Actor Zack Birthday relies on a motorized wheelchair and a medical ventilator powered by Medicaid. He now finds himself balancing a prominent television career against federal healthcare rollbacks.
On July 24, 2025, Birthday detailed how the federal program funds the daily equipment and personal care assistance necessary for his employment. Even so, legislative changes threaten to upend coverage for millions of Americans.
The One Big Beautiful Bill Act Signed on July 4
President Donald Trump signed the One Big Beautiful Bill Act into law on July 4, 2025.
According to Congressional Budget Office accounting, the legislation’s Medicaid provisions reduce federal spending by approximately $1 trillion over a decade. The cuts are projected to leave 7.5 million more people uninsured by 2034. Total coverage losses across the law’s health provisions reach an estimated 10 million individuals.
Tax Cuts for the Top 1% of Households
Data from the Center for American Progress indicates that the Medicaid spending reductions closely match the law’s tax cuts.
Those tax cuts total about $1 trillion directed toward the top 1% of households. Nearly half of those tax benefits flow to roughly 200,000 households with annual incomes exceeding $2 million.
Preventable Deaths Projected in Medical Analysis
Before the final legislation expanded, three physician-researchers published a peer-reviewed analysis in the Annals of Internal Medicine evaluating the potential mortality impact of the funding reductions.
Their mid-range estimate projected 16,642 additional preventable deaths annually.
The researchers noted that if healthcare losses disproportionately affect high-cost enrollees rather than distributing evenly, the impact on disabled beneficiaries could intensify. For individuals requiring ventilators and motorized mobility devices, high maintenance and support costs place them directly within the fiscal targets of a budget reduction measure.
Colliding With the 36th Anniversary of the ADA
The legislative rollbacks coincide with the 36th anniversary of the Americans with Disabilities Act (ADA).
President George H.W. Bush signed the ADA into law on July 26, 1990. The ADA established comprehensive civil rights protections for disabled Americans, aimed at securing independence, freedom of choice, and integration into the economic and social mainstream.
These exact programs enable disabled individuals to remain in private residences rather than entering institutional nursing facilities, undermining the framework of independence established by the ADA.
Television Visibility Meets Institutional Defunding
Birthday’s television series, Furious, premieres today. It highlights a paradox where increased media visibility for disabled performers occurs simultaneously with reductions in state-supported care.
While streaming platforms and networks feature more disabled actors, industry presence operates independently of public healthcare funding.
As promotional events for the series continue through the month, beneficiaries of Medicaid home-care provisions face ongoing uncertainty regarding the long-term stability of their medical equipment, personal assistance, and institutional support systems.
