Every year, there are new breakthroughs and new challenges in the world of speech-language pathology (SLP). That’s not news—in fact, your clinical training as an SLP is designed to give you the know-how and flexibility to adapt to new developments and needs. But you still have to stay up-to-date with what those are.

ASHA, the American Speech-Language-Hearing Association, is the major player for speech-language pathologists and audiologists when it comes to monitoring and advocacy. The organization has successfully pressed for licensing laws, billing standards, and regulations that ensure the American public can get the therapy it needs from highly-trained SLPs and audiologists.

Some years are easier than others when it comes to keeping the cause of advancing speech therapy afloat.

So far, 2025 is looking like it’s going to be a tough one. Each year ASHA puts out a list of advocacy priorities for the profession, dealing with current challenges. It’s fair to say that events may be unfolding a little more quickly than even ASHA envisioned.

Unsurprisingly, many of the top concerns ASHA has revolve around the new presidential administration and its actions that are shaking both the federal government and healthcare regulatory systems.

It was clear even back in 2024 that this was going to be a serious consideration for SLPs across the country. ASHA even put out a post-election explainer of potential impacts from the election.

Things have been moving faster and breaking harder than even ASHA forecast, however. As of March, 2025, these are the Top 10 Issues Facing Speech-Language Pathologists this year.

1. K-12 Education Funding and Administration

“President Trump cannot eliminate the Department of Education through executive action,” ASHA explained, but failed to foresee that the administration would chop staffing by half within the first two months.

While the claim is that all current programs will continue with current funding, it’s crystal clear that without the people administering them, they won’t be distributed evenly or effectively. Since many of these federal oversight and funding programs deal expressly with students with disabilities, this is already having a rapid and negative impact on services for those kids.

2. Higher Education Support and Research Funding Cuts

The Department of Education (ED) isn’t just involved in K-12 educational support—it’s also a big player in ensuring that American higher education is some of the best in the world. That includes the very master’s programs in speech-language therapy that SLPs have to earn for licensure. But grants have already been yanked from university researchers across the country.

It’s too soon to say if the chainsaw has ripped through any SLP-specific programs, but considering how many ED grants were made to support programs specifically helping students in SLP and other developmental and educational therapy roles, like this 2020 grant to Case Western, it’s a sure bet that some will be gone.

3. Gender-Affirming Care

It may come as some surprise to people outside the profession that SLPs are important providers in gender-affirming care. In fact, according to ASHA, “Speech-language pathologists play a central role in clinical services for gender affirmation.” Even the VA had SLP services supporting veterans finding a voice in line with their gender.

As the administration makes attacks on transgender individuals, it’s likely that fewer will seek out treatment. It’s also less likely that their treatment will be covered.

4. Diversity, Equity, and Inclusion

Hand-in-hand with attacks on transgender and homosexual individuals comes administration efforts to stomp out efforts in diversity, equity, and inclusion.

ASHA began including a DEI certification maintenance requirement in 2023. According to the requirement, if you’re a current CCC-SLP, you will need PDH (Professional Development Hours) in the subject by the end of 2025 to renew your credential… maybe. With the administration issuing three executive orders seeking to eliminate such requirements, maybe not seems increasingly likely.

While ASHA isn’t a government agency, many SLPs are employed by the government or in government contracts—all of which are now expressly forbidden from conducting such training.

5. Compensation Disruptions

While Medicaid and Medicare are the best known federal healthcare insurance programs, there’s another big one that SLPs who work with American military service members and their families know just as well: Tricare.

With more than 9 million beneficiaries, including young families and retired service members, the system heavily overlaps SLP populations. That’s been a problem since Elon Musk’s arbitrary DOGE cuts kicked in around mid-February of 2025, at which time many SLPs and other healthcare providers stopped getting paid for services rendered. Worse, support has almost evaporated, with no replies to emails and hours-long hold times. This has created problems in not just treatment, but delays in authorization or credentialing. ASHA is “deeply concerned.”

6. Medicaid Restrictions

While the administration has not yet taken on the social safety net directly, it announced in early March that Medicaid is on the chopping block to come up for extra money for border security, defense funding, and tax cuts. It’s likely that the program will at a minimum see more extensive work requirements, which in turn will probably take some of your current patients out of coverage.

ASHA fought hard to get SLPs covered by the program, and many have a patient load with a substantial percentage whose bills are paid by Medicaid.

7. Medicare Support and Telehealth Authorities

Medicare may be safer than Medicaid, but it was on the ASHA priority list to lobby for relief from payment cuts and to extend SLP authorities to provide telehealth services.

Although telehealth itself is a cost-saving measure, and despite the fact that both parties support these adjustments, the level of partisan rancor that has so far absorbed Congress makes it unlikely that this will happen. That throws any progress on these positions into grave doubt for 2025.

8. Student Loan and Public Service Loan Forgiveness

With so many SLPs working in public service, and with a graduate degree being required for licensure, government support is often critical for funding.

You don’t make a lot of money as a public or nonprofit employee, but a major benefit has been the chance to have your student loans forgiven in return for your service. But a new executive order rips away that benefit from many organizations, including those support DEI, providing gender affirming care, or basically anything the administration doesn’t like. And Education Department cuts are already hitting even ordinary student financial aid—the FAFSA website went down the day after the layoffs were made.

9. The Elephant in the Room: ACA Repeal

ACA repeal was a threat that was leveled and then whiffed during the first Trump Administration with Senator John McCain’s famous thumbs-down vote on the Senate floor. But with a more favorable Congressional composition this time around, it was the issue that made the top of ASHA’s list of concerns.

While the administration has focused on the more hot-button issues listed above at the moment, there are four years to go, and ACA remains in the cross-hairs. This could create entire populations of clients for whom SLP therapy would no longer be covered.

10. Artificial Intelligence

There’s at least one issue for 2025 that SLPs are facing that doesn’t have anything to do with politics: artificial intelligence. While AI in clinical practice is something that’s been front and center for a couple of years, it’s not the real risk for SLPs. Instead, ASHA has been keeping an eye on the use of AI in policy-making and in the insurance industry. While it promises efficiency and speed, it’s not clear yet if it can make decisions that prioritize patient access and care over cost-cutting… with no easy way to appeal.

How These Issues Shape Considerations for SLPs Picking Degree Programs Today

Naturally, all these issues have implications for the master’s degree in communicative sciences and disorders you choose on your path to becoming a speech-language pathologist.

For starters, with so much uncertainty in certain practice areas, specialization may no longer be a winning strategy. While specialists often win out on positions in specific types of treatment, they may have less ability to slide over into other SLP roles. When the market drops out for certain jobs, like those addressing gender issues, that can leave you high and dry.

A more generalist education in SLP therapies can better prepare you for uncertain job markets.

Furthering that trend, a strong liberal arts emphasis in your program will help you prepare for issues that SLPs have not traditionally had to deal with—but may in the future. Understanding your individual rights, those of your patients, and the system of law and government that you operate under may be more important than ever in the coming years.

Next, you’ll want to consider your funding options. With many student loan and public service loan forgiveness options in the cross hairs, it may be a better idea to look for private scholarship funds to help float your studies.

Finally, a strong and broad education in technology will help you prepare for work with, and perhaps around, artificial intelligence. While no one is expecting an SLP to get into the algorithmic wiring of an LLM, understand the basics of how they are built and operate also prepares you for their limitations and strengths. With intermediate jobs like prompt engineers already indispensable in business AI, it’s just as likely that the medical professions will need experts who can read the soul of the machine to get results as well.