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Colin Killick: Cuts in Medicaid threaten independence for the disabled

Colin Killick: Cuts in Medicaid threaten independence for the disabled

Twenty-seven years ago this month, years of work by disability advocates culminated in the Americans with Disabilities Act, enshrining our right to be included in the community. Last week, disabled advocates protested in Sen. Jeff Flake’s Phoenix office, fighting back against proposed legislation that could banish us from the community again.

The health-care bills in Congress go much further than repealing the Affordable Care Act. They radically cut Medicaid — more than $700 billion in the Senate plan, more than $800 billion in the House proposal — and fundamentally change the structure of the program.

While White House advisor Kellyanne Conway has claimed that those who lose coverage could go find employment, Medicaid in fact enables people with disabilities to work.

Unlike nearly all other insurance programs, Medicaid covers long-term services and supports both durable medical equipment, like wheelchairs, and personal-care attendants who help people with disabilities with activities such as dressing and bathing.

Thanks to Medicaid, hundreds of thousands of people with disabilities across America who otherwise would likely be institutionalized are employed, living independently and contributing to the society around them. One of my own mentors obtained multiple master’s degrees, works full-time and helped design a health-care program for people with disabilities, despite being paralyzed from the neck down.

The proposed bills would put all of that in jeopardy. Medicaid would lose billions and more than 600,000 Arizonans, it is estimated, would lose health coverage.

Moreover, the bill would cap Medicaid spending, giving states only a certain amount per person regardless of the actual medical needs of the people they serve. Top executives of 10 major health insurers estimated that funding would fall short of meeting existing medical need by 25 percent — before considering that an aging population will have even greater health-care needs.

With about 40 percent of Medicaid spending covering people with disabilities, draconian service cuts would inevitably result.

Moreover, under current Medicaid rules, services that help people stay at home and continue to work are optional for states, while covering nursing homes is mandatory. You could envision a scenario where currently independent people with disabilities, many aged 40 or younger, would have to choose between living in nursing homes or getting no care at all.

Neither Sens. Jeff Flake nor John McCain have yet taken a firm position on the whole Senate health-care bill. The greater attention on Flake is likely due to his spottier record on disability rights.

For instance, he was one of 17 lawmakers who voted against the 2008 ADA Amendments Act that protected people with disabilities from discrimination, a bill supported by 174 Republicans and 228 Democrats. To his credit, Flake and his staff spoke by phone to the protesters about their concerns.

As the Senate returns from its Independence Day recess, Arizonans with disabilities will be watching both of our senators closely and hoping they do not vote to take our independence away.

Colin Killick is a political strategist for Disability Action for America. A native Tucsonan, he is currently a master’s candidate at Harvard Kennedy School of Government.

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