In February, the U.S. House of Representatives approved a budget proposal calling for the House Committee on Energy and Commerce (EEC)—which oversees both Medicaid and Medicare—to cut $880 billion in federal spending.
Although the proposal contains no direct order to target Medicaid or the Children’s Health Insurance Program (CHIP) that covers many disabled children, experts say it’s impossible to reach the proposed $880 billion reduction without significant cuts to the program.
If the proposed budget cuts go through, Medicaid will be a central target. Although supporters of the proposed cuts have said publicly that the goal is to eliminate waste, fraud, and abuse from the program, even if all instances of those were found and eliminated, the savings wouldn’t come close to the proposed figure.
Michael Kinnucan, Health Policy Director at the Fiscal Policy Institute in New York—an independent non-profit public policy institute aimed at promoting “sound and equitable” fiscal policies that strengthen the state’s economy—told Able News that Medicaid would feel the brunt of the financial impact because it’s the only EEC program big enough to cut from. The federal government will likely reduce its portion of funding to each state and force state officials to decide which of its programs will be impacted.
Medicaid is obligated by federal mandate to cover hospital care and primary care visits for its members. Most states also cover home care and other services classified as optional waiver programs, which disabled kids and adults need to live and thrive at home and in their communities.
“[The program] doesn’t have to cover home care or home modifications or hot meals for people who might not be able to get around…It doesn’t cover employment services for people with intellectual disabilities. That’s all optional,” Kinnucan told Able News.
He added that although classified as elective, for people in disability and chronic illness communities, many of those programs are “crucial to people’s survival and independence” so their fear of cuts is valid.
Children with disabilities and low-income disabled adults are at risk.
Disabled children in particular would be vulnerable if Medicaid cuts took effect because CHIP exempts guardians who aren’t on Medicaid from the income limit adults on Medicaid must adhere to in order to qualify for the program. Each state sets Medicaid income limits based on federal guidelines, state policies, and program eligibility criteria. Factors like disability status, household size, and Medicaid expansion influence these limits.
Some of these services provide medically complex children with overnight care from nurses or trained caregivers who administer medications, monitor vital signs, and oversee feeding or breathing equipment, allowing guardians to rest peacefully through the night knowing a child is safe.
Medicaid waivers can also help cover the cost of therapies beyond health insurance limits, home modifications like ramps, and adapted vehicles for traveling.
“For some of our families, the reality is that Medicaid allows them to live full and vibrant lives at home and hospitalization or institutionalization will be necessary if waivers don’t exist,” Shannon Dingle, the Community Engagement Associate at Little Lobbyists told Able News. The nonpartisan organization consists of families who fight to protect the rights of medically complex and disabled children.
Little Lobbyists focuses on issues beyond healthcare, but recently, potential Medicaid cuts have become its primary concern because of the financial and emotional strain they could put on families the organization supports.
“Not having nursing care at night, for example, makes it so that a family has to choose between staying up all night to care for their child or being able to go to work the next day and make money for their family,” Dingle said of the impossible choices families could face amid decreased funding.
Margo Gignac, a model, actor, and quadriplegic wheelchair user living in Brooklyn who receives home healthcare 18 hours per day, plus medical equipment that helps her body function, is deeply concerned.
“It’s literally a life and death situation for me,” she told Able News when asked about what could happen if she were kicked off of Medicaid.
Even thinking about the pending cuts is impacting Gignac’s mental health. “I can’t imagine being forced to live in an institution just because I can’t afford the basic necessities [of living with my disability].”
Kinnucan clarified that the severity of the cuts will depend on each state’s plan to compensate for the lost funding. So a wealthy, liberal state like New York might raise taxes to make up the difference. But he can’t predict what lawmakers in poorer, more conservative states will do.
“People are going to die,” he said.
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People with disabilities have been integral in efforts to protect and expand Medicaid when the program was threatened in the past, like during the Reagan administration. Humanizing the issue forces lawmakers to consider the people in front of them rather than the stereotype in their heads.
So, advocates against the proposed budget cuts encourage people to keep calling their state and local representatives and telling them why defunding Medicaid is unacceptable.
“When lawmakers try to say, ‘oh, no, no, no, no, we’re not talking about families like yours.’ The reality is that they are,” said Dingle.
A recent poll by the Kaiser Family Foundation (KFF) found that 83% of adults oppose cuts to Medicaid, and 42% of respondents supported an increase in funding.
Kinnucan said that if the cuts go through, people who don’t understand the role Medicaid and CHIP play in the lives of nearly 80 million Americans will find out just how important these programs are. And when they realize how their local hospital is funded or how their aunt can live safely in a nursing home, their frustrations are likely to come out at the polls in November.
Gignac went a step further, pointing out that many people become disabled as they get older. “Put yourself in our shoes. Think about your family, your loved ones, and how you would want them to be taken care of [if they were ill or disabled],” she said.