Last month the US House of Representatives voted on their budget bill which would make significant cuts to Medicaid and SNAP (formerly food stamps). This week the Senate Finance Committee released their version of a budget bill that makes even more drastic cuts to Medicaid.
As I participate in our democracy by communicating about the importance of Medicaid and SNAP benefits to people The Arc serves, I have been met with the response that this legislation, “is meant to strengthen Medicaid specifically for low-income mothers, children, the elderly, and disabled.”
This statement is simply untrue, and based on a misunderstanding of how Medicaid works to support access to healthcare for all Americans.
People with disabilities qualify for Medicaid in a variety of ways, and many people with disabilities will thus be subject to work requirements.
Many people with disabilities are exempt from the work requirements. But “exemptions” and “carve outs” are not as clear-cut as you think. People with disabilities enter Medicaid and SNAP through all possible pathways. When states implemented this approach in the past, the exemptions did not protect people. In practice, the screening process and other outreach and access failures left many people with disabilities without an exemption and locked out of Medicaid coverage. The work requirements also hurt caregivers, who may not bring home a paycheck, but perform critical jobs at home. Combined with the fact that nearly 70% of Medicaid beneficiaries are working, work requirements primarily push people out of the program through the cynical mechanism of tripping people up by imposing more hoops to jump through.
Even if people with disabilities are able to retain access to Medicaid healthcare coverage, cuts to ‘optional’ home and community based services would limit their ability to live independently.
The House-proposed cuts to Medicaid and SNAP would leave a hole of $2.4 billion in Michigan’s state budget. Michigan will have three options to respond: raise taxes, limit coverage, or reduce benefits that are considered ‘optional’ under federal law. “Optional” services are not medically optional. “Optional” in this case means a state is not required to offer a service. For example, physician, hospital, and nursing home care is largely mandatory. However, prescription drugs, much of mental health or substance use disorder treatment, and the home and community-based services (HCBS), such as those provided by The Arc, are largely optional.
Medicaid HCBS enable 35,740 Michiganians to live, work, and participate in their communities. It is not an idle fear to worry about cuts to home and community based services. When the federal government cut Medicaid matching funding in 2011, all states reduced spending on home and community based services.
Medicaid’s benefits ripple out to all of us, similarly medicaid cuts will impact the quality of services for all of us.
Medicaid is how we ensure that health care is available everywhere and for everyone. It’s public health insurance for those who don’t get private health insurance from their job. As a program designed for public good, not private profit, Medicaid ensures that doctors’ offices, pharmacies, and hospitals are available in areas that aren’t densely populated or wealthy enough to have plenty of privately insured patients to sustain the services.
In rural communities, especially, the loss of Medicaid payments will translate into closed clinics and hospitals, leaving everyone in the area with no place to go. Here in Calhoun County an estimated 25% of people are on Medicaid. If people in our community cannot go to a doctor or nurse when they are sick, they will go to the only place that must see them without insurance: the emergency room. That means longer wait times for you and me when we have a true emergency.
The House bill on balance is a transfer of wealth from the most vulnerable in our community to the richest.
Beyond the effect of Medicaid and SNAP cuts on the people my organization serves, taking from the poor to give to the rich does not align with what The Arc's and others' values. The non-partisan Congressional Budget Office estimates:
- Resources for households in the lowest 10% of the income distribution would decrease by about $1,600 per year.
- Households in the middle of the income distribution would see their resources increase by $500-$1000/year.
- The top 10% of households would gain about $12,000
We can stop this! Contact your Representative and Senator today!
It is simply not common sense to defund Medicaid and SNAP, and cause this much harm in our communities, to increase the wealth of the few.
Contact your legislators today. The Arc US website makes it easy to take action.
