Steep cuts to Medicaid are a drop in the ocean of proposed changes found in Republicans' "Big Beautiful" tax and spending bill, but one Bloomington provider is celebrating an expansion to Illinois' Medicaid coverage.
Effective July 1, Illinois is the first state to allow music therapists to bill Medicaid for services—something Julie Englesdorfer said is a game-changer.

Englesdorfer graduated from Illinois State University's music therapy program and has remained in the area, founding Harmonium Music Therapy in Bloomington. But making ends meet in what she calls a "niche" field has been difficult.
Englesdorfer's inability to bill insurance has long created an accessibility barrier, with the average session costing around $120/hour.
“When most people hear about the reimbursement, they have a misunderstanding of what music therapy is,” she said. “Some people who I’ve talked to think that music therapy is ‘poor people get music activities for fun.’”
Englesdorfer said music therapists frequently support people with disabilities in reaching functional and cognitive goals, among other benefits.
“Music therapy has been proven to help, for example, people with Alzheimer's or dementia,” Englesdorfer said. “It’s been proven to decrease isolation; it’s been proven to increase positive mood and mental health, and it’s been proven to decrease the psychosocial and behavioral symptoms of dementia.”
In terms of the addendum's staying power, there aren't any clear answers on if or how the Big Beautiful Bill will impact Medicaid in Illinois. Eligibility and work requirements are the biggest Medicaid-related issues in the bill, which do not currently include changes for people with disabilities or their caretakers.
With the Senate passing steep cuts to the federal social safety net as part of its sweeping budget proposal, states could be responsible for shouldering those costs—leaving additions like music therapy hanging in the balance.
The bill will now be sent back to the House of Representatives, where Republicans only narrowly passed an earlier version of the bill. President Trump has urged Congress to get the bill onto his desk by July 4.