaccine, and came back, and a week later got a tremendous fever, got very, very sick, now is autistic.”

Curiously, Trump used almost the same words three years ago. “It happened to somebody that worked for me recently,” he said on Fox News in 2012. “I mean, they had this beautiful child, not a problem in the world, and all of the sudden they go in and they get this monster shot…then all of the sudden the child is different a month later.”

{mosads}Wherever this mysterious anecdote came from, Trump was talking nonsense. Multiple scientific studies have shown that there is no connection between autism and the vaccine schedule, or any individual vaccine. The idea of such a linkage has been circulating for years because of a 1998 study that turned out to be fraudulent. The British medical journal that ran the piece later retracted it, and its lead author lost his medical license.

Stigma and Employment

In The Politics of Autism, I discuss the employment of people on the autism spectrum.

Poiencot, L.M., Vogtle, L.K. & Franc, I. Autism Stigma and Employment: A Scoping Review. J Autism Dev Disord (2026). https://doi.org/10.1007/s10803-026-07477-z

Abstract

Purpose

Despite the growing awareness of neurodivergence, autistic adults continue to face disproportionately low employment rates worldwide compared to the neurotypical population. This scoping review investigates the impact of social stigma on the employment outcomes of autistic individuals, aiming to understand the experiences of autistic adults in the workplace with the research question: How does the stigma surrounding autism affect the employment outcomes of autistic individuals?
Methods

This scoping review examined 14 qualitative studies published over the last 10 years and synthesized the perspectives of both employers and autistic employees to identify key themes shaping their workplace experiences.
Results

The findings suggest that stigma, evident through misconceptions and a lack of inclusive workplace cultures, often results in discriminatory practices and limits employment opportunities while negatively affecting the well-being of autistic individuals. Four consolidated themes emerged from the autistic perspective: inclusive practices, the importance of fitting in, generalizations about autism, and masking or social camouflaging. From the employer’s perspective, three consolidated themes were identified: inclusive versus non-inclusive practices, understanding of autism, and attitudes towards discrimination and disclosure.
Conclusion

These results highlight the need for a societal shift in perceptions toward more inclusive workplace practices, including community-level anti-stigmatization education and workplace accommodations that support all employees.

Is the Spectrum Too Wide?

In The Politics of Autism, I discuss the uncertainty surrounding estimates of autism prevalence. 

Frith U. Autism spectrum disorder: has it lost its meaning and is it leading to misdiagnosis? Psychological Medicine. 2026;56:e240. doi:10.1017/S0033291726105376.

Abstract: 

Background

Since the 1940s, the concept of autism has undergone marked changes, and autism spectrum disorder (ASD) is a wildly heterogenous condition. At the same time, the prevalence of ASD has increased massively.

Methods

This essay considers possible reasons for the changes and their consequences.

Results

Among drivers for the increase in prevalence are cultural changes, such as the desire for inclusion, harm avoidance, reliance on self-report, and the acceptance of masking. These have all led to a lowering of the diagnostic threshold. Furthermore, the popularity of the concept of autism boosted numbers via self-diagnosis and a search for identity.

Conclusions

Marked differences now exist between those first diagnosed in childhood and others first diagnosed in adolescence or adulthood. The time has come to examine reasons for these conceptual changes and the consequences for clinical practice and research.

From the article:

By continually loosening the diagnostic criteria to accommodate a vast range of social difficulties, anxieties, or sensory sensitivities, the clinical meaning of ASD has been diluted. Yet I believe that the characteristic social and nonsocial features of core autism will still be detectable in a strictly pruned spectrum.

The shift from a precise clinical into a vague, culturally amplified identity category has generated a massive demand for assessments in adolescents and adults, with an almost magnetic attraction to the ASD label. The challenge for the future is to use greater precision in the diagnostic process by giving more weight to careful objective observation, and by scrupulously probing contraindications.

We need a fresh attempt to define the specific causes of the distress and disability experienced by many of the late-diagnosed cases so we can custom-make the support they need. For example, specific therapies could address sensory issues and could prevent burnout. There are ways to reduce the symptoms of anxiety disorder and depression. There are also ways to build resilience in the face of significant social stress. None of these approaches are likely to be appropriate for early-diagnosed cases, where different types of support are needed.

Splitting up the spectrum would ultimately prevent misdiagnosis. New labels may appear, and different specialists are likely to be needed, at least for the two large subgroups that are now emerging. Such a reorientation would signpost a new route toward the correct support for many of the individuals who are on the expanding waiting list. At the same time, it would counteract the tragic neglect of those with the most severe impairments.

 

Alex Mann and Police Training

In The Politics of Autism, I discuss interactions between police and autistic people. When cops encounter autistic people, they may not respond in the same way as NT people, and things can get out of hand. Among other things, they may misinterpret autistic behavior as aggressive or defiant. Training could help.

Matt DeLucia at WCAU_TV Philadelphia:

A Chester County autism advocate is on a mission to visit as many police departments as he can to spread awareness on autism spectrum disorder.

Alex Mann, 26, from Malvern, Pennsylvania, has spent the last seven and a half years traveling the country, teaching police officials how to interact with people on the autism spectrum. As of August 2026, Mann has been to 539 police departments across five states.

Mann, who is diagnosed with autism, said he understands how people on the autism spectrum may respond during encounters with law enforcement.

He said some people may become overwhelmed by police presence, may not respond to commands like "stop," or avoid making eye contact with an officer.

"Autistic behavior can be, is, misinterpreted by law enforcement. Where really, law enforcement just needs to sort of take a step back and realize that there may be something else going on," Mann said.

Recently, NBC10's Matt DeLucia joined Mann on one of his visits, this time to the Bridgeton Police Department in New Jersey, where he offered his expertise to the department's chief and other officers.

"Hearing his message, it kind of hit home for me and I just I connected with it. The impact, I'm hoping, is if an officer comes upon an autistic individual, to have a very smooth and hopefully non-harmful or violent interaction with them," Bridgeton Police patrolman Nicholas Grusemeyer said.

Measles in August

 In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

Since President Trump took office in 2025, the U.S. has recorded more confirmed measles cases than in the previous 20 years combined. 

From CDC:

As of August 6, 2026, 2,465 confirmed* measles cases were reported in the United States in 2026. Among these, 2,449 measles cases were reported by 47 jurisdictions: Alabama, Alaska, Arizona, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York City, New York State, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming. A total of 16 measles cases were reported among international visitors to the United States.

There have been 38 new outbreaks** reported in 2026, and 94% of confirmed cases (2,309 of 2,465) are outbreak-associated (936 from outbreaks starting in 2026 and 1,373 from outbreaks that started in 2025).

Instead of focusing on this dangerout public health problem, Trump is considering an executive order advancing the totally debunked idea that vaccines cause autism. 

No Link to Circumcision

In The Politics of Autism, I discuss various ideas about what causes the condition.  RFK Jr. connected circumcision to autism on the grounds that parents often give their kids Tylenol after the bris.  He was talking nonsense.

McGrath M, Li X, Jacobson LP, et al. Neonatal Medical Male Circumcision and Child Autism Diagnosis. JAMA Pediatr. Published online August 03, 2026. doi:10.1001/jamapediatrics.2026.3239

Key Points

Questions Is neonatal medical male circumcision (NMC) associated with child autism spectrum disorder (ASD) or autism-related traits and behaviors?

Findings In this cohort study of 2771 male children from 14 cohort sites in the Environmental Influences on Child Health Outcomes (ECHO) Cohort, NMC was not associated with ASD diagnosis or autism-related traits and behaviors. These findings were robust after stratification by geographic region, preterm birth, and neonatal intensive care unit admission status; additionally, acetaminophen use during the procedure or in the neonatal period was uncommon (<5%).

Meaning This study found no evidence that NMC is associated with an increased risk of ASD, which may provide reassurance for families who are considering or have elected NMC for their child.

Another Study Finds No Association Between the MMR Shot and Autism.

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

 Meghan Holohan at CIDRAP:

A national retrospective cohort study of more than 2.5 million children found no association between receiving the measles, mumps, and rubella (MMR) vaccine before age 2 years and having an autism diagnosis.

“These results reinforce existing evidence supporting the safety of MMR vaccination,” wrote the authors, from the University of Washington.

Some people worry that MMR vaccines cause autism, despite a lack of evidence supporting this theory. This paper is the latest to examine the MMR vaccine and autism by looking at the timing of the vaccine.

Using the Cosmos electronic health record database, researchers looked at the records of more than 2.5 million children who had linked parent information from January 2015 through December 2024. The scientists followed the children until age 8 or their last doctor’s appointment before the study end date.

Receiving the first MMR vaccine dose from ages 11.5 to 24 months was not associated with an increased likelihood of having an autism diagnosis.

Burstain, J. M., Burstain, T. L., & Jacques, D. (2026). Association Between First MMR Vaccination Before Age 2 Years and Childhood Autism in a U.S. EHR Cohort of 2.5 Million Children. Pediatric Infectious Disease Journal https://doi.org/10.1097/INF.0000000000005349

RFK Jr. Lies in CNN Interview

In The Politics of Autism, I analyze the myth that vaccines cause autism. This bogus idea can hurt people by allowing diseases to spread.    Examples include measles, COVID, flu, and polio.  A top antivaxxer is HHS Secretary RFK Jr. He is part of the "Disinformation Dozen." He helped cause a deadly 2019 measles outbreak in Samoa.

Since Trump took office in 2025, the U.S. has recorded more confirmed measles cases than in the previous 20 years combined.

Ryan Mancini at The Hill:

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. on Sunday said President Trump “certainly” wants him to investigate perceived links between autism and vaccines.

Kennedy made the remark during a heated interview with CNN’s Dana Bash on “State of the Union,” when Bash asked if the Wall Street Journal was accurate in reporting that Trump wants Kennedy to “probe the link.”

“He certainly does,” Kennedy said.

Bash pressed on about why HHS does not study potential causes of autism after establishing that experts have “studied this for 25 years and found no link between autism and vaccines.” Kennedy attempted to address Tylenol, which the Trump administration late last year linked to autism, as an example of the work at HHS before Bash, as Kennedy remarked, began rolling her eyes.

“I am because I don’t want to have you use our air to say this,” Bash said. “There have been more than 40 studies involving 5.6 million people to conclude there is no link between vaccines and autism,” she continued, citing the American Academy of Pediatrics’ Committee on Infectious Diseases.

Kennedy claimed that “none of the eight vaccines that are administered during the first six months of life have ever been studied for the relationship to autism,” and said what Bash referred to was regarding a measles, mumps and rubella (MMR) vaccine ingredient.

That’s false: the scientific community has investigated every single fake assertion from Kennedy and the antivaccine activists: 1) starting in 1998 with their false assertion about MMR, 2) then Kennedy wrote that ridiculous article in Rolling Stone in 2005 also retracted, 3) then… https://t.co/xnVUkRTocr

— Prof Peter Hotez MD PhD DSc(hon) (@PeterHotez) August 3, 2026

Representation on Film

In The Politics of Autism, I discuss depictions of ASD in popular culture. 

Gallego, Ana Guadalupe, Camino Ferreira, and Ana Rosa Arias-Gago. 2025. "Stereotyped Representations of Disability in Film and Television: A Critical Review of Narrative Media" Disabilities 5, no. 4: 87. https://doi.org/10.3390/disabilities5040087

Abstract:

Film and television play a key role in shaping cultural perceptions of disability, but they often rely on recurring stereotypes that may reinforce stigma and exclusion. Although scholarly interest in this issue has increased, the academic literature remains fragmented and lacks a comprehensive synthesis. This critical review examines how disability is represented through stereotypical portrayals in narrative audiovisual media, specifically scripted films and television series. It synthesizes peer-reviewed studies that explicitly analyze these representations and their narrative or sociocultural functions. The review identifies dominant tropes, theoretical frameworks, and disciplinary approaches while providing a qualitative synthesis of key trends and findings. Although persistent stereotypes are still common, the review also highlights a growing presence of more inclusive and complex portrayals that challenge traditional norms. By providing a structured overview of existing research, this study enhances academic understanding of how disability is depicted on screen and supports efforts to promote more inclusive and accurate representations in popular media.

Jones SC, Gordon CS, Mizzi S. Representation of autism in fictional media: A systematic review of media content and its impact on viewer knowledge and understanding of autism. Autism. 2023 Nov;27(8):2205-2217. doi: 10.1177/13623613231155770. Epub 2023 Feb 19. PMID: 36802826; PMCID: PMC10576905.

Abstract:

 Media depictions of autism have the potential to have either positive or detrimental impacts on the lives of autistic people. This systematic review aimed to examine (1) the accuracy and authenticity of fictional media portrayals of autism (Part A) and (2) the impact of viewing such portrayals on knowledge about autism and attitudes towards autistic people (Part B). Seventeen articles met the inclusion criteria and were included in the review: 14 for Part A and 3 for Part B, comprising five experimental studies. The media reviewed in Part A covered a 30-year period (1988–2017). Several stereotypical and unhelpful portrayals surfaced. Positive portrayals of autism highlighted strengths and reflected nuance. Overall, participants in the fiction conditions in Part B were significantly more likely to attribute positive traits to an autistic person than those in the control conditions, with medium effect sizes ranging from 0.57 to 0.73. There were no improvements in knowledge. Given the small number of studies included in this review, further evidence is needed to understand the conditions under which fictional media may be effective. There is also a need to develop measures that accurately and respectfully measure autistic people’s experiences of community knowledge and attitudes.

From the article:

The representation of autistic people in fictional media remains problematic. The studies included in this review found that portrayals of autism in film tend to focus on individuals with high support needs (e.g. full-time care and support), thus disregarding the varying levels of support that may be required by different individuals on the spectrum and the fluctuations in the amount of support required within the life span of an autistic person. Studies also contained explicit or implicit disablism, and consistent with findings from previous reviews, television series tended to focus on stereotypical portrayals of the autistic savant (Dean & Nordahl-Hansen, 2021; Fontes & Pino-Juste, 2021). Across all mediums, there was an overrepresentation of repetitive/restricted behaviours and an underrepresentation of social communication deficits; although, somewhat encouragingly, recent novels, picture books and television series were more likely to provide a nuanced representation of autism (Kelley et al., 2018; Kelley et al., 2015; Wolff, 2018).

 

Incidence and the Identification of Autism in Girls and Women

In The Politics of Autism, I discuss gender differences in autism identification.

Messias E, Casanova E, Huang R, et al. Autism Spectrum Disorder Incidence by Age and Sex in a US Health Care System, 2016 to 2024. JAMA Netw Open. 2026;9(7): e2624561. doi:10.1001/jamanetworkopen.2026.24561.

Key Points

Question How did age- and sex-specific incidence of newly recorded autism spectrum disorder diagnoses change from 2016 to 2024, including before and after the onset of the COVID-19 pandemic, within a large US health care system?

Findings This cohort study of first recorded diagnoses of autism spectrum disorder across 171 134 participants—between 2016 and 2024—found an overall increase in case identification since 2020. This increase was associated with first diagnoses among females, with male trends remaining stable over this period.

Meaning These findings suggest that the reported increases in first autism spectrum disorder diagnoses postpandemic are due to increased recognition of females with autism spectrum disorder rather than a uniform population level increase.

Abstract

Importance Despite the increasing prevalence of autism spectrum disorder (ASD) in the US, underlying temporal trends in newly recorded diagnoses remain poorly understood.

Objective To evaluate age- and sex-specific incidence trends of ASD from 2016 to 2024 and quantify the temporal patterns before and after the COVID-19 pandemic and diagnostic substitution.

Design, Setting, and Participants This retrospective cohort study used electronic health record data from a large US health care system. Analyses were conducted from October to December, 2025. The study population included 171 134 participants (stratified as children [0-9] years, adolescents [10-18] years, and adults [≥19] years) who maintained continuous engagement with the health care system, defined as having at least 1 clinical encounter annually from 2016 to 2024.

Main Outcomes and Measures The primary outcome was the annual incidence of newly recorded diagnoses of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes F84.0 and F84.5. Temporal trends were analyzed using joinpoint regression to calculate annual percentage changes (APCs) and identify significant inflection points.

Results Among 171 134 participants (mean [SD] age, 26.78 [16.38], 63.8% female), females received autism diagnoses a mean (SD) of 3.4 years later than males (age at diagnosis, 15.7 years for female individuals vs 12.3 years for male individuals; P < .001). Male autism incidence remained stable or declined 2016 to 2024; female incidence increased significantly post-2020 (APC, 19.0%; 95% CI, 12.1% to 33.4%). In the pediatric cohort, decreasing annual incidence among males (APC, −2.0%; 95% CI, −3.7% to −0.3%; to APC, −2.0%, 95% CI, −3.7% to −0.3%) alongside increasing incidence for females since 2020 (APC, 17.4; 95% CI, 9.0% to 45.3%). In adolescent males, incidence declined from 2016 to 2018 (APC, −29.6%; 95% CI, −48.9% to −1.2%), and stabilized from 2018 to 2024. In adolescent females, autism incidence increased significantly between 2020 and 2024 (APC, 22.3%; 95% CI, 6.1% to 62.8%). In adult males, autism incidence showed a downward trend in the 2016 to 2024 period, while in adult females, the APC from 2016 to 2024 was positive, but the finding was not statistically significant (APC, 8.0%; 95% CI, −0.9% to 20.0%).

Conclusions and Relevance In this cohort study, ASD diagnoses increased disproportionately among females after 2020 while remaining stable or declining among males. These patterns suggested that increasing ASD prevalence reflected improved identification of historically underrecognized presentations rather than a uniform population-level increase. These findings highlight the need for screening strategies that address sex-specific presentations.

Medicaid Cuts and Home Care

The Politics of Autism includes an extensive discussion of insurance and Medicaid services for adults with intellectual and developmental disabilities.  Home and Community-Based Services (HCBS) are particularly important. 

 O. Rose Broderick at STAT:

Thousands of family caregivers of people with intellectual and development disabilities in Maryland are facing a grim future after the Maryland Department of Health’s Developmental Disabilities Administration proposed steep cuts to their wages earlier this summer. Some caregivers are looking at $20 per hour pay cuts. The new wage tables were slated to go into effect July 1, but pushback from disability advocates delayed the changes to October. They say the cuts will force families to make an impossible choice between going bankrupt and institutionalizing their loved ones in facilities that often face higher rates of abuse and neglect.
...
Maryland is not an isolated case. Idaho, Indiana, Missouri and Colorado have all introduced proposals in 2026 that would dramatically slash pay for family caregivers and community care. Ohio legislators even proposed banning family members from being certified caregivers before ultimately dropping the measure. These states’ moves are a sign of the deadline looming over state health departments as the $1 trillion Medicaid funding cut tucked in the 2025 GOP-backed tax bill goes into effect Jan. 1, 2027.

...

“We know from the past that whenever the federal government reduces Medicaid, almost every state has made cuts to home and community-based services, and that those optional services include paying family caregivers,” said Kim Musheno, senior director of Medicaid policy at The Arc, a national nonprofit that advocates for people with developmental and intellectual disabilities.

Soon after President Trump started his second term and discussed cutting Medicaid funds, disability advocates raised the alarm that home and community-based services probably would feel the brunt of those cuts, since the care is not mandatory. Since then, the Trump administration has targeted family caregivers, with health secretary Robert F. Kennedy Jr. saying in April that Medicaid-funded programs that pay family caregivers are “rife with fraud” and that those caregivers are doing tasks they used to do for free.