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  • Posted September 24, 2017


Normally I’m agnostic, at best, when it comes to politics – however with the threat of cuts to MEDICAID as a means to fund a new healthcare bill I cannot stay silent. I admit I have selfish reasons for my concern, as my son is very likely to be negatively affected should MEDICAID cuts take effect. I’m not looking for to argue, and I’m going to do my best to leave my opinions out – sticking strictly to the facts as I understand them.

My plan has been to help my son live as independently as possible, through the use of self-direction – rather than relying on an organization for Residential, Day or Vocational programs. I would provide his home, help him with the job search by coordinating with DORS; and, whenever possible, avoid any type of Day program.

For those of you without family members who have a disability(ies) some of these terms may be completely foreign; and I encourage you to do your own research on what these programs are, and how they are administered. Each of these programs are protected, MEDICAID would still pay for them – however, if shifted to block grants States may not be able to fund these programs to the current level; because the Federal government is currently heavily subsidizing them. The same is true for programs for the elderly, everyone who cannot afford long term care is receiving it through MEDICAID. Again, subsidized by the Federal government.

Self-Directed services are covered by MEDICAID waivers, and these waivers are not guaranteed. What would likely happen is these programs would be cut, because although they are less expensive than using organizations; States would need to continue paying the organizations – so the money has to come from somewhere. It also means the States would need to reduce the amount of money they are providing to the organizations; forcing these non-profits to rely more heavily on private donors.

There are waiting lists for services, my expectation would be these lists would grow in size; because scarcity of resources. The Henry J. Kaiser Family Foundation has a fantastic article about Block Grants, so rather than try to recreate it I’m providing the link here.

To be clear, it’s not the idea of a Block Grant I oppose, it’s the rush to get a solution in place by the end of September. I believe these grants may be part of the overall solution, but in my opinion we need to do more prep work. We need to work with provider agencies, helping them shift their focus to fundraising. We need to educate families; and work with insurance companies – explore if there are opportunities to have more of the services needed covered; even at the risk of higher premiums.

MEDICAID serves a purpose. I acknowledge the issue of fraud, but block grants won’t solve this. There will still be individuals and families who do the best they can to transfer their assets so they don’t have to pay for their long term care; and other instances. But let’s be fully cognizant of who the majority is – individuals with disabilities and the elderly. Is this really who we want to cut benefits for?