In The Politics of Autism, I discuss Medicaid services for people with intellectual and developmental disabilities.
Overlooked in the Republican bill to repeal the Affordable Care Act (ACA) is a drastic change to traditional Medicaid funding that threatens services for more than 10 million people with disabilities. For decades, Medicaid has been their lifeline — providing everything from specialized therapies to support for daily living. Medicaid keeps people with disabilities out of institutions. It pays for caretakers so their parents can go to work. And it’s more efficient than private insurance.
Aside from phasing out coverage for 400,000 low-income Coloradans who gained health insurance through Medicaid expansion, the bill moving quickly through Congress would place a per-person cap on pre-ACA Medicaid funding for people with disabilities, children and the elderly. Since the program’s creation in 1965, states and the federal government have split the bill. Capping Uncle Sam’s share leaves two options: either shift costs to already stretched state budgets or cut services drastically.
With Colorado lawmakers locked in perpetual budget gridlock, a funding increase is unlikely. So here come the cuts. Hearing aids, at-home care, physical therapy, and some people denied coverage altogether. The American Hospital Association warns the plan could mean further pay cuts for providers who already struggle to break even. The Arc, an advocacy group for those with disabilities, says the GOP plan will leave Medicaid decimated, threatening beneficiaries’ “basic human right to a life in the community.”
Say what you will about the Affordable Care Act, but massive changes to a program that was not even part of Obamacare to begin with deserve bipartisan debate that ensures all are heard — not to be buried in a political football and rushed to a vote.Dan Gorenstein writes at Marketplace:
The Republican plan – or the American Health Care Act – radically reconfigures Medicaid by cutting federal funding by $880 billion over 10 years, according to recently released figures from the Congressional Budget Office. That could mean a loss of services for millions of people, including one in 10 million Americans with disabilities on the program.
The proposed cuts have many disability advocates concerned. That includes Fern and Brad Pivar, whose 32-year-old son Scott has Fragile X syndrome, a genetic disorder that means he’s non-verbal, has autistic tendencies and the cognitive capacity of a kindergartner.
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Right now, disabled Americans like Scott make up about 15 percent of Medicaid enrollment, and 42 percent of spending.
That spending is already a big target for states, which have been cutting costs by creating wait lists. More than half a million people with disabilities were waitlisted for services in 2015, according to the Kaiser Family Foundation.
Fern said she’s terrified for Scott’s future.
“I am scared as to what his life will be, that he’s going to be alone and put away somewhere and no one is going to take care of him,” she said as her voice dropped to a whisper. “You are trusting someone else to take care of the most important thing in the world. And it’s not going to be there.”
