by Mike Hyland, Venture President & CEO
People living with disabilities already face a multitude of challenges including chronic illness, access to medical care, bullying, discrimination, adequate education, access to the community, and meaningful opportunities for employment. They also encounter all too often the stigma that is still attached to living with a disability. Now a new threat looms: a potentially major shift in Medicaid.
In 1965, the Medicaid program was created to provide assistance to low income and disabled persons who could not otherwise afford it. It also provides matching funds to states that participate and meet certain requirements set forth by the federal Centers for Medicare and Medicaid Services. In Massachusetts, these funds are absolutely crucial for the development of programming that allows people with disabilities to live in the community with the supports that ensure dignity, safety, and opportunity. Currently, there is discussion within the Trump administration about eliminating these matching funds and moving the Medicaid program to a Block Grant funding system. Such a move has the potential for devastating consequences for the people who rely on community-based services.
Under a Block Grant system, Massachusetts and all other states would receive a lump payment rather than matching funds now received for needs based service delivery. A lump sum would be a one-time annual payment, and once the payment is exhausted, states would be on their own to pay for programs that support people in the community. Typically this would require states to spend money they simply don’t have, and in that case, people who rely on supports to survive, could be left without vital services. This jeopardizes their independence and their safety as well as eliminating any chance for growth. To put it mildly, that’s an indefensible burden to put upon people who already have to overcome significant struggles on a daily basis.
Any plan that reshapes Medicaid into a system that is not directly tied to individual service needs is nothing short of a betrayal to the thousands of people currently receiving help in the Commonwealth. It’s also dangerous. A recent posting from the Association of Disabilities Providers notes in an analysis that “without the guarantee of matching funds, states will not be able to sustain existing services-much less expand them to meet the tremendous unmet need in the disability community”. The reduction in services would undoubtedly be the first step on the road to eventually eliminating some services and would surely put people with disabilities, particularly older people, at genuine risk of being re-institutionalized in facilities and nursing homes. Society has kind of already been there and done that and it was an epic fail. To create a system that could put people back into situations that shutter them further from society is not misguided; it is unconscionable.
We must be mindful that people who are already disadvantaged cannot be left behind yet again. It is most important that their voices be heard through advocates in society and on Capitol Hill. The new administration needs to hear that a Block Grant program will harm elders and people with disabilities. Doing anything that knowingly puts that population front and center in harm’s way and cuts at the heart of the progress made in society over 40 + years, would be nothing short of a national disgrace.