In Annual Events, Legislative Breakfast, Testimony


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We are seeing and hearing more and more about possible changes to the Medicaid Program. It’s easy to read between the lines:

Changes = Cuts. Big ones.

Cuts to Medicaid, especially in the form of block grants, pose significant access risks to health care and long-term care, especially for people with disabilities. These services and supports enable individuals to exercise their right to live and participate in their communities.

Examples that won’t surprise you:

  • A child with cerebral palsy who relies on Medicaid for a wheelchair, physical therapy and transportation to get to and from school, medical appointments and after-school programs.
  • A woman with an intellectual disability who works as a part-time assistant at your local grocery store who uses a Medicaid home attendant to help her eat, bathe, dress, and get to work on time.
  • A man with significant developmental disabilities whose well-being and community engagement are completely dependent upon his group home, day services, transportation and medical and behavioral health services funded by Medicaid.

What if these three individuals couldn’t get adequate medical care or therapy, or were forced into a nursing home or other large facility because they couldn’t get the services and supports they need?

Now more than ever we must work together to protect access to health care and community living and working options for people with disabilities.

Here are some helpful facts about Medicaid (some courtesy of the Arc):

  1. Medicaid helps make life in the community possible for many people with disabilities.
  1. Together, state and federal Medicaid provide more than 75% of the funding for services for people with intellectual and developmental disabilities (I/DD)—over 90% in New York State.
  1. Medicaid provides health care for one in five Americans, including people with disabilities, working families, children, and seniors.
  1. Medicaid is the primary health insurance program for people with disabilities. Over 10 million non-elderly people with disabilities are covered by Medicaid. People with disabilities often lack access to employer-based or other private coverage and typically have greater medical needs, and may need essential medical supplies like a wheelchair.
  1. Medicaid is federal-state partnership that provides matching funds on a state-specific basis.
  1. New York is 50/50 state. For every dollar New York spends on Medicaid services, the federal government provides, on average, an additional dollar.

Many other states receive a higher-percentage match than New York. With federal approval, New York designs services to meet their residents’ needs. Under the current structure, the federal government helps states cover costs, and in turn states are required to offer specific benefits to certain groups of people, including those with disabilities.

So what could happen if we are not vigilant?   Block grants to states.

This is very different than the current Medicaid “federal share” model that is pegged to the dollars states put into the program. While Congress has yet to make decisions about how block grants could be designed, the assumption is that the federal government provides a fixed amount of money (that’s the block) to each state based on the number of people enrolled. The current funding system provides for an increase in funding when the cost of providing covered services to eligible individuals goes up. A block grant specifically restricts federal government spending on Medicaid, regardless of the needs of the people receiving services. There might be a small growth adjustment for increases in enrollment but it is unlikely that it would be sufficient to make up for the overall cuts to the program.

During our program today you will see that the needs of people with disabilities who rely on Medicaid are not decreasing – quite the contrary – in many cases they are increasing. This is why block grants are a direct threat to the many years of progress we have made in ensuring the rights of people with disabilities in New York State. Block grants will cause a decrease in vital services for New Yorkers with disabilities.

What happens then?

Constraining eligibility for Medicaid, limiting services and supports, and reducing payments to agencies and providers who are already cash-strapped. This will likely grow waiting lists for services and promote even greater uncertainty for individuals with disabilities, their families and the organizations that support them.

Slashing Medicaid through block grants or other means is an attack on the most vulnerable members of our society.

Is this what we’ve become as a country?

Don’t we want healthier, more productive and engaged fellow citizens, not sicker and marginalized ones? Of course we do. Let’s make sure all of our elected officials understand this threat and demand that do all they can to move this already great state and country forward, not backward.

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