The Republican bill to replace Obamacare could harm Illinois residents with disabilities — a group that hasn’t gotten much attention in the debate, advocates warned Wednesday, one day before a scheduled House vote on the measure.
More than 140,000 Illinois residents with disabilities receive Medicaid-funded services that allow them to remain in their homes or in community settings instead of nursing homes, according to the Illinois Department of Healthcare and Family Services. Another 19,000 Illinois residents with developmental disabilities want services but have not received them, according to the Illinois Department of Human Services.
The bill’s proposed changes to Medicaid could squeeze funding for those services, endangering the quality of life for those with disabilities and hampering their ability to contribute to society, advocates say.
That’s because the bill would change how the federal government pays states for Medicaid, capping the amount of federal dollars states receive per Medicaid beneficiary, or giving states block grants for Medicaid. The Congressional Budget Office has estimated the replacement bill would reduce Medicaid spending by $880 billion from 2017 to 2026.
“Why is this not at the center of the debate for health care in America?” asked Amber Smock, director of advocacy at Access Living, a Chicago-based disability rights group that hosted a news conference Wednesday.
Proponents of the GOP bill say it would help, not hurt, people with disabilities.
Evanston resident David Gayes, 31, who has cerebral palsy, said Medicaid-funded services have allowed him to live at home with his family and hold a part-time job at a nonprofit organization. Gayes has an assistant paid through Medicaid funding who gets him out of bed in the morning, bathed and ready for the day.
“People like me have worked so hard to use our gifts and talents to contribute to society,” Gayes said.
Jimmie Yarbrough, who also spoke at the news conference, said he spent four years living in a nursing home before Medicaid funds allowed him to live independently. Yarbrough, who has a spinal disability, works part-time for Access Living and lives on Chicago’s West Side with the help of an assistant.
“I almost lost my independence,” said Yarbrough, 55, of Chicago. “Without Medicaid, I really would end up back in a nursing home.”
Home- and community-based services are typically less expensive than nursing homes. But state Medicaid programs must cover nursing home services, while home- and community-based services are generally optional, meaning they could be vulnerable to cuts, according to the Henry J. Kaiser Family Foundation.
A White House official, however, said in an emailed statement Wednesday that the replacement bill would “allow states to prioritize their most vulnerable populations, especially those with disabilities.”
Under the Affordable Care Act, the federal government pays a much higher share of Illinois’ costs for people covered by Medicaid expansion, who are typically able-bodied adults, than it does for Illinois’ costs to cover people with traditional Medicaid, who may have disabilities.
The GOP replacement bill would effectively freeze Medicaid expansion starting in 2020, which would “reverse that trend, and allow states the freedom to focus their Medicaid dollars to those who are in greater need, such as the disabled,” according to the White House statement.
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