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The NDIS remains a lifeline for people with disability. Increasingly, it’s also a lightning rod for budget restraint. From July 1, the NDIA will impose new pricing reforms. The aim is to bring the cost of NDIS-funded therapy into line with what Medicare and private health insurers pay.
The justification? People with disability have been charged a “premium”—sometimes up to 68% more—for the same services.
On the face of it, the changes make sense. They promise fiscal discipline and fairness. Backed by the Independent Pricing Committee—established last year to bring rigour to the system—the review draws on more than ten million therapy transactions. It’s data-driven. Thorough. Reassuring.
But scratch beneath the spreadsheet and it gets messy.
The government says the move is about curbing rorts. Critics agree—at least, up to a point. A 3.95% pay rise for support workers also kicks in, reflecting award changes. So far, so good.
The trouble comes next. In regional areas, or where markets are thin, prices were deliberately inflated to attract providers. Cut them back, and services may vanish.
The IPC talks about “value-based pricing” and “blended payments”—concepts borrowed from health systems overseas. But disability supports are different. Therapy isn’t a commodity. It depends on individual needs, local conditions, and practitioner skill.
Efficiency matters. But service quality matters more—especially for those with complex needs.
The point is, this isn’t a real market. It never was. That’s why the government is stepping in.
Still, the shift toward so-called “market maturity” is telling. It reveals where government priorities now lie—not in expanding access, but in controlling growth.
The scheme is no longer viewed solely as a moral obligation or human rights commitment. It’s now a line item. A cost to be contained.
This is the quiet pivot that has reshaped the politics of disability in Australia.
Once, NDIS expansion was bipartisan orthodoxy. Now, the subtext is about restraint. Treasury wants predictability. The public wants accountability. And ministers want to be seen fixing a problem that’s grown too big, too fast.
That pressure is being channelled through pricing.
But technical reforms like this rarely land evenly.
In practice, the people most affected aren’t those manipulating the system—they’re the ones already at the edge of it. Participants with complex needs. Families without advocates. Carers navigating an already fragmented web of providers.
Many providers—especially smaller ones—lack the capacity to absorb sudden drops in revenue. Their business models were built on existing price caps. Reduce the margin, and something gives. Often, that “something” is service intensity, flexibility, or continuity of care.
Therapists already report they’re being asked to shorten appointments or offer less experienced staff. That might balance the books—but it doesn’t deliver outcomes.
Meanwhile, unregistered providers continue to expand. The NDIA’s own data shows a 6% increase in unregistered therapy operators. These are less regulated, harder to monitor, and not necessarily subject to the price caps the agency just adjusted. In other words: we’re cutting oversight where we need it most.
And then there’s the broader question—what does “value” mean in the context of disability?
A person learning to speak through AAC (augmentative and alternative communication) might require dozens of hours of therapy before they say a word. A child with a degenerative condition may need therapy not to improve, but to maintain function. These aren’t outcomes you can price per hour.
Yet the current model attempts exactly that.
The real test for the NDIA isn’t whether it can engineer a tighter, more efficient market. It’s whether it can protect the principle that disability supports are a public good—not a product.
If the scheme becomes just another service economy, it won’t just lose money. It will lose trust.
And once that’s gone, getting it back is far harder than crunching numbers.
This article was first published by Ability News on June 11th 2025. Republished with permission. Read the original article here.