145,000 autistic people may lose NDIS support under Labor cuts

Australia's NDIS was designed to support people with permanent, significant disabilities. But over the past decade, autism diagnoses have grown so dramatically that the scheme is now straining under their weight, and the government has responded by proposing to remove around 145,000 autistic people from eligibility. Before the debate about those cuts can be properly settled, there is a prior question almost nobody in politics wants to ask: are we confident that every one of those 145,000 people has the condition the scheme was built to serve?

Australia's autism rate rose tenfold — but not all of that is science

Autism diagnoses in Australia have risen roughly tenfold since the early 2000s. The Australian Institute of Health and Welfare recorded around one in 150 children meeting the diagnostic threshold in 2003. By 2022, the figure was closer to one in 40. Some of that shift reflects genuine scientific progress: the diagnostic criteria broadened, awareness improved, and children who were previously misdiagnosed or missed entirely were correctly identified. Real. Important. Worth celebrating.

But broadened criteria alone cannot account for the full trajectory. The NDIS created something else: a financial incentive to diagnose. A formal autism assessment unlocks access to publicly funded therapy, support workers, specialist equipment, and, in some cases, tens of thousands of dollars in annual support. For families navigating a system with long waitlists and high out-of-pocket therapy costs, a diagnosis is not just a medical finding, it is a key that opens a door. That is not a cynical observation about families. It is a structural observation about what happens when a large subsidy is attached to a specific diagnostic label.

The government built a scheme around a label and then watched the label expand to fit the scheme's budget.

The same mechanism has been observed in other subsidised markets. When government funding becomes conditional on meeting a defined threshold, the population meeting that threshold tends to grow. The Bearing has examined this pattern in housing, where the term "affordable" expanded to include things that plainly are not, because the label carried financial benefits. Diagnostic categories can behave the same way when the incentive is large enough.

Clinicians face the same structural pressures as families

Clinicians are not immune to this pressure. Private assessment practices have proliferated alongside the NDIS, and the commercial model for many of them depends on assessments that lead to diagnoses. That does not mean assessors are acting in bad faith. It means they are human and operating within a system that rewards a particular outcome. The American Psychiatric Association, in reviewing the expansion of autism spectrum disorder in its diagnostic manuals, noted explicitly that broadening the category would increase prevalence estimates, and that this carried real trade-offs in terms of what the diagnosis would mean for the individuals who received it.

None of this means that the 145,000 people in question are not experiencing genuine difficulties. Many of them clearly are. What it means is that the category "autistic" now covers a range of presentations so wide that using it as the criterion for a single, large-government support program is doing a lot of heavy lifting. A child with level 3 autism who cannot speak and requires around-the-clock support has something real and serious in common with a school-age child who struggles socially and gets a level 1 diagnosis after a two-hour assessment, but that shared label is doing something closer to a political fiction than a clinical one.

Cutting access without building alternatives solves nothing

The Greens are correct that there is no alternative system ready to absorb the people the government proposes to remove. That is a serious policy failure, and the government has not explained it adequately. If 145,000 people lose NDIS access and there is nothing on the other side of that transition, many of them will fall through. That is a predictable and preventable harm.

But the Greens are also making an argument that treats the current diagnostic rate as a fixed fact about the Australian population rather than as a partially constructed outcome of a payment system. The stronger case against cuts is not that every diagnosis is beyond scrutiny. It is that you cannot responsibly remove support without first building what replaces it, and that the proper instrument for managing diagnostic inflation is a better-defined assessment framework, not a funding guillotine.

The government built a scheme around a label and then watched the label expand to fit the scheme's budget. That is a design problem. Cutting the people who hold the label, without redesigning either the assessment process or the support alternatives, solves nothing, it just moves the cost elsewhere, mostly onto families. What Australia actually needs is a clearer, more honest definition of who the NDIS was built for, enforced at the assessment stage rather than the funding exit, before anyone loses anything.

Sources

Australian Greens — Labor using disabled kids and families to balance the budget

The Guardian — NDIS cuts internal documents

Australian Institute of Health and Welfare — Autism in Australia

American Psychiatric Association — DSM-5 Autism Spectrum Disorder Fact Sheet

National Disability Insurance Agency — NDIS Quarterly Report

Frequently Asked Questions

Why is Labor cutting NDIS support for autistic people?
The NDIS has grown far beyond its original budget projections, driven in significant part by a tenfold increase in autism diagnoses since the early 2000s. Labor is proposing to remove approximately 145,000 autistic people from eligibility as a cost-containment measure, though the government has not detailed what support, if any, will replace NDIS access for those removed.

Has Australia's autism diagnosis rate really increased that much?
Yes. The Australian Institute of Health and Welfare recorded roughly one in 150 children meeting the diagnostic threshold in 2003; by 2022 that figure was closer to one in 40. The increase reflects a genuine broadening of diagnostic criteria and improved awareness, but also the financial incentive created by attaching large government subsidies to a specific diagnostic label.

What happens to autistic people who lose NDIS funding under the proposed cuts?
There is currently no alternative support system ready to absorb them. If the cuts proceed without a transition pathway in place, most of the cost will shift onto families — a group that two-thirds of those affected, being children, relies on directly.

Are clinicians inflating autism diagnoses to access NDIS funding?
Not necessarily in bad faith, but the structure of the system creates pressure toward diagnosis. Private assessment practices have proliferated alongside the NDIS, and their commercial model depends on assessments that result in diagnoses. The American Psychiatric Association itself noted that broadening the autism category would increase prevalence estimates and carry real trade-offs for what the diagnosis means clinically.

What would a better alternative to cutting NDIS autism support look like?
The core problem is a diagnostic label that has expanded far beyond what the scheme was designed to fund. A more defensible approach would tighten the assessment framework — through functional capacity thresholds or tiered eligibility based on support intensity — before removing anyone's access, rather than using a funding cut as a substitute for better-defined eligibility.