An open letter to Rep. Trey Hollingsworth:
Medicaid is an often invisible source of government funding for many different programs that help thousands of Hoosiers with disabilities and their families. Medicaid provides government-funded health insurance for children and adults who do not have much money or who have a disability. Medicaid also provides community-based services that people with disabilities often rely on throughout their lives. These services are separate from Affordable Care Act. However, the bill to repeal and replace the ACA also contained fundamental and drastic changes to Medicaid – changes that would negatively impact people with disabilities. As possible future changes in health care are debated, we feel strongly that Medicaid must remain whole for the vulnerable people for which it was created over 50 years ago.
The American Health Care Act that failed to be approved by the House included moving Medicaid to a per-person cap or a block grant, instead of matching federal and state funds at a 2:1 ratio. Either change would provide a set amount of federal money to states to fund its Medicaid program. This would end the flexible state and federal partnership and would reduce the federal government’s participation over the next ten years by over $880 billion. States would be responsible for covering costs beyond the federal allotment. This may force states to reduce eligibility, limit services and supports, cut reimbursement to providers or any number of methods to save money in the Medicaid program. Ultimately, vulnerable people with disabilities could lose their community-based services and be forced into institutional care, which has proven to be more expensive and prohibits these individuals from living and participating in the community.
Most of the services that our organizations provide are part of community-based Medicaid programs. The cuts to funding resulting from the proposed reforms would threaten an already fragile system. Agencies are already dealing with massive staff shortages and further cuts will put the following essential services in danger:
- Day services that provide employment assistance, adult learning, personal care and community engagement. This often allows families to continue working because their loved ones are meaningfully involved in programs with trained staff.
- Residential supports, such as group homes and supported living arrangements, where the level of in-home support can be adjusted to the individual’s needs.
- Behavior supports that teach individuals coping skills and train staff in the best strategies to overcome behavioral challenges.
- Health care coordination to monitor and manage health issues on an ongoing basis. This can help prevent or delay hospitalization and nursing home care.
Many people with disabilities live with their families. This means Medicaid services are critically important to not only the quality of life of these individuals, but also the quality of life of the families that care for them. Furthermore, Medicaid expansion has enabled many individuals with disabilities to gain health insurance for the first time.
Representative Hollingsworth, we urge you to reject any bill that changes the Medicaid program. It must continue in its unique roles as both the provider of health insurance for the country’s most vulnerable citizens and as a provider of essential supports for community inclusion of people with disabilities.
There is no other program that does what Medicaid does for individuals with disabilities and the families that care for them. We implore you to prevent negative changes in the program on these citizens.
Susan Rinne, CEO and Bonnie Peischl, President, LIFEDesigns, Bloomington, IN
Leslie Green, CEO, and Catherine Gray, President, Stone Belt Arc, Bloomington,IN
Bettye Dunham, CEO, and Jay Connor, President, Rauch Incorporated, New Albany, IN