Senate Bill to "Repeal and Replace" Obamacare targets Medicaid expenditures to reduce federal spending

According to the federal Medicaid website, “Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements. The program is funded jointly by states and the federal government.” As of April 2017, it provides health care coverage to 69 million people.

The purpose of the GOP plan to repeal and replace Obamacare appears be to be to reduce federal expenditures so that Congress can afford to give tax cuts to mostly wealthy citizens. Whether you agree with this assessment or not, the plan will have that effect.

People with disabilities rely on Medicaid for their health care coverage as well as for services they need to live safely in settings appropriate to their needs. Here are excerpts from two articles, that explain proposals to place caps on federal Medicaid spending.

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From Disability Scoop, “Caps Would Pinch Medicaid For Decades To Come” by Michelle Diament, 6/30/17:

“The Republican proposal under consideration in the Senate would convert Medicaid to a per-capita cap system, much like a version of the legislation passed by the House of Representatives in May.

“Currently, Medicaid operates as an entitlement program meaning that services are provided to anyone who meets eligibility requirements. The federal government provides matching grants to states to help cover the cost.

“Under a per-capita cap system, however, the federal government would chip in a fixed amount for each beneficiary regardless of the true cost of their care and leave states to make up any difference.

"The budget office previously projected that the Senate plan would mean $772 billion less in federal Medicaid spending over the next decade, a drop of 26 percent.” 

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“Individuals with disabilities represent just 15 percent of Medicaid beneficiaries, but account for 42 percent of the program’s costs, according to the Kaiser Family Foundation.” [emphasis added]

Read the full article here

From Together by Choice, “The Impact of the Proposed Medicaid Cap on Individuals with Intellectual and Developmental Disabilities” by Scott Mendel, 6/22/17:

“…The details of the bill were released today. It seeks to cap the federal portion of Medicaid at each state’s current per capita Medicaid expenditure. In addition, the federal portion of Medicaid would increase by the rate of inflation as measured by the consumer price index. Historically, the per capita cost of Medicaid has increased at a faster rate than the consumer price index.

"The Effect of a Medicaid Cap on Individuals with Intellectual and Developmental Disabilities

“Capping the federal portion of Medicaid will have a serious detrimental effect on individuals with intellectual and developmental disabilities. Individuals with intellectual disabilities suffer from a wide range of disabilities, from autism to down syndrome to cerebral palsy. The common feature is that individuals with intellectual disabilities do not function at an adult level. Many function at the level of a three or five year old and are in need of 24 hour care. For these individuals, Medicaid is the only option available to them to cover the cost of the intensive 24 hour care they need. Most individuals with intellectual disabilities will never have full-time employment, will never receive health insurance coverage through a job, and do not have income sufficient to purchase private health insurance. They are totally reliant on Medicaid.

“Capping the federal portion of Medicaid means that the portion of the cost of meeting the needs of individuals with intellectual disabilities that will be picked up by the federal government will shrink…[costs] will be shifted to the states or to the individuals. Neither can afford to pick up the portion that the federal government will no longer cover. In many states, services for individuals with intellectual disabilities are already under funded…These most vulnerable members of our society have nowhere else to turn to receive the services they need."


Read more  to see the “Call to Action” from Together for Choice with specific recommendations on how to contact Senators to voice your opinion on how these proposals will affect your disabled family member.

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More resources from the Kaiser Family Foundation, Medicaid's Future