Disability advocates are pleading with the government not to cut critical services in its May budget as some Labor MPs call for a wholesale redesign of the National Disability Insurance Scheme.
The government says "extensive" work is being done to rein in the spiralling cost of Australia's $50 billion disability support program, which is growing at more than 10 per cent a year.
Mandatory registration for providers of supported independent living, which can cover personal care and other tasks such as showering, dressing and cooking, will form a key part of the government's plan to halve the growth rate.
Most operators providing NDIS services are not registered, and registration will require them to meet higher quality, safety and worker training standards.
The conversation around reforming the scheme should extend to a major redesign, including a difficult conversation about eligibility, 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."
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.
But any cutbacks should not come at the expense of participants' care, disability advocates warn.
"If we don't make sure that the NDIS is sustainable, we really understand that has long-term implications," People With Disability Australia acting chief executive Megan Spindler-Smith told AAP.
"But we need to make sure that we're not creating a situation where people with a disability are kind of thrown into a void where they have access to no supports whatsoever."
The NDIS had made an "enormous difference" to participants' lives, Prime Minister Anthony Albanese said, but needed to be sustainable in the long term.
"We want to make sure that it's fit for purpose ... we'll be working on the budget like we do on other items for that," he told reporters in Canberra on Tuesday.
Opposition NDIS spokeswoman Melissa McIntosh agreed an "overhaul" was needed but warned cuts to eligibility were unlikely to help bring down costs.
"When you're trying to tidy up and minimise the types of disability that is covered by the scheme, (you) risk having cost shifting," she told 3AW Melbourne on Tuesday.
