Zach Coble is the Board president of DIRECT Center For Independence. DIRECT advocates for voice, choice and independence for people with disabilities. 

Zach Coble

I am a disabled Arizonan. I enjoy living, working and participating in the community life of Tucson. Although I have private insurance, my future prospects of living in the community feel more precarious with each new development in the congressional effort to cut over $800 billion from Medicaid funding. My future is the present for thousands of people with disabilities in Arizona who do not have a choice of whether to rely on government health insurance. Private insurance does not cover extensive long-term care.

Currently, nearly 48,000 disabled Arizonans rely on the Arizona Long Term Care System (ALTCS) for services and supports in their homes and communities. ALTCS is consistently rated as one of the best Medicaid programs in the country at providing supports in the community rather than an institution like a nursing home or a hospital.

Many states have long waiting lists for community supports while Arizona consistently offers quality community care. These support services have many important, if unsung, benefits. They keep families together, allowing a disabled person to stay with their loved ones. They give people with disabilities the option of advancing their education. They help disabled individuals contribute to their local economy through employment. Ultimately, the greatest benefit of these services is that they give us the dignity of choice.

The proposed cuts to Medicaid put home and community-based services in grave danger. The federal government requires state Medicaid programs to fund costly nursing facilities and other institutional care. Community-based services often cost half as much as care found in an institutional setting. Unfortunately, the federal government has made community care optional for state Medicaid programs.

The state Legislature and Gov. Doug Ducey will be faced with a simple and terrible dilemma if Medicaid is reformed: increasing state funding to Medicaid to make up for lost federal dollars will be extremely difficult with budget politics already fraught. However, slashing funding for community-based care options would cause many disabled people to be placed in institutional settings away from their families, friends and lives.

Rep. Martha McSally has already signaled her endorsement of this potential reality by voting for the American Health Care Act (AHCA). Now the onus is on Senators Jeff Flake and John McCain. Will they vote for a bill that devalues disabled lives and shuts us out of society, or will they demand that Medicaid community care funding be guaranteed for disabled people without other options?

I hope Senator McCain, Senator Flake and their colleagues in the chamber choose wisely. The lives and freedoms of people with disabilities hang in the balance.

Zach Coble is the board president of the DIRECT Center For Independence. DIRECT advocates for voice, choice and independence for people with disabilities.