by Carrie Baatz
As long as Medicaid is funded, 1 in 5 people in Colorado are receiving medical benefits that enable them to be healthy and independent.
Discussions led by the Trump Administration have been underway about replacing Obamacare and converting Medicaid into a block-grant program, which would give states more power to minimize health care coverage for vulnerable people. Historically, when federal programs are turned into block grants, funding is cut between 25% and 51%, according to Congressional Research Service.1
If federal funding for Medicaid programs were cut, close to 700,000 people in El Paso County could lose some or all of their health care. They would be left with little to no health care options. Those who cannot afford to pay out of pocket for medical services would be forced to go without care, increasing their risk of injury, illness, and mental health crisis.
At least 100,000 Coloradans who use Medicaid have disabilities. More than others, people with disabilities are likely to have serious health issues and need medications.
It’s too soon to tell which Medicaid programs will be on the chopping block. Funding for mental health treatments and medications could be precarious, since over half of state and locally administered mental health funding comes through Medicaid.
People with disabilities are worried that waiver programs will be targeted first. These are critical Medicaid services that enable people to live and work in the community:
Acute care: Including hospital care, physician services, and laboratory and x-ray services. These acute care services are mandatory which means they must be provided to everyone who is eligible. States have the option to offer (and most do) prescription drugs, dental, physical therapy, speech therapy, prosthetic devices and other services. Many people with disabilities have implanted devices (catheters, colostomies, pumps, g-tubes, etc.), that need to be serviced and need supplies for sanitary use.
Equipment and supplies: People with disabilities often need equipment and supplies that are expensive. A custom seating system for a power wheelchair, and a power wheelchair that functions properly costs over $10,000, sometimes double that and requires regular repairs. Most insurance companies have a $2,500 cap and Medicare does not cover equipment except for in the home. The “in the home” equipment is not rugged enough to function for someone with a full life and a job.
Long term services and supports (LTSS): This includes help getting dressed, taking medication, preparing meals, managing money, bathing, toileting, getting in and out of bed. For people with intellectual and mental disabilities, this can also mean cueing, helping people with problem solving, and communication assistance. This can also involve home modifications, assisted living, and non-medical transportation.
Transportation: Medicaid is unique in that it covers transportation to medical appointments. Many people with disabilities cannot drive or do not own a vehicle. This service is particularly critical in rural areas of the state.2
If people with disabilities lost their long-term care, they would have little choice but to move into nursing homes – the most expensive form of housing – on the government’s dollar. Many people would be at risk of becoming homeless.
For all the risk cutting Medicaid will pose to human life, we don’t know what it will solve. While the repeal of Obamacare looms ahead, policy makers will have to decide what programs are medical necessities for Medicaid to cover.
Use your voice to make a difference! Write or call Congress, and tell your representatives that Medicaid block grants are not the right solution for people with disabilities.
1Source: Congressional Research Service, Using CLS and BO data on inflation
2Information taken from the Colorado Cross Disability Coalition.
For more information on the potential impact to people with disabilities, see this video.
*Due to the fluid and political nature of this ongoing discussion, the context of this post will likely change as time goes by. The background presented represents the state of the public discussion on publish date.