Friday, July 14, 2017

Disability advocates scream SOS

Share with The Arc why "Medicaid Matters to Me"

UPDATED July 17:  
Would you trade $202 billion for $8 billion?

According to analysis by the Community Living Policy Center at the University of California San Francisco, that's what one change to the Better Care Reconciliation Act amounts to.

The Arc of the United States has put out another call to action following the latest proposals from the U.S. Senate to change federal law about health coverage and cuts to Medicaid.

They'd like you to send your story via email to The Arc's national offices. The Arc will then print out the emails and hand-deliver them. (Send your story to PLEASE INCLUDE YOUR STATE IN THE SUBJECT LINE OF THE EMAIL.) Emails must be received by midnight Wednesday to be printed.

The latest push is in response to a revised Better Care Reconciliation Act shared Thursday. A vote is expected next week. But attempts to alleviate some of the harmful effects have come up short. Way short.

For instance, with Medicaid capped, big cuts are expected to Home and Community Based Services (HCBS), sometimes also referred to as "waiver services" because people apply for them instead of institutional care. These include everything from assisted technology, to ABA therapy, to employment support and residential care, to respite for caregivers.

If you (or someone you know) get services through the state Developmental Disabilities Administration, they are likely Home and Community Based Services and they are in danger of being cut. Nationally, 10 million people rely on this Medicaid program to live in the community.

In response to concern about cuts to community supports for people with disabilities, Senate leadership proposed offering a new HCBS demonstration program. Thing is, it is budgeted at $8 billion total. It would replace only about 4 percent of the potential $202 billion in reduced expenditures.

The analysis comes from H. Stephen Kaye, Ph.D., with Community Living Policy Center at the University of California San Francisco. He wanted to know what kind of effect the cuts to Medicaid might have on home and community based services, so he applied them (on paper) retroactively. His findings:

"Over the nine years of caps, total HCBS spending would have been reduced below actual by between $72 billion and $98 billion. Adjusting for inflation to 2020-28 dollars, reductions would total between $149 and $202 billion." - Excerpt from 'The Potential Impact of the Better Care Reconciliation Act on Home and Community-Based Services Spending'

The U.S. Senate was set to the week of July 17 on the latest version of the Better Care Reconciliation Act. So far, leadership does not have votes and the plan could be revised, yet again.

The Arc continues to warn leaders that this legislation would be dangerous to people with disabilities and complex health needs. The latest version of the act:
  • Deconstructs, caps, and cuts Medicaid
  • Shifts billions of dollars in care costs to states and individuals
  • Allows waivers to eliminate the essential health care benefits
  • Allows waivers to disregard the prohibition to discriminate against pre-existing conditions
  • Eliminates incentive to provide home and community-based services 
  • Creates risk pools - segregating out people with high health care need - and increases premium costs
 -Ramona Hattendorf, Director of Advocacy, The Arc of King County