Three Strikes Against People with Disabilities: The Graham-Cassidy Amendment
CAPS MEDICAID FUNDING FOR ESSENTIAL SERVICES AND SUPPORTS FOR CHILDREN AND ADULTS WITH DISABILITIES
- Section 124 ends Medicaid as we know it by removing the federal government commitment to match a state’s actual costs to care for and provide supports for people with disabilities and others who are enrolled in Medicaid.
- The funding for the care and supports for children and adults with disabilities will be calculated by a per capita cap formula rather than the actual costs of the care for all enrolled individuals. Even worse, the formula will pay for less care over time because it does not account for full medical inflation.
- Individuals with disabilities and other Medicaid enrollees “would lose access to Medicaid coverage” and may be left without any services as “fewer providers might be willing to accept Medicaid patients,” according to Congressional Budget Office analysis.
- Significant cuts to Medicaid, according to the CBO’s per capita cap analysis, will leave states with little choice but to:
- ELIMINATE and RESTRICT home and community-based services (HCBS) and
- CUT RATES for community providers who deliver essential HCBS supports to children and adults with disabilities.
DIRECTLY CUTS $19 BILLION FROM INDIVIDUALS WITH DISABILITIES
- Section 119 ends the Community First Choice program in 2020 that pays for supports that allow individuals with disabilities to transition from institutions to live independently in their communities.
- This provision will result in a $19 billion cut in currently available services for people with disabilities, according to the CBO’s earlier analysis.
PUTS AT-RISK ESSENTIAL HEALTH BENEFITS & PRE-EXISTING CONDITION PROTECTIONS FOR INDIVIDUALS WITH DISABILITIES
- Section 106 creates great uncertainty for individuals with disabilities who currently can afford to buy health insurance that covers their pre-existing conditions.
- While the proposal requires states to describe how it “intends to maintain access to adequate and affordable health insurance coverage for individuals with pre-existing conditions,” it does not establish criteria or minimum standards for determining “adequate and affordable” coverage. This decision will be made solely by the Administrator of the Centers for Medicare & Medicaid Services.
- People with disabilities need a guarantee, not simply a statement of intent, that their access to affordable health care, including essential health benefits and pre-existing condition protections, will continue under any waiver program.
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