In The Politics of Autism, I discuss Medicaid services for people with intellectual and developmental disabilities, as well as other government programs at the federal and state levels.
Since the 1960s, when California Governor Ronald Reagan signed the Lanterman Act, conservative Republicans have often supported legislation to help people with disabilities. (Rick Santorum, for instance, was prime Senate sponsor of the Combating Autism Act of 2006.) One persuasive argument for conservative support is that it is more efficient and effective to help people with disabilities achieve independence than to pay for their institutionalization. Pay now, or pay later.
A couple of recent articles explain why conservatives should oppose the Medicaid cuts in BCRA.
HCBS keep people with mental illness, Intellectual & Developmental Disabilities (I/DD), and traumatic brain injury (TBI) — including members of our state’s sizable veteran population — in their communities and out of institutions. The data has shown over, and over, and over again that HCBS are one of the most fiscally effective parts of Medicaid. They are two to 30 times less expensive than comparable institutional placement. And they produce better results.
By keeping people in their communities, HCBS also promote independence and self-reliance. People who stay in their communities contribute to their communities. They live fuller, freer, more productive lives. They are more likely to get and maintain employment, and pay taxes as a result. Without access to HCBS, more Americans will face a life of purgatory in costly state-managed institutions — where the government can decide where you will live, when you eat, and what you do in your spare time.
With soaring healthcare costs, we absolutely need to rein in spending where it is wasteful. But why are we trying to pass healthcare legislation that would gut the most fiscally effective parts of Medicaid?Jason Sattler at USA Today:
The 50 unique state programs cover 60% of all children with disabilities, affirming the “pro-life” decisions of parents to have children regardless of the potential complications. The expenses incurred by parents of kids with severe special needs are so immense that even affluent families could be bankrupted without the supplemental support of Medicaid.
The Senate GOP argues its proposed Medicaid cuts of up to 39%, which survived the bill’s second draft intact, won’t hit families caring for children with disabilities.
But don’t believe the spin.
Yes, there is a “carve out” to protect “blind and disabled” children, but that will only protect a “fraction of kids” with severe special needs, according to Janis Guerney, co-public policy director at Family Voices. Additionally, kids with “complex conditions — such as cystic fibrosis, autism and Down syndrome — would be vulnerable to whatever cuts their states make,” according to Kaiser Health News’ Jordan Rau.
States, which have to balance their budgets by law, will be forced into constant “Sophie’s Choices” requiring them to decide who is most deserving of care — the elderly, poor kids or people with disabilities.