Tag Archives: People with disabilities

Medicaid Cuts Issue Brief

Medicaid Cuts Would Force People With Disabilities Into Nursing Homes

Colorado is in danger of losing $14 billion in Medicaid funding, if the American Health Care Act (AHCA) passes.1 The Colorado Health Institute estimates that this will likely cause nearly 600,000 Coloradans to lose their eligibility for Medicaid by 2030. These people 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.

The bill converts federal funding for Medicaid to block grants and per capita caps, which will likely result in cutting funds from critical programs. While reducing Medicaid, the AHCA would give states more power to minimize health care coverage for vulnerable people. Proposals in the AHCA would also result in an enormous transfer of wealth from low income to high income populations, according to Disability Rights Maryland.

Funding cuts could mean the loss of Medicaid services and supports for close to 100,000 children, adults and seniors in Colorado who live with disabilities.

More than others, people with disabilities are likely to have serious health issues and rely on long-term services in order to work and live in the community. Without long-term services and support, people with disabilities would have no choice but to move into nursing homes, each
person costing the state and federal government $6,900 per month. Many caregivers would have to choose between going to work and caring for their loved one who has a disability. For all the risk cutting Medicaid will pose to human lives, this will not solve problems; it will create new ones. People with disabilities will continue to need financial support, and net savings in federal spending will be required to fund additional hospital charges, and the cost of institutionalization.

Until an alternative solution to Medicaid exists, cutting funding will create drastic consequences in the daily lives of people with disabilities:

• Loss of the basic right to live in the community
• Loss of safety net
• Loss of access to resources
• Loss of hearing aids and other assistive technologies
• Worsening health or disabilities
• Loss of ability to work
• Loss of housing
• Loss of life

 

Home and Community Based Services for Adults and Children with Disabilities Could Lose Some or All of These Services2

Adults With Brain Injuries
• Adult Day Services
• Behavioral Management
• Day Treatment
• Home modifications
• Non-medical Transportation
• Respite care
• Personal care
• Personal emergency response system
• Counseling
• Specialized Medical Equipment/Supplies
• Consumer directed attendant support services
• Support Living Program
• Transitional Living

Respite Care Adults With Major Mental Illness
• Adult day services
• Alternative care facilities
• Consumer directed attendant support services
• Home Modifications
• Homemaker services
• Non-Medical Transportation
• Personal care
• Personal emergency response system
• Respite care

Adults who are Elderly, Blind and
Physically Disabled
• Community transition service
• Alternative Care Facilities
• Adult day services
• Consumer directed attendant support services
• Personal care
• Personal emergency response system
• Non-Medical Transportation
• Homemaker services
• In Home Support Services
• Respite Care

Adults With Spinal Cord Injury
• Alternative therapies (acupuncture, chiropractic care, massage therapy)
• Transportation
• Home modifications
• Homemaker services
• Personal injury response system
• Consumer directed attendant support services
• Adult Day Services
• Respite Care
• Personal Care
• Personal Emergency Response System

Children With Disabilities at Risk of
Hospital or Nursing Facility Placement
• Case management
• In Home Support Service

Children with Autism that have intensive
behavioral needs could lose behavioral
therapies.

Adults who Need Supported
Living Services
• Assistive technology
• Behavioral services
• Day habilitation services
• Dental service
• Home modifications
• Homemaker services
• Mentorship
• Personal care services
• Professional services (Hippo, massage, and/or movement therapies)
• Respite services
• Specialized medical equipment/supplies
• Supported employment
• Transportation
• Vehicle modifications
• Vision services
• Personal emergency response system

Adults With Developmental Disabilities
• Behavioral services
• Specialized habilitation, supported community connections
• Dental service
• Prevocational services
• Residential habilitation (24 hour individual or group)
• Specialized medical equipment/supplies support employment
• Transportation
• Vision services
• Case management
• In Home Support Service

Children in the Care of Social Services
• Cognitive Services
• Community Connections
• Communication Services
• Emergency Services
• Personal Assistance
• Self-Advocacy
• Supervision Services
• Travel Services

Children With Intensive Behavioral or
Medical Needs
• Adapted Therapeutic Recreation and Fees
• Assistive Technology
• Behavioral Services
• Community Connector
• Home Accessibility Adaptations
• Homemaker Services
• Parent Education
• Personal Care
• Professional Services
• Respite Care
• Specialized Medical Equipment/Supplies
• Vehicle Modification
• Vision Services
• Youth Day Services

Children With Life Limiting Illness at Risk of Hospital Placement
• Therapeutic Services (Counseling/Bereavement Services)
• Expressing Therapy (art, play, music therapies)
• Palliative/Supportive Care
• Support (Individual/Family/Group)

 

Tell your Congressman how Medicaid cuts would impact you and your loved ones:
Call Congressman Doug Lamborn: (202) 225-4422
Call Senator Michael Bennet: (202) 224-5852
Call Senator Cory Gardner: (202)-244-6524

Questions to Ask:
1. How will costs for long-term services and supports be covered?
2. Proponents say this will give the states more flexibility to serve the most in need but there are no requirements that states do so. Who determines the most in need?
3. Will the federal government allow a state to decide to only serve the healthy because it is easier and cheaper to serve them?
4. Will the federal government require states to serve people with disabilities including those who require expensive services?
5. How will you as our representative protect the most vulnerable who rely on these services for daily support?3

For more information, visit:
National Council on Independent Living
Colorado Cross Disability Coalition
Colorado Health Institute
Disability Rights Maryland

1 In the next 10 years, Medicaid will lose $880 Billion nationwide
Information adapted from the Colorado Department of Health Care Policy and Financing, effective June 2015 (Children) and December 2015 (Adults)
Questions adapted from the Colorado Cross Disability Coalition

Medicaid cuts would leave people with disabilities high and dry

 

by Carrie Baatz

Happy senior patient with friendly female nurse

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.

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