The government says "extensive" work is being done to rein in the spiralling cost of the National Disability Insurance Scheme ahead of the budget in May.
The cost of the NDIS is growing at more than 10 per cent a year, around half the expansion rate when Labor came to office in 2022 but still well above the government's target of five per cent.
Mandatory registration for providers of supported independent living, which can cover personal care and other tasks like showering, dressing and cooking, will form a key part of the cost-cutting plan.
Most operators providing NDIS services are not registered, and registration will mean they will have to meet higher quality, safety and worker training standards.
The conversation around reform of the $50 billion scheme should extend to a wholesale redesign, including a difficult conversation about who is eligible and who is not, Labor backbencher and paediatrician Mike Freelander told AAP.
"The NDIS was designed for people with severe disability, and it's vitally important... that we do keep it for people with severe disability," he said.
"We need to be quite black and white about it.
"There are going to be people who will be very angry with us, but we need to try and keep that to a minimum."
Federal and state governments needed to work together to provide better disability supports outside the NDIS, he said.
An example of such a plan is the $4 billion "Thriving Kids" program, which was unveiled in 2025 to provide support to children with mild to moderate autism and developmental delays.
The government was looking at ways to rein in the growing cost of the NDIS, cabinet minister Michelle Rowland told reporters on Tuesday.
"Extensive work is being done to bring that (growth rate) onto a more sustainable footing," she said.
"We all need to take a step back and realise how important the NDIS is for Australians, but it needs to be sustainable if it's going to meet its mission."
Fellow Labor senator Michelle Anandah-Rajah, also a doctor, described the NDIS as "fundamentally flawed".
"I am concerned that the medicalisation of the normal range of neurodiversity has resulted in a whole new industry, and this should be the coalface of eligibility reform," she told the Sydney Morning Herald and the Age.
