National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
Submission to the Senate Community Affairs Legislation Committee inquiry into the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026
This submission is made on behalf of the NHMRC CRE Achieving Health Equity for all People with Disability (AHEAD).
Prepared by Sophie Yates, Helen Dickinson, Hannah Badland, Molly Saunders, Jodie Bailie, Alexandra Devine, Glenda Bishop, Zoe Aitken, Manasi Murthy Mittinty, Tess Bright
About AHEAD Achieving Health Equity for All People with Disabilities (AHEAD) aims to enhance health equity by implementing sustainable, co-designed solutions that address the social determinants of health for people with disabilities and are shaped through our expanded research capacity and new innovative research infrastructure. AHEAD is an interdisciplinary research group with Chief Investigators from Monash University, University of New South Wales, University of Sydney, University of Melbourne, RMIT and the Australian National University with multidisciplinary skills in epidemiology, health economics, health and social policy and public health. We work closely with peak bodies in the disability and advocacy sector, government and service providers. https://ahead.org.au/
Enquiries about AHEAD should be sent to AHEAD@Monash.edu
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
Introduction
In this submission, we outline concerns with several reforms proposed in the National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 (The Bill). In particular, we focus on concerns with:
New Ministerial power to reduce funding for groups of supports o Proposed cuts to social, civic and community participation enabled as a result of this power The presumption that parents are responsible for providing substantial care and support for their children with disability Proposed changes to the definition of functional capacity that do not align with international definitions Gendered impacts of the proposed reforms Requirement for participants to demonstrate “significant and ongoing” loss of function for the purposes of reassessment
Overall, we have significant concerns regarding the time that has been allocated to scrutinise the legislation and for the broader community to consider what these changes will mean for the future of the scheme. The changes outlined in the legislation collectively represent the most significant changes that have been made to the scheme over its history. The time allocated to digest and respond to these changes is far too little to do this effectively. This is particularly the case with respect to some groups. For example, Easy Read information about changes was not released until 26 May, less than a week before the submission deadline for the Senate Committee inquiry. We believe there should be an extension to the inquiry to allow for adequate scrutiny of the legislation and to allow for meaningful engagement with the disability community.
List of recommendations
Extend the Senate Committee inquiry to allow for adequate scrutiny of the legislation and to allow for meaningful engagement with the disability community. Require a rights-based intersectional impact assessment before the Bill proceeds. Prioritise home and community care support programs as recommended by the NDIS Review (Recommendation 1.9) so that people with disability who are denied scheme access as a result of these reforms can still receive necessary supports. Schedule 1 Part 1 Section 9B(1) o Align any definition of functional capacity with internationally accepted tools such as the WHO ICF. Schedule 1 Part 2 48A o Ensure the reassessment process is able to accommodate people with fluctuations in support needs. o Ensure pathways for participants to appeal decisions not to have their plan reassessed. o Reduce administrative barriers to requesting reassessment, for example through a no wrong door approach. Schedule 1 Part 6 Subsection 34 (1G – 1K)
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
o The Bill should recognise the additional levels of parent care and support required for children with disability compared with caring for non-disabled peers. o The Bill should consider the impacts of informal and formal supports on parents and families when caring and supporting for children with disability. Schedule 1 Part 4—Support determinations o The Bill should not give the Minister the power to reduce funding for groups of supports. Any proposed funding reductions for groups of supports or groups of participants should be placed in primary legislation to enable the necessary levels of parliamentary scrutiny. o If partial funding of assessed needs is to be permitted (for either old or new framework plans), the Bill should require independently conducted impact statements to be regularly produced. Schedule 1 Part 8—Tightening meaning of permanence o Amend the test of permanence so that applicants are required to demonstrate that they have tried treatments likely to ‘substantially’ (not ‘materially’) improve, reverse or alleviate the impact of impairments. Schedule 1 Part 3—Strengthen link between an impairment and need for support o Remove the proposed requirement for needs to ‘directly’ arise from the qualifying impairment. Retain Note 2 in 32L(6) clarifying whole-of-person impacts.
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
Responding to Schedule 1 Part 1 Section 9B(1) Definition of functional capacity
This section of the legislation defines functional capacity as a person’s ability to undertake an activity ‘in a context that excludes, as far as possible, the impact of the person’s environmental and personal circumstances’. While we appreciate the policy intent to introduce a more consistent approach to assessment to identify functional capacity, we have concerns that this goes against many of the contemporary understandings of disability.
For example, the World Health Organisation’s International Classification of Functioning, Disability and Health (WHO ICF) acknowledges that functional capacity is a product of the interaction between impairments, supports and environmental factors. Functional capacity needs to take into account the full range of tasks a person may need to complete in their daily life and the decisions that person makes about whether to undertake each and how to balance them in the context of limited energy. In isolation, a person may be able to undertake individual tasks in domains such as paid work, childcare, cooking, cleaning, social connection, exercise, or healthcare – but in the context of their environmental and personal circumstances, they face daily decisions about what is achievable. Therefore excluding a person’s environmental and personal circumstances will not give a realistic picture of an individual’s needs, and risks entrenching any inequalities they experience due to intersectional factors such as gender and socioeconomic disadvantage.
Recommendation: Align any definition of functional capacity with internationally accepted tools such as the WHO ICF.
Responding to Schedule 1 Part 2 48A Conditions for conducting reassessment of participant’s plan on request
The proposed reassessment changes are likely to disproportionately disadvantage people with fluctuating or episodic conditions, whose support needs can vary significantly over time but may not meet the requirement for a “significant and ongoing” loss of function. Individuals with conditions such as mental illness, autoimmune disorders, chronic pain, neurological conditions, or other episodic disabilities may experience periods of substantial functional decline requiring additional supports, yet be unable to access a reassessment because their increased needs do not meet the proposed test.
The reforms also introduce additional administrative barriers by requiring reassessment requests to be made in a prescribed form and supported by any information requested by the NDIA. These requirements may be particularly challenging for participants with cognitive, psychosocial, communication, literacy, or executive functioning impairments, as well as those with limited access to advocacy or professional support. Together, these changes risk reducing access to appropriate supports for some of the most vulnerable participants while increasing procedural hurdles to having changing needs recognised.
An example of how these reforms may negatively impact participants is provided in the below vignette:
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
Sarah is a 38-year-old woman with cerebral palsy who works part-time. Her condition is permanent, but her functional capacity fluctuates due to fatigue, pain and muscular issues. In some weeks, she can travel independently and manage household tasks. In others, she requires taxi transport to work and additional support worker assistance with cooking and cleaning. Under the proposed reforms, these increased support needs may not qualify for reassessment because they are not considered a “significant and ongoing” change. As a result, Sarah may need to either go without essential supports (risking her employment, nutrition and hygiene) or use additional funding and exhaust her budget early. If her needs are viewed as fluctuating rather than permanently changed, she may have limited ability to obtain a reassessment or seek review, leaving her without adequate supports despite experiencing genuine increases in need.
Recommendation: Ensure the reassessment process is able to accommodate people with fluctuations in support needs.
Recommendation: Ensure pathways for participants to appeal decisions not to have their plan reassessed.
Recommendation: Reduce administrative barriers to requesting reassessment, for example through a no wrong door approach.
Responding to Schedule 1 Part 4—Support determinations 34A Determination reducing funding for groups of supports
The Bill introduces a Ministerial power to reduce funding for certain groups of supports in old framework plans. These changes aim to improve the long-term sustainability of the Scheme by allowing targeted funding reductions across groups of plans, for example where supports are generally considered overfunded, rather than through individual reassessments. The determinations would operate automatically through legislation and would not be subject to merits review.
The mechanism assumes that all participants within a support category are overfunded to the same extent, and risks penalising participants whose funding levels are already appropriate and justified. Drawing on the example of Omar (from Explanatory Memorandum): even where a delegate determines that $35,000 is a reasonable and necessary amount for Omar’s supports, the automatic 25% reduction would override that professional assessment. This weakens the core NDIS principle that supports should be tailored to individual needs.
We have grave concerns about introducing powers that allow for partial funding of support needs previously assessed as reasonable and necessary. Schedule 4 Item 4 Subsection 3C also supports a partial funding power for new framework plans, as it states that a funding amount in new framework plans “may be more than, equal to or less than the actual cost of providing or acquiring the support or group or class of supports”.
Risks to mental health posed by reduction to social and community participation supports
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
Research conducted by AHEAD members demonstrates that Australians with disability already have persistently poorer mental health outcomes compared to people without disability. A third of people with disability experience high or very high levels of psychological distress, compared to 12% of people without disability. Australians with disability are also nearly twice as likely to experience loneliness compared to people without disability.1
Evidence increasingly links inequalities in mental health for people with disability to socio-economic disadvantage and barriers to social participation. To add to this, our recent analysis of Australian longitudinal data suggests that 40% of the difference in mental health between people with and without disability is explained by social exclusion. If social exclusion explains a substantial portion of the mental health inequalities, then strengthening social inclusion becomes central to any effective response. For many people with disability that experience substantial and systemic barriers to inclusion, investing in social supports to enhance inclusion is critical.
Indeed, our research highlights the critical role that social supports (informal and paid) play in reducing social exclusion and its impact on mental health. People with disability with low levels of social supports for example, experience poorer mental health outcomes compared to people with stronger social supports.2 Noting concerns raised by Minister Butler about the quality of supports (e.g. disengaged workers), we argue that the solution is to focus on enhancing quality - not withdraw essential supports. Similarly, while we welcome investment in community organisations to promote inclusion, this must complement - not replace - individual participation supports.
Even before Minister Butler announced a significant reduction to the social and community participation component of NDIS budgets, participants and their families had already been experiencing significant cuts to their plans. We argue that any NDIS savings the government expects from further mandatory cuts as proposed in the Bill are likely to be temporary, whilst shifting costs to other systems. Individuals who experience significant impacts to mental health and wellbeing are more likely to use, for example, hospital services. These are more expensive and often negatively impact on other areas of individuals’ functional ability. The NDIS was originally designed as an investment in the lives of people with disability to reduce downstream costs in the future. Reducing funding around areas such as social and community participation risks undermining the effectiveness of the scheme to reduce lifetime costs of care.
Mandatory reduction to any supports will also shift costs onto families or leave individuals without essential services and supports, generating serious immediate and long-term threats to the socio-economic participation of individuals, family carers (predominantly women) and current disability workers. Reduced access to supports will further jeopardise the safety, physical health, mental health and overall well-being of affected individuals and their
1 Bishop, G.M., Llewellyn, G., Kavanagh, A.M. et al. Disability-related inequalities in the prevalence of loneliness across the lifespan: trends from Australia, 2003 to 2020. BMC Public Health 24, 621 (2024). https://doi.org/10.1186/s12889-024-17936-w 2 Devine A., Ye L, Bishop G., Huska M., Dickinson H., Barney J., Bogumil R., Elliott N., Kavanagh A., Aitken Z. The impact of multiple experiences of social exclusion on the mental health of Australians with disability: insights from a mixed-methods study (under review at Social Science and Medicine - Mental Health)
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
families. Taken together, these outcomes also amount to an erosion of the human rights of people with disabilities.
Given the links between exclusion, loneliness, adverse health outcomes and reduced social and economic participation for people with disability – and the estimated national cost of $2.7 billion – further reductions to supports are likely to produce avoidable long-term health burdens and fiscal pressures, including increased demand for NDIS services. This is alongside the wider repercussions for the Australian population and economy through disruptions to labour markets and greater demand on health and crisis services.
While the NDIS cannot resolve these problems on its own, dramatic reductions to supports - without significant investment and action to remove systemic barriers such as discrimination and persistent obstacles to education, health, employment, housing, transport and social and community participation - will only deepen these inequalities.
Key insight: The proposed reduction in social and community participation funding (and accompanying commentary) significantly devalues the importance of these supports.
Recommendation: The Bill should not give the Minister the power to reduce funding for groups of supports. Any proposed funding reductions for groups of supports or groups of participants should be placed in primary legislation to enable the necessary levels of parliamentary scrutiny.
Recommendation: If partial funding of assessed needs is to be permitted (for either old or new framework plans), the Bill should require independently conducted impact statements to be regularly produced.
Responding to Schedule 1 Part 6 Subsection 34 (1G – 1K): Family etc. support—children
This subsection outlines the expectation that parents are responsible for providing substantial care and support for their children with disability. However, because it does not consider whether the needs of a child with disability are greater than those of a child without disability, this amendment has the risk of further entrenching disadvantage for families of children with disability.
It could reasonably be expected that a child with a disability will have greater care and support needs compared with their non-disabled peers, in areas such as personal care and supervision. In turn, extensive caring responsibilities may result in parents having reduced capacity to engage in paid employment, impacting career trajectories and housing, for example, or providing care and support to other family members.
Subsection 34 amendments also prioritise provision of informal over formal supports. The implications are a likely increase to the overall caring responsibility falling to parents and families, and required formal supports being overlooked in favour of informal supports.
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
Collectively, deprioritising formal supports may reduce opportunities for child inclusion and participation and risk poorer parent mental health.3
Particular attention should be given to the new subsection 34(1H), which defines substantial care and support as including behavioural support. While parents can reasonably be expected to provide day-to-day behavioural guidance and support, children with disability may require specialised behavioural supports, interventions or therapies that extend beyond ordinary parental responsibilities. The legislation should clearly distinguish between informal behavioural support provided by families and disability-related therapeutic or specialist behavioural supports, to ensure that necessary formal supports are not inappropriately characterised as parental responsibilities.
Key insight: The proposed reliance on parents to provide substantial care and support for their children with disability risks further entrenching disadvantage.
Recommendation: The Bill should recognise there are additional levels of parent care and support required for children with disability compared with caring for non- disabled peers.
Recommendation: The Bill should consider the impacts of informal and formal supports on parents and families when caring and supporting for children with disability.
The gendered impacts of the proposed reforms
Previous research by AHEAD members outlines gendered issues with NDIS implementation.4 Women and girls are underrepresented in the scheme, including across nearly all disability types, and women are denied scheme access at a higher rate than men. Researchers and advocates have long called for an NDIS Gender Strategy, and we understand that the NDIA work began on this strategy in 2024, but paused it in 2025 to prioritise work on other reform initiatives. The current Bill poses gendered risks to both participants and carers if passed in its current form.
Cuts to groups of supports Schedule 1 Part 4 of the Bill enables the Minister to reduce funding for a specified group of supports. The Bill makes it clear that limitations can be put on the funding available to a participant, even if that results in partial funding of a support deemed reasonable and necessary. This will allow for the blunt reduction in social and community participation (50 per cent) and capacity building supports (10 per cent) proposed in the Explanatory
3 Fleitas Alfonzo, L., Taouk, Y., Emerson, E., & King, T. (2023). Impact of informal care on the mental health of caregivers during the COVID-19 pandemic. Journal of Public Health, 45(4), e668-e676. 4 Yates, S., Carey, G., Hargrave, J., Malbon, E., & Green, C. (2021). Women’s experiences of accessing individualized disability supports: Gender inequality and Australia’s National Disability Insurance Scheme. International Journal for Equity in Health, 20(243). https://doi.org/10.1186/s12939-021-01571-7 Yates, S., Carey, G., Malbon, E., & Hargrave, J. (2022). ‘Faceless monster, secret society’: Women’s experiences navigating the administrative burden of Australia’s National Disability Insurance Scheme. Health & Social Care in the Community, 30(5), e2308–e2317. https://doi.org/10.1111/hsc.13669
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
Memorandum. The cuts to these supports will shift these responsibilities back onto informal carers – largely women. Of those providing care to people with disability, there are over twice as many female primary carers as male. When it comes to primary carers of children with disability, the overwhelming majority are women (84.7%). 43.8% of primary carers also have disability themselves. These changes will increase unpaid caring responsibilities and may lead carers to cutting back on paid employment, deepening women’s socioeconomic exclusion. Cuts to capacity building supports also have implications for carers, as capacity building supports need to be available to plan for the future as carers’ own capacity declines.
The Explanatory Memorandum says that “opportunities to increase gender equality will be considered as part of the design and evaluation of future market reforms to delivering social and community participation and capacity building activities”. However, no timeframes, benchmarks, or accountability mechanisms are provided for when or how this work will occur.
Permanence Schedule 1 Part 8 tightens the meaning of permanence. It requires scheme applicants to access all ‘appropriate’ treatments (meaning known, evidence-based and available in Australia) likely to materially (meaning ‘noticeably’) improve or alleviate the impact of the impairment, before NDIS access is granted. Such a subtle test of permanence blurs the lines between a ‘treatment’ that noticeably alleviates the impact of an impairment (and therefore falls outside the NDIS) and a capacity building support (that falls inside the NDIS).
This rule privileges those with stable, medically recognised disabilities – but the systemic underfunding of women’s health research contributes to a greater prevalence of medically unexplained symptoms and ambiguous, complex chronic illness in women,5 making treatment pathways more difficult and expensive for them. Under the new permanence definition, people may have to try many potentially marginal treatments that might improve functioning even a little, even if their conditions are not understood, or the treatment is expensive or difficult to access.
These ‘pay to prove’ dynamics disadvantage those living in rural/regional/remote areas and those with fewer financial resources. Women with disability are more likely than men with disability to live on lower incomes, and have higher expenses and lower earning capacity due to caring responsibilities. Further, the home and community-based foundational supports recommended by the NDIS Review (Recommendation 1.9) are not even close to being implemented, with Thriving Kids the only foundational supports announced so far. Tightening scheme access in this way, in the context of discriminatory, costly and difficult-to- access treatment pathways, and a lack of disability supports outside the scheme, risks excluding many women and girls with complex health and disability needs from crucial supports.
5 Merone, L., Tsey, K., Russell, D., & Nagle, C. (2022). “I just want to feel safe going to a doctor”: experiences of female patients with chronic conditions in Australia. Women’s Health Reports, 3(1), whr- 2022.
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National Disability Insurance Scheme Amendment (Securing the NDIS for Future Generations) Bill 2026 Submission 578
Reversing progress toward ‘whole of person’ approach Part 3 Paragraph 34(1)(aa) restricts funded supports to needs arising directly from an impairment for which someone meets NDIS requirements. This reverses legislative progress toward ‘whole of person’ servicing made in 2024 (Section 32L Note 2), which allowed for recognising the complex way people actually experience impairments.6 This was reinforced by the Federal Court decision in CEO of the NDIS v Eastham [2026] FCA 147. AHEAD members are currently conducting a study into chronic pain, employment support, and the NDIS. We have interviewed many people in this study whose experience of pain, often related to impairments that are not recognised by the NDIS, is systemic. Pain from one condition can affect the functional impacts of another impairment, which can then impact on a third. For them, it is impossible to distinguish between support needs ‘arising directly’ from their NDIS-recognised impairment and support needs that are indirectly related to that impairment. This is gendered because women are more likely than men to experience multi- morbidity, especially in age groups under the NDIS cut-off of 65. Women’s experience of impairments is complicated by trauma, violence, and chronic conditions ill-understood due to the long history of gender bias in medicine.
Recommendation: Amend the test of permanence so that applicants are required to demonstrate that they have tried treatments likely to ‘substantially’ (not ‘materially’) improve, reverse or alleviate the impact of impairments.
Recommendation: Remove the proposed requirement for needs to ‘directly’ arise from the qualifying impairment. Note 2 in 32L(6) clarifying whole-of-person impacts.
Recommendation: Prioritise home and community care support programs as recommended by the NDIS Review (Recommendation 1.9) so that people with disability who are denied scheme access as a result of these reforms can still receive necessary supports.7
Recommendation: Require a rights-based intersectional impact assessment before the Bill proceeds.
6 Calderón-Larrañaga, A., Vetrano, D. L., Ferrucci, L., Mercer, S. W., Marengoni, A., Onder, G., Eriksdotter, M., & Fratiglioni, L. (2019). Multimorbidity and functional impairment-bidirectional interplay, synergistic eƯects and common pathways. Journal of internal medicine, 285(3), 255–271. https://doi.org/10.1111/joim.12843 7 NDIS Review: Final Report, p. 34-35.
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